HAND WASHING &
HAND HYGIENE
Every health care worker is at risk of infection and so every health care worker
has a role to play in practicing appropriate infection prevention measures
Clients are at risk of post-procedure infection for example:
~when service providers do not wash their hands in-between patients and
procedures;
~when they do not adequately prepare clients before a clinical procedure
~ when used instruments and other items are not cleaned and processed correctly .
The community is also at risk of infection, particularly from
inappropriate disposal of medical waste-contaminated dressings,
tissue, sharps etc.
The best way to prevent infections at a health facility is by
following standard precautions –the standard infection
prevention guidelines.
These are a set of recommendations designed to help minimize
the risk of exposure to infectious materials by both clients and
staff.
At the centre of these recommendations is asepsis.
The standard precautions should be followed with every
client regardless of whether or not they are thought of
having infection.
It is safer to act as if every client is infected rather than
to apply the standard precautions to some clients and not
others.
HANDWASHING
Very important in every Health care Setting
Hand washing is stated to be the single most important,
effective element in the control of infection, particularly
regarding transfer of organisms by contact.
The hand is the commonest vehicle for the transmission of
infection.
There are two types of microbes found on our hands
1. Resident microbes: live on and within the skin and are difficult
to remove.
2. Transient microbes: are acquired during daily activities and can
be removed easily.
HAND WASHING AND HAND
HYGIENE
Hand hygiene: is a general term that applies to
Hand washing – washing of hands with plain soap
and water
Antiseptic hand wash- washing of hands with water
and soap or other detergent containing antiseptic agent
Antiseptic (alcohol) hand rub-applying antiseptic
hand rub agents to all surfaces of the hands to
reduce microorganism present.
Surgical hand antisepsis- antiseptic hand wash or
rub that is performed preoperatively
TYPES OF HW
Social/routine hand washing
Hygienic hand washing or antisepsis-Clean procedures
Surgical hand washing/scrub- Invasive procedures
SOCIAL/ROUTINE HW
Social /routine hand washing is done with plain soap and running
water for at least 10-15 seconds to remove most transient
microorganism from the hand
To reduce the number of micro-organisms on hands
To reduce the risk of transmission of micro-organisms
To reduce the risk of cross-contamination among clients
To reduce the risk of transmission of infectious organisms to one
self
REQUIREMENT
Soap(plain)-bar in a soap dish/liquid soap
Running tap water/ Veronica bucket/Tipi Tap
Paper towels/disposable towels/single use towels
Trash basket
WHEN TO PERFORM HW
When you arrive at work.
Before leaving the ward.
After cleaning, dusting and mopping.
Before putting on and removing gloves.
Before and after each procedure.
Before direct contact with clients intact skin i.e.
before and after checking of vital signs, lifting of
patients etc.
After contact with body fluids or secretions, mucus
membrane, wounds, brake in skin with or without
gloves, whether there is visible stain or not.
PREOCEDURE FOR HW
Stand in front of but away from sink to avoid touching of uniform
to a sink.
Turn on water using facet (using elbow or hand) so that flow is
adequate but not splashing.
Adjust temperature to warm (hot is damaging to skin).
Wet hands under running water (wet hands facilitate distribution
of soap over entire skin surface
Apply recommended amount of soap on hands and palm (soap
should come from a dispenser/dish to prevent spread of
microbes)
Thoroughly distribute over hands
Rub to make lather
Rub the hands together i.e. palm to palm, palm to dorsum and
cup them around each other to massage the finger tips, thumbs
and web of fingers while keeping your fingers pointed down (over
the other wrist
Wash the wrist and the back of the hands
Rinse thoroughly under running water and keep hands down to
avoid water running down to the forearm
Dry hands thoroughly with recommended drying material e.g.
towel, tissue
Use the towel or paper to turn the faucet if not the elbow
HYGIENIC HAND WASH/HAND
ANTISEPSIS
It involves the use of antiseptic detergents to wash hands for
about 10-15 seconds.
This removes transient microorganisms, soil, and kills or
inhibits the growth of resident microorganisms
INDICATIONS
Before performing invasive procedures such as setting iv lines,
Lumbar puncture and catheterisation.
Before caring for immunocompromised (susceptible) patient/client
After contact with blood or body fluids following situations in
which microbial contamination is likely to occur.
Before and after wearing sterile gloves
PROCEDURE
Just like the one for routine hand washing
ALCOOL HAND RUB
Another form of hand antisepsis is the use of alcohol hand rub
Alcohol hand rub is the only kind of antiseptic hand rub.
It kills or inhibits the growth of transient and resident
microorganisms but does not remove microorganisms
This method can be used when hand washing with antiseptic and
running water is not possible or practical or when there is no
visible dirt, blood or other body fluids, secretions or excretions
If hands are dirty, wash with soap and running water.
It is not effective if hands are soiled or contaminated with blood
or other organic matter.
Efficacious at 70% concentration
PROCEDURE
Pour not less than 5ml of alcohol hand rub into the palm of your
hand and cover all surfaces of the hand
Rub hands as per procedure for hand washing till they are dry
SURGICAL HW
This involves the use of antiseptic detergents to wash hands for
5-6 minutes.
Hands are washed from fingers to elbow.
Surgical hand wash kills and removes both transient and
resident microbes.
It is done before all surgical procedures
REQUIREMENT
Warm running water
Soap- liquid, cake (antiseptic detergents)
Disposable or sanitized/sterile towel
PROCEDURE
Remove all jewellery on your hands and wrist.
Wet your hands and forearms thoroughly.
Holding hands up above the level of the elbow and apply antiseptic.
Clean under each fingernail with brush, using circular motion, begin
at the finger tips of hand and wash between the fingers to the
elbowRepeat for the second hand and arm. Continue for 5-6
minutes.
Rinse each arm separately.
Using a sterile towel dry your arms from finger tips to elbow using
different side of the towel on each arm.
Keep your hands above the level of your waist and do not touch
anything before putting on sterile surgical gloves