The How- T os of Hand Hygiene

The How-Tos of Hand Hygiene

Training Module 1 for All Long-term Care Staff

Upon completion of this training module, long-term care staff will be able to demonstrate a working knowledge of:Why

hand hygiene is so important to prevent the spread of infectionsWhen

and how to perform hand hygiene

Key

hand hygiene practices for prevention of health care-associated infections (HAI), particularly catheter-associated urinary tract infections (CAUTI)

2

Objectives

Health Care Workers’ Hands Spread Infections

1-3 million serious infections estimated to occur every year in U.S. nursing homes

Hand hygiene is one of most important ways to prevent the spread of infections

3

Strausbaugh

LJ, Joseph CL. Infect Control

Hosp

Epidemiol

.

2000;21:674

.

Centers

for Disease Control and Prevention. Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no.

RR-16.

Mody

et al Infect Control

Hosp

Epidemiol

; 2003:24:165-171

Simplifying the Moments for Hand Hygiene4

Adapted from World Health Organization Guide on Hand Hygiene in Outpatient and Home-based Care and Long-term Care Facilities. Just Clean Your Hands Educational

Resources: http://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/JustCleanYourHands/Pages/JCYH-ltch-Education-and-training.aspx

Alcohol-Based Hand Rub (ABHR)Hand Hygiene Technique

Apply

hand rub to palm of hand

Rub hands together, covering all

surfaces

Focus on thumbs, tips of fingers, and under

fingernails

Hands are clean when dry

Usually takes about 15-20 seconds

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http://

www.cdc.gov/handhygiene/Resources.html#HCP

Soap and Water Hand WashingHand Hygiene Technique

Wet hands with water

Apply soap to palm of handRub hands together, covering all surfaces for at least 15 seconds

Rinse hands with water

Dry hands with paper towel and use towel to turn off faucet

Paper towel prevents hands from being re-contaminated by faucet handles

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http://

www.cdc.gov/handhygiene/Resources.html#HCP

Notes About Hand Hygiene Products

Alcohol-based hand rubs/gels are preferred for hang hygiene when hands are not visibly soiled or dirtyTimes when hands should be washed with soap (non-antimicrobial or

antimicrobial) and water:When hands are visibly dirty, contaminated

or

soiledAfter care with residents with infectious diarrhea

7

Centers for Disease Control and Prevention. Guideline

for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.

Efficacy of Hand Hygiene Preparations

in Killing Bacteria8

Guideline for

Hand Hygiene in Health-care Settings.

MMWR

2002; vol. 51, no. RR-16.

Good

Better

Best

Plain

soap

Antimicrobial soap

Alcohol-based

hand rub

Hand Hygiene and C. diff

Hand hygiene with soap and water is superior at removing the spore form of C. diff

AHBR is more effective for hand disinfection with all other organisms

N

o studies linking ABHR use with an increase in C. diff infection

Encourage soap and water

after care of residents with acute diarrhea

and use of gowns/gloves to prevent spore contamination of hands

9

Oughton

MT et al. J Infect

Hosp

Epidemiol

2009;30(10):

939–944.

Dubberke

E et al. SHEA/IDSA Practice Recommendation. J Infect

Hosp

Epidemiol

2014;35(6):628-645

Important Points About Glove Use

Gloves play a key role in preventing hand contamination—but do NOT

replace hand hygieneChange

gloves during care when moving from a contaminated body site to a clean body

siteDo not wear the same pair of gloves for the care of more than one

resident

Remove and discard gloves after

use

Do not wash

gloves

10

Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16

Hand Hygiene Before Urinary Catheter Care

Perform hand hygiene and wear gloves immediately before:Placing or removing an indwelling catheter

Accessing the drainage system to empty the drainage bag or collect a urine sample

Why?

Interacting with the

resident

or environment before handling the urinary

device

may contaminate

hands

Reaching for gloves

with

unclean hands may contaminate the glove box and outside of the

gloves

Then, gloves

will contaminate the urinary catheter or urine collection

system

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Hand Hygiene After Urinary Catheter Care

Remove gloves and perform hand hygiene immediately after:

Handling an indwelling catheter

Accessing the drainage system to empty the drainage bag or

collect a urine sample

Why?

Hand contamination may occur as a result of

small

undetected holes in

gloves

Hand contamination may occur during glove

removal

Hand

hygiene protects your hands and the environment from being

contaminated

12

Hand Hygiene Case Scenarios

Let’s chat!Review the three hand hygiene case scenarios as a group. As you discuss them, think about the following questions:

Does our facility staff experience similar challenges to performing hand hygiene at the appropriate times? Why or why not?

What could our facility do to reduce barriers to hand hygiene?

How can I

help support a culture of safety around improving hand hygiene in our facility?

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Take the Pledge…

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15

Take the Pledge

World Health Organization How to Handrub PosterWorld Health Organization How to

Handwash

Poster

References

Centers for Disease Control and Prevention. Guideline for Hand Hygiene in Health-Care Settings. MMWR 2002; vol. 51, no. RR-16.

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm

Centers for Disease Control and Prevention. Hand Hygiene Resources.

http://www.cdc.gov/handhygiene/Resources.html#HCP

Dubberke E et al. SHEA/IDSA Practice Recommendation. J Infect

Hosp

Epidemiol

2014;35(6):

628-645.

Mody et

al.

Infect Control

Hosp

Epidemiol

;

2003:24:165-171.

Oughton

MT et al. J Infect

Hosp

Epidemiol

2009;30(10):939–944.

Strausbaugh

LJ, Joseph CL. Infect Control

Hosp

Epidemiol

. 2000;21:674

.

World

Health Organization Guide on Hand Hygiene in Outpatient and Home-based Care and Long-term Care Facilities.

Just Clean Your Hands. http://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/JustCleanYourHands/Pages/JCYH-ltch-Education-and-training.aspx

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