Training Module 1 AHRQ Pub No 161700038EF March 2017 Upon completion of this training module longterm care staff will be able to demonstrate a working knowledge of Why hand hygiene is so important to prevent the spread of infections ID: 668175
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Slide1
The How-To’s of Hand Hygiene
Training Module 1
AHRQ Pub. No.
16(17)-0003-8-EF
March
2017Slide2
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 infections
When 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)
Hand Hygiene │ 2
ObjectivesSlide3
Health Care Workers’ Hands Spread Infections1
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
Hand Hygiene │
3Slide4
Simplifying the Moments for Hand Hygiene2-3
Source: Public Health Ontario
Hand Hygiene │
4Slide5
Alcohol-Based Hand Rub (ABHR)4,5
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; follow manufacturer’s guidance
Source: World Health Organization
Hand Hygiene │
5Slide6
Soap and Water Hand Washing4,6,7
Hand Hygiene Technique
Wet hands with water
Apply soap to palm of hand
Rub 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
recontaminated
by faucet handles
Source: World Health Organization
Hand Hygiene │
6Slide7
Notes About Hand Hygiene Products4,7
ABHRs/gels are preferred for hand hygiene when hands are not visibly soiled or dirty
Times when hands should be washed with soap (non-antimicrobial or antimicrobial) and water:
When hands are visibly dirty, contaminated, or soiled
After care of residents with infectious diarrhea
Hand Hygiene │
7Slide8
Efficacy of Hand Hygiene Preparations
in Killing Bacteria7
Good
Better
Best
Plain soap
Antimicrobial soap
Alcohol-based hand rub
Hand Hygiene │
8Slide9
Hand Hygiene and Clostridium difficile (C.diff
)7-9
Hand hygiene with soap and water is superior at removing the spore form of
C. diff
ABHR is more effective for hand disinfection with
other organisms
No 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
Hand Hygiene │
9Slide10
Important Points About Glove Use7
Gloves play a key role in preventing hand contamination—but do
NOT replace hand hygiene
Change gloves during care when moving from a contaminated body site to a clean body site
Do 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
Hand Hygiene │
10Slide11
Hand Hygiene Before Urinary Catheter Care
Perform hand hygiene and wear gloves immediately before
—
Placing or removing an indwelling catheterAccessing 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
Hand Hygiene │
11Slide12
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
Hand Hygiene │
12Slide13
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?
Hand Hygiene │
13Slide14
References
Mody L, McNeil SA, Sun R, et al. Introduction of a waterless alcohol-based hand rub in a long-term-care facility. Infect Control and Hospital Epidemiology.
2003 Mar;24(3):165-71. PMID: 12683506.
Guide on hand hygiene in outpatient and home-based care and long-term care facilities: A guide to the application of the WHO multimodal hand hygiene improvement strategy and the “My Five Moments For Hand Hygiene” approach. 2012. World Health Organization.
http://www.who.int/gpsc/5may/hh_guide.pdf. Accessed on April 14, 2015.
Just Clean Your Hands educational resources. Ontario Agency for Health Protection and Promotion.
http://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/JustCleanYourHands/Pages/JCYH-ltch-Education-and-training.aspx
. Accessed on April 14, 2015.
Centers for Disease Control and Prevention. Handy Hygiene in Healthcare Settings.
http://www.cdc.gov/handhygiene/providers/
. Accessed on August 29, 2016.
World Health Organization. WHO
Handrub
poster.
http
://www.who.int/gpsc/5may/How_To_HandRub_Poster.pdf
.
Accessed
on April 14, 2015.
World Health Organization. WHO
handwash
poster.
http
://www.who.int/gpsc/5may/How_To_HandWash_Poster.pdf
.
Accessed
on April 14, 2015.
Boyce JM,
Pittet
D, Healthcare Infection Control Practices Advisory Committee, et al. 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. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America.
MMWR
Recomm
Rep. 2002 Oct 25;51(RR-16):1-45. PMID:12418624.
Pop-Vicas A, Baier R. Healthcare workers’ hands and Clostridium difficile spores: Making progress? Infection Control and Hospital Epidemiology. 2014 Jan;35(1):16–17.Yokoe DS, Anderson DJ,
Berenholtz SM, et al. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates. Am J Infect Control. 2014 Aug;42(8):820-8. PMID:25087135. Hand Hygiene │ 14