Welcome to the Hand
Hygiene Learning
Module
Infection Prevention & Control
This presentation will take you through the who, what, where, why,
when and how of hand hygiene. Some important points will be
reviewed to improve your hand hygiene practice.
* The word “patient” will be used to
indicate patient, resident, or client.
By the end of this presentation you will be able to:
Identify who should practice hand hygiene
Describe what hand hygiene is
Identify where hand hygiene practices should take place
Explain why hand hygiene is important
Describe when hand hygiene is to be performed
Describe how to perform hand hygiene using various methods
Describe tips for success for effective hand hygiene
How do we measure up when it comes to hand hygiene?
Most healthcare provides believe they’re already practicing appropriate
and effective hand hygiene.
Take a guess at what the Hand Hygiene compliance is among healthcare
providers in Winnipeg:
According to hand hygiene
audits, Winnipeg’s hand hygiene
compliance among healthcare
providers is 65%
The “who, what, where,
when, how and why” of
Hand Hygiene
What is hand hygiene?
Hand Hygiene includes cleaning hands with soap and water or alcohol-
based hand rub in order to remove germs, also known as microorganisms
Who should practice hand hygiene?
EVERYONE!
Hand Hygiene is important not only for healthcare providers; everyone needs to
be practicing appropriate and effective hand hygiene regardless of work setting.
Where should you perform hand hygiene?
Busy health care providers need access to hand hygiene
products where patient or patient environment contact is
taking place.
Hand hygiene is important in all work settings, including
Acute Care, Long Term Care Facilities, Community and
Corporate sites
Providing alcohol-based hand rub at the point of care
(within arm’s reach) is an important system support to
improve hand hygiene.
This enables health care providers to quickly and easily
fulfill the 4 moments of Hand Hygiene
Points of Care
The patient
The Health Care Provider
Care involving Contact
External or Healthcare Environment
VS
Patient Care Environment
It’s important to know the difference between these two
areas
When moving between these two areas you should be
cleaning your hands
External or Healthcare Environment
The external or healthcare environment The external or healthcare environment
can be a space, for example: can be an object, for example:
Nursing Station Cafeteria
Computer Watch Stethoscope
Hallways Shared Bedroom
Medication cart Vital sign
machine
More examples of the external or
healthcare environment:
In a single room the external or healthcare space is outside the room
In a multibed room it is everything out the bed area of the patient
In a clinic it is everything beyond the treatment and the equipment
beside it
In a home it is the equipment and transport of storage container
temporarily brought into the home
The patient care environment
The patient care environment is the space of the person receiving care, the immediate
surrounding area and surfaces in contact with that person. It also contains frequently
touched surfaces within the area of that patient.
It can be the
patient’s bed, It can also be the overbed
bedrails, linens and table, IV poles, patient
pillows purses, wheelchairs, etc.
The patient care environment
With an infant the patient care
environment is their bassinet
In Long Term Care it’s the entire
room (if it’s a single room)
In a home the patient care
environment is the entire house
Why do we need to learn about Hand Hygiene?
Hand hygiene is the most important way to prevent the
spread of germs
Hand hygiene helps keep you healthy by reducing the
number of germs on your hands and helps reduce the
spread of germs to your family, friends, coworkers,
patients, residents or clients
Using appropriate hand hygiene prevents contamination of
the patient’s, client’s or resident’s environment
When do you perform Hand
Hygiene?
There are 4 moments when hand
hygiene is performed:
1. Before initial patient or patient
environment contact
2. Before aseptic or clean procedure
3. After body fluid exposure risk
4. After patient or patient
environment contact
Remember….hand hygiene prevents carrying germs
into and out of the patient’s environment.
Moment 1: Before contact with a patient or patient
environment
Before transferring Before shaking hands
Clean your hands when entering or before touching
the patient
Moment 1: Before contact with a patient or patient
environment
Before taking temperature, blood Before making someone
pressure or pulse comfortable in bed
This will protect the patient from harmful organisms
carried on your hands
Moment 1: Before contact with a patient or patient
environment
Before contact with…
Equipment Wheelchair or
Resident’s Room
stretcher
Clean your hands when entering or before touching
any objects or furniture in the patient’s environment
Moment 1: Before contact with a patient or patient
environment
Before contact with…
Home Environment Treatment area or clinic room
This is to protect the patient environment
from harmful organisms carried on your hands
Moment 2: Before aseptic/clean procedure
Handling dressings or Performing invasive
touching open wounds procedures
This prevents the patient’s Clean your hands immediately
own organisms from before any aseptic or clean
entering his or her body procedure to protect the
patient against harmful
organisms
Moment 3: After body fluid exposure
Contact with blood, body Removal of gloves Contact with
fluids, non-intact skin or contaminated items
mucous membranes
Clean your hands immediately after an exposure
to body fluids (and after glove removal)
Moment 3: After body fluid exposure
Using a tissue to wipe your nose
Performing invasive procedures
or toilet use
This can help protect yourself and the health care
environment from harmful patient organisms
Moment 4: After contact with a patient
After Transferring After Shaking hands After making someone
comfortable in bed
Clean your hands when leaving the environment after
touching the patient.
Help protect yourself and the health care environment from
harmful patient organisms.
Moment 4: After contact with patient environment
Patient’s Room Equipment Wheelchair or
stretcher
Clean your hands when leaving after touching any object or
furniture in the patient’s environment
Moment 4: After contact with patient environment
Home Environment Treatment area or clinic room
Helps protect yourself and the health care environment from
harmful patient organisms.
Let’s Review
The 4 moments of hand hygiene
are:
1. Before initial patient or
patient environment contact
2. Before aseptic or clean
procedure
3. After body fluid exposure risk
4. After patient or patient
environment contact
A word about Clean Supplies
You must handle clean supplies and equipment with clean hands.
Perform hand hygiene prior to handling clean supplies and
equipment.
If it’s clean, keep it clean!
How to perform hand hygiene
Proper technique is important when it comes to effective hand hygiene.
Without proper hand hygiene technique, we can still spread many
microorganisms with our hands. This section will cover the proper
techniques for the following methods:
Alcohol-based Soiled hands and
Liquid soap and
hand rub no running water
water
(ABHR) available
Alcohol-based Hand Rub
Alcohol-based hand rub is the recommended method of hand
hygiene in any healthcare setting when hands are not visibly
soiled.
Click link for video on how to properly use Alcohol-based hand rub
[Link]/files/Hand-Hygiene-with-ABHR.mp4
Alcohol-based hand rub
Apply a dime-sized amount (2-3ml) of product into palms of dry hands
Rub product into hands
Palm to palm
Rub fingertips of each hand in opposite palm
Between and around fingers
Rub each thumb clasped in opposite hand
Rub back of each hand with opposite palm
Rub hands until dry before performing another task
DO NOT WIPE OFF
Alcohol-based Hand Rub
Alcohol-based hand run (ABHR) is at least 60% ethyl alcohol or ethanol
(equal to 120-proof). To compare, a bottle of vodka is 80-proof
Ingesting small amounts of ABHR can produce the same side effects as
consuming large amounts of alcohol:
Headache, dizziness, drowsiness, incoordination, nausea, slowed reaction time,
slurred speech, giddiness, and unconsciousness
Consumption of ABHR can also result in:
Brain, liver and kidney damage (from log-term use)
Toxic ethanol levels
Soap and Water
Soap and water is the recommended method when hands are
visibly soiled. Plain soap is used for routine hand hygiene while
anti-microbial soap is used in acute care high-risks areas.
Clink the link below for a video on how to properly wash with soap and water
[Link]/files/Hand-Hygiene-with-Soap-and-Water.mp4
Soap and Water
Wet hands under warm running water
Apply soap and distribute over hands
Rub hands vigorously for 15 seconds to create a good lather
Palm to palm
Rub fingertips of each hand in the opposite palm
Between and around fingers
Rub each thumb clasped in opposite hand
Rub back of each hand with opposite palm
Rinse hands thoroughly under warm running water
Pat hands dry with a paper towel
Turn off faucet using a paper towel
Hand are soiled and no water
On occasion, you may find yourself with soiled hands and no access to running water.
When assess to hand washing facilities are limited and running water is unavailable, use
a moist towelette to remove visible soiling from hands followed by alcohol-based hand
rub.
Click link below for video on how to properly wash with no water
[Link]/files/Hand-Hygiene-Soiled-Hands-ABHR-.mp4
Moist Towelette Followed by hand-rub
Hands are soiled and no water
Apply a dime-sized amount (2-3ml) of product into palms of
dry hands
Rub product into hands
Palm to palm
Rub fingertips of each hand in opposite palm
Between and around fingers
Rub each thumb clasped in opposite hand
Rub back of each hand with opposite palm
Rub hands until dry before performing another task
DO NOT WIPE OFF
“Handy” Tips
1. Artificial nails, gel nails or extenders are not to be worn by staff who
have direct patient contact
2. Contaminated surfaces or objects should not be touched after
performing hand hygiene
3. Avoid touching your face, especially your eyes and nose
4. Fingernails should be kept short – no longer than ¼” or 0.635cm long
5. Nail polish may be worn, but should be removed when chipped
“Handy” Tips
6. Do not “top up” a partially-used hand hygiene product
dispenser
7. If re-usable dispensers are used they must be emptied,
washed and dried prior to being refilled. Hand lotion bottles
must not be re-used.
8. Include frequently missed areas when preforming hand
hygiene, such as thumbs, palms, web spaces, under nails and
the backs of fingers and hands.
9. Use supplied lotions that are compatible with hand hygiene
products and gloves to minimize skin irritation that can occur
with frequent hand hygiene
10. Wearing hand and wrist jewelry is not recommended
Hand Hygiene Quiz
Select an answer. The correct response will be underlined.
1. Hand hygiene is the most important way to prevent the spread of germs (microorganisms)
a) True
b) False
2. When washing hands, which of the following is important to remember?
a) Wash with hottest water possible
b) The focus of good hand washing is the palms
c) Turn faucet off after disposing of your paper towel
d) Lather and rub all sides of your hands together for 15 seconds
3. Alcohol-based hand rub may be used instead of soap and water when hands are not visibly
soiled.
a) True
b) False
Hand Hygiene Quiz
4. Which of the following is the correct order when performing hand hygiene?
a) Wet hands; apply soap, rub vigorously getting all sides, rinse hands
b) Apply soap, wet hands, rub vigorously, rinse hands
c) Apply soap, rub vigorously, rinse hands, turn off faucet
d) Wet hands, apply alcohol-based hand rub, rub vigorously, turn off faucet
5. When hands are visibly soiled and water is not available, how is hand hygiene performed?
a) Using a moist towelette
b) Using alcohol-based hand rub
c) Using a moist towelette followed by alcohol-based hand rub
d) Using a disinfectant wipe
Thank You !
You’ve now completed the Hand Hygiene
Learning Module.
Thank you for participating in this important
exercise.
Remember the 4 Moments of Hand Hygiene….
Remember the 4 Moments:
[Link] initial patient or patient environment contact
[Link] aseptic or clean procedures
[Link] body fluid exposure
[Link] contact with patient or patient environment