Presentations text content in GBMC Corporate Competency for Hand Hygiene
GBMC Corporate Competency for Hand HygieneSlide2
The Case for Hand Hygiene in Healthcare Settings
Selection of AgentsTechniques Indications SummarySlide3
Let’s Get Committed…to Prevention
Healthcare Associated Infections (HAI’s) have increased morbidity and mortality rates among hospitalized patients worldwide
HAI pathogen transmission most often occurs via the contaminated hands of health care workers
HAIs affect nearly 2 million individuals annually in the United States
Approximately 80,000 deaths each year
Hand Hygiene with alcohol- based hand rub (preferred) or soap and water has proven to be most effective measure in preventing HAI’s.Slide4
Hand Hygiene Costs
Performing hand hygiene with soap and water or with alcohol hand sanitizer costs
less than a penny
However, healthcare workers cost hospitals $1.98 for every missed hand hygiene opportunity (Bloomberg, 2008)
The missed action costs patients significantly more suffering
In the USA 1/136 patients become infected from HAI at a cost of $4.5-5.7 billion per year
Bacteria can survive for
on patient care equipment and other surfaces.By washing your hands you can prevent the spread of HAI’s to your patient and yourselfSlide5
Definition of Hand HygieneThe killing or removal of microorganisms on the hands that have been picked up by contact with patients, staff, contaminated equipment or the environmentSlide6
Two Approved Methods for Hand Hygiene
Hand Washing with soap & water
– performed when hands are
with organic matters, i.e., food, soil, blood, body fluid-urine, stool
-- performed when caring for a patient with Clostridium difficile (C. diff)
Hand Sanitation with Alcohol-based Hand Rub (ABHR)
– preferred method in healthcare settings to clean hands that are
not visibly soiledSlide7
Alcohol-based Hand Rubs (ABHR)
Alcohol-based Hand Rub is
the preferred method of hand hygiene in a healthcare setting
Provides a rapid kill or removal of most bacteria on hands
Takes less time than using soap and water
Contains emollients to reduce skin irritation
They can be easily available at the “point of care”
Remember not to rinse off with water immediately after application These cleansers are well tolerated, but may cause temporary stinging when in contact with skin cracks.Slide8
Hand Soaps and Soap and Water Washing
Types of Hand Soap
1. All purpose soap
Used for most patient care
Appropriate for most hand washing
2. Antibacterial Soap Soap and water hand washing works by rinsing bacteria off the hand and down the drain.According to the Centers for Disease Control and Prevention (CDC), antibacterial soaps are not necessary, but washing your hands thoroughly with ordinary soap and warm water is one of the most effective ways to break a link in “the chain of infection”.Slide9
HOW DO I PRACTICE HAND HYGIENE CORRECTLY?
(foam and gel) Apply to palm of one hand (the amount used depends on specific hand rub product).
Rub hands together, covering all surfaces, focusing in particular on the fingertips and fingernails, until dry. Use enough rub to require at least 15 seconds to dry.
Wet hands with water.
Apply soap.Rub hands together for at least 15 seconds, covering all surfaces, focusing on fingertips and fingernails.Rinse under running water and dry with disposable towel.Use the towel to turn off the faucet.Slide10
Steps for hand hygiene using alcohol-based hand rub (ABHR)
Your hands are now safe hands “prepared to
Steps for Hand Washing with Soap & Water
Your hands are now safe hands “prepared to care”.Slide12
Maintaining Healthy Skin Integrity
1st line of defense against infection
and cracked skin harbor more microbes
Apply hospital provided lotion to
protect skin after frequent
hand washing to prevent skin breakdownSlide13
Hand lotions are important to prevent skin dryness and irritation.
shall be used. Keep personal lotions at home.
Personal lotions are prohibited because they can:
make hand hygiene products less effectivecause breakdown of latex glovesbecome contaminated with bacteria in the hospital environmentSlide14
Finger Nails and Hand Hygiene
Fingernails shall be natural and must be ¼ inch in length
nails, chipped polish, artificial nails,
and nail jewelry
for microorganisms. Shellac (gel) polish, gel overlays, acrylics, and silks are considered artificial overlays and not permitted by healthcare workersArtificial overlays have been implicated in outbreaks and can tear glovesSlide15
GBMC’s Hand Hygiene Program
GBMC’s Hand Hygiene policy is based on the WHO (World Health Organization) 5 Moments.
Policy is visible on the “Info Web” under Infection Prevention dept tab
Includes a policy on Nail length and prohibitions regarding nail jewelry,
, shellacs etc. for direct care givers, nurses,
GBMC’s Hand Hygiene Monitoring Program
GBMC participates in the Maryland Patient Safety Center (MPSC) Hand Hygiene Collaborative
State facilitated program
Observations conducted by anonymous observers
Report results monthly involving all inpatient units and all disciplines
GBMC also developed a patient observation program titled “Hand to Hand”
Anonymous patient and visitor submission regarding compliance
Over 14,000 patients submitted survey’s on GBMC’s Hand Hygiene practices in FY14!
GBMC is committed to improving compliance and fostering a culture of safety for staff and patients. The Goal for both programs in FY15 is 92% compliance.Slide17
INDICATIONS for Hand Hygiene
perform Hand Hygiene:
Before touching a patient
Before a clean/aseptic procedure
After body fluid exposure risk; including after glove removal
After touching a patient
After having contact with the healthcare environment
****AND….Crossing the room threshold at entry and exit
Semi-Private Rooms with curtain divider:
Health care providers should perform hand hygiene upon crossing the curtain line, ensuring hands are disinfected before moving to the next patientSlide18
Perform a Standard Precautions Risk Assessment before providing care
Before providing care, ask the following questions?
is the risk of
(microbes, non-intact skin, body fluid & substance, mucous membrane, contaminated equipment, etc.)
is this organism transmitted?
Is the patient cooperative? How can I prevent spreading the microbes to others? Having the Questioning Attitude: “what task am I going to perform?”
“what PPE do I need to wear to protect myself and help stop the spread of infections”Slide19
GLOVES and Hand Hygiene
Gloves should be worn when:
hands may become contaminated with blood, body fluids, excretions, or secretions
when touching mucous membranes, non-intact skin,
contaminated surfaces or objects (urinary catheters,
Key Reminders with glove use:Do not resuse or wash glovesGloves are not a replacement for hand hygiene
Always change gloves between patients
Discard gloves prior to exiting patient roomSlide20
“BUT I DIDN'T TOUCH THE PATIENT.
WHY SHOULD I PRACTICE HAND
Bacteria can survive for
on patient care equipment and other surfaces.
IV pumps, and
Are all contaminated with bacteria.
It’s important to practice hand hygiene after you leave the room, even if you only touched patient care equipment or environmental surfaces.Slide21
BE A ROLE MODEL FOR GBMC
Colleagues, students, trainees, and other staff watch what you do!
Research has shown that the actions of clinicians influence the behavior of others.
Show your colleagues that hand hygiene is an important part of quality care.
Your patients watch you too!
Your actions send a powerful message.
Show your patients that you are serious about their health and the prevention of infectionSlide22
TAKE HOME HYGIENE FACTS
Hand Hygiene is the most effective way to prevent the spread of healthcare associated infections (HAIs)
Hand Hygiene is the most cost-effective measure to prevent the spread of germs
Wash hands with soap and water for at least 15 seconds and use warm water
Preferably, if hands are not visibly soiled, use the alcohol based hand sanitizer, as it is more effective than soap and water and better for your skin
Artificial Nail Enhancements are
allowed if GBMC employee provides patient care
Gloves do not prevent the need for hand hygieneSlide23Slide24
ReferencesCenters for Disease Control and Prevention (CDC): Guideline for Hand Hygiene in Health-care Settings.
MMWR 2002; vol. 51, no. RR-16.
World Health Organization (WHO): Guideline on Hand Hygiene in Healthcare, 2009