WASHINGTON ADVENTIST UNIVERSITY PRACTICUM II

1. EDMUND A. DOWUONA, MSN, RN WASHINGTON ADVENTIST UNIVERSITYPRACTICUM II

2. Hand hygiene is one of the best prevention behaviors in the hospital setting where health care-associated infections (HAIs) represent a significant patient safety issue and one of the leading causes of death in the U.S. Although there is substantial evidence to the effect of hand washing on patient outcomes, healthcare workers are not compliant. HAND HYGIENE

3. Each year in U.S. hospitals, there are approximately 1.7 million health care associated infections and nearly 100,000 associated deaths. Studies conducted between 1980 and 2000 by the Centers for Disease Control and Prevention (CDC) found that compliance among healthcare workers was 40% of the time. Hand hygiene

4. Hand Hygiene: Performing hand washing, antiseptic hand wash, alcohol-based hand-rub, surgical hand hygiene/ antisepsis. Hand washing: Washing hands with plain soap and water. Antiseptic hand wash: Washing hands with water and soap or other detergents containing an antiseptic. Alcohol-based hand-rub: Rubbing hands with an alcohol containing preparation. Surgical hand hygiene/antisepsis: Hand washing or using an alcohol-based hand-rub before operations by surgical personnel. DEFINITIONS

5. The purpose of this presentation is to teach you the importance of good hand hygiene. You will learn that hand washing and alcohol-based hand rubs can reduce the risks of spreading bacteria. HAND HYGIENE

6. At the end of this presentation, you will be able to: Explain the importance of hand hygiene. Demonstrate proper hand hygiene techniques. Discuss the importance of alcohol-based hand hygiene. BEHAVIORAL OBJECTIVES

7. Many studies have shown that the bacteria that cause hospital-acquired infections are most frequently spread from one patient to another on hands of healthcare workers. The Centers for Disease Control and Prevention (CDC) and other healthcare related organizations believe that cleaning your hands before and after having contact with patients is one of the most important measures for preventing the spread of bacteria in healthcare settings. HAND HYGEINE

8. Postulated the theory of hand washing with chlorinated lime solutions in 1847 at Vienna General Hospital. semmelweis’ historical study

9. When hands are visibly dirty, contaminated, or soiled, wash with non-antimicrobial or antimicrobial soap and water. If the hands are not visibly soiled, use an alcohol-based hand rub for routinely decontaminating hands. Indications for hand hygiene

10. Alcohol hand rub Routine hand wash 10-15 seconds Aseptic procedures - 1 minute Surgical wash- 3-5 minutes Hand hygiene techniques

11. Hand rubs: Apply to palm of one hand, rub hands together covering all surfaces until dry. Hand washing: 1. Wet hands with water, apply soap, rub hands together for at least 15 seconds 2. Rinse and dry with disposable towel 3. Use towel to turn off faucet. Recommended hand hygiene techniques

12. Numerous published studies have shown that alcohol-based hand rubs remove bacteria from hands more effectively than washing hands with plain soap and water. Most studies show that alcohol-based hand rubs removed bacteria from the hands to a greater degree than did washing hands with an antimicrobial soap and water. Alcohol-based hand rubs contain skin conditioners that help prevent the drying effects of alcohol. Alcohol-based hand hygiene

13. In comparison to soap and water hand washing, alcohol-based hand rubs have the following advantages: 1.Take less time to use 2.Can be made more accessible than sinks 3. Cause less skin irritation and dryness. 4.Are more effective in reducing the number of germs on hands 5. It has led to improved hand hygiene practices Advantages of using alcohol-based hand rubs

14. If your hands are not soiled or contaminated with blood or body fluids, use an alcohol-based hand rub to clean hands; 1. before having direct contact with patients 2. after having direct contact with a patient’s skin 3. after having contact with body fluids, wounds or broken skin 4. after touching equipment or furniture near the patient 5. after removing gloves. When to use an alcohol-based hand rub

15. Apply 1.5 to 3 ml of an alcohol gel or rinse to the palm of one hand, and rub hands together Cover all surfaces of your hands and fingers, including areas around or under fingernails Continue to rub hands together until alcohol dries If sufficient alcohol gel is used, it should take at least 10-15 seconds of rubbing before your hands feel dry How to use alcohol-based hand rub

16. A new 2002 guideline has been developed by the Centers for Disease Control and Prevention (CDC) and infection control organizations which recommends that healthcare workers use an alcohol-based hand rub (a gel, rinse, or foam) to routinely clean their hands between patient contacts, as long as hands are not dirty. New cdc guidelines

17. By now, you should understand the importance of good hand hygiene. Hand washing and alcohol-based hand rubs can reduce the risks of spreading bacteria in healthcare facilities. Traditionally, education is often the first and only strategy to promote behavioral changes. Let us use this educational tool to achieve compliance. Yes, we can do it. conclusions

18. Benton, C. (2007). Hand hygiene- meeting the JCAHO safety goal. PlastSurgNurs. 2007. Vol. 27, No. 1, pp. 40-44. Boyce, J.M., & Pittet, D. (2002). Guideline for Hand Hygiene in Health- Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA APIC/IDSA Hand Hygiene Task Force. MMWR 2002. Vol. 51, No. RR-16, pp. 1-45. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Hand washing: hand hygiene saves lives-2008 Accessed online November 17,2011, at http://www.cdc.gov/features/handhygiene/ Maskerine, C., & Loeb, M. (2006). Improving adherence to hand hygiene among health care workers. J ContinEduc Health Prof. Vol. 26, No. 3, pp. 244-251. references