Hand Hygiene

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To emphasize the importance of hand hygiene (HH) in the prevention of disease transmission among healthcare providers, patients and their visitors and the indications and techniques needed.

1. Hands may easily become contaminated with infectious microorganisms, which can enter the body through a break in the skin or be transmitted to a susceptible host & cause infection.
2. All hospital personnel, physicians, nurses, technicians & others including patients & visitors who are responsible for complying with the hand hygiene policy should lead by example & call observed infractions to the attention of any offenders.
3. Jewelries, artificial nails & chipped nail polish may be associated with an increase in the number of bacteria on finger nails & should not be used.
4. Resident flora refers to the microorganisms residing under the superficial cells of the stratum corneum & also found on the surface of the skin.
5. Transient flora refers to the microorganisms that colonize the superficial layers of the skin & are easily removed by routine hand hygiene.

Clean your hands:

1. Before touching a patient
2. Before clean/aseptic procedures
3. After body fluid exposure risk
4. After touching a patient
5. After touching patient’s surroundings

Other Opportunities for Hand Hygiene

1. When hands are visibly soiled
2. After contact with a source of microorganisms (body fluids & substances, mucous membranes, non-intact skin, surfaces that are likely to be contaminated)
3. Before wearing & after removing gloves.
4. Before & after eating or preparing food
5. Before leaving the patient’s room
6. After bodily functions (e.g., using the toilet, blowing one’s nose, sneezing)
7. When moving from a contaminated body site to a clean body site during patient care.
8. Hands & other skin surfaces exposed to blood / body fluids must be cleansed as soon as patient safety permits.
9. On arrival & after completion of hospital duty, perform hand hygiene.
10. The use of gloves does not replace the need for hand hygiene.

Techniques:
Hand washine ( Routine / Social)
Wash hands for a minimum of 40 – 60 seconds

1. Remove jewelry / wrist watches & roll the sleeves upto the elbow
2. Select a comfortable water temperature
3. Wet hands with running water
4. Apply soap solution to cover all surfaces of the hands
5. Rub hands palm to palm
6. Right palm over left dorsum with interlaced fingers & vice versa
7. Palm to palm with fingers interlaced
8. Backs of fingers to opposing palms with fingers interlaced
9. Rotational rubbing of the left thumb clasped in the right palm & vice versa
10. Rotational rubbing backward & forward with clasped fingers of the right hand in the left palm & vice versa
11. Rinse the hands with running water to remove all soap residue.
12. Dry the hands with a paper towel
13. Turn the faucet off with the used paper towel & discard them in waste bin

Hand rubbing (R0utine / Social)
Use alcohol-based hand antiseptic rub for a minimum of 20 – 30 seconds

1. Apply palmful of the alcohol based handrub in a cupped hand to dry, visibly clean hands
2. Rub hands vigorously to apply hand antiseptic to all surfaces of hands (as in steps 5 to 10 above)
3. Allow hands to dry

Note: USE ONLY SOAP & WATER WHEN DEALING WITH SPORE-FORMlNG BACTERIA (e.g., Clostridium difflcile) AND OR WHEN YOUR HANDS ARE VISIBLY SOILED.