PowerPlusWaterMarkObject3 Hand Hygiene Policy And Procedure Purpose Effective Hand

powerpluswatermarkobject3 hand hygiene policy and procedure purpose effective hand hygiene reduces the incidence of healthcare-associat

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Hand Hygiene Policy and Procedure
Purpose
Effective hand hygiene reduces the incidence of healthcare-associated
infections.
Policy
All members of the healthcare team will comply with current Centers
for Disease Control and Prevention (CDC) hand hygiene guidelines.
Procedure
Indications for Handwashing and Handrubbing
A. Indications for Handwashing
1. When hands are visibly dirty or contaminated with proteinaceous
material or are visibly soiled with blood or other body fluids, wash
hands with either a non-antimicrobial soap and water or an
antimicrobial soap and water.
2. Before eating and after using a restroom, wash hands with a
non-antimicrobial soap and water or with an antimicrobial soap and
water.
3. Handwashing may also be used for routinely decontaminating hands in
the following clinical situations:
*
Before having direct contact with patients
*
Before inserting indwelling urinary catheters, peripheral vascular
catheters, or other invasive devices that do not require a
surgical procedure
*
After contact with a patient’s intact skin (e.g., when taking a
pulse or blood pressure, and lifting a patient)
*
After contact with body fluids or excretions, mucous membranes,
non-intact skin, and wound dressings, even if hands are not
visibly soiled
*
When moving from a contaminated body site to a clean body site
during patient care
*
After contact with inanimate objects (including medical equipment)
in the immediate vicinity of the patient
*
After removing gloves
B. Indications for Handrubbing
If hands are not visibly soiled, an alcohol-based hand rub may be used
for routinely decontaminating hands in the following clinical
situations:
*
Before having direct contact with patients
*
Before inserting indwelling urinary catheters, peripheral vascular
catheters, or other invasive devices that do not require a
surgical procedure
*
After contact with a patient’s intact skin (e.g., when taking a
pulse or blood pressure, and lifting a patient)
*
After contact with body fluids or excretions, mucous membranes,
non-intact skin, and wound dressings, only if hands are not
visibly soiled
*
When moving from a contaminated body site to a clean body site
during patient care
*
After contact with inanimate objects (including medical equipment)
in the immediate vicinity of the patient
*
After removing gloves
Non-Surgical Hand Hygiene Technique
A. Handwashing with soap and water (either non-antimicrobial or
antimicrobial)
1. Wet hands with running water
2. Apply hand washing agent to hand
3. Vigorously rub hands together for at least 15 seconds, covering all
surfaces of hands and fingers
4. Rinse hands thoroughly with water and with hands angled down in the
sink
5. Dry hands thoroughly with a disposable towel(s)
6. Use disposable towel to turn off the water
B. Alcohol-based hand rub
1. Apply product to palm of one hand
2. Rub hands together, covering all surfaces of hands and fingers
3. Continue to rub until hands are dry
Nails
1. Artificial fingernails or extenders may not be worn if duties
include direct contact with patients
2. Natural nail tips shall be less than ¼ inch long
Gloves and Hand Hygiene
Gloves reduce hand contamination by 70 – 80 percent, prevent
cross-contamination and protect patients and health care personnel
from infection. However, the use of gloves does not eliminate the need
for hand hygiene.
1. Wear gloves when contact with blood or other potentially infectious
materials (other body fluids, secretions and excretions), mucous
membranes, non-intact skin and contaminated items will or could occur.
2. Change gloves during patient care if moving from a contaminated
body site to a clean body site.
3. Remove gloves promptly after use, before touching non-contaminated
items and environmental surfaces, and before caring for another
patient.
4. Decontaminate hands after removing gloves.
Glossary of Commonly Used Hand Hygiene Terms
Alcohol-based hand rub. An alcohol-containing preparation designed for
application to the hands for reducing the number of viable
microorganisms on the hands. In the United States, such preparations
usually contain 60%–95% ethanol or isopropanol.
Antimicrobial soap. Soap (i.e., detergent) containing an antiseptic
agent.
Antiseptic agent. Antimicrobial substances that are applied to the
skin to reduce the number of microbial flora. Examples include
alcohols, chlorhexidine, chlorine, hexachlorophene, iodine,
chloroxylenol (PCMX), quaternary ammonium compounds, and triclosan.
Antiseptic handwash. Washing hands with water and soap or other
detergents containing an antiseptic agent.
Antiseptic hand rub. Applying an antiseptic hand rub product to all
surfaces of the hands to reduce the number of microorganisms present.
Cumulative effect. A progressive decrease in the numbers of
microorganisms recovered after repeated applications of a test
material.
Decontaminate hands. To reduce bacterial counts on hands by performing
antiseptic hand rub or antiseptic handwash.
Detergent. Detergents (i.e., surfactants) are compounds that possess a
cleaning action. They are composed of both hydrophilic and lipophilic
parts and can be divided into four groups: anionic, cationic,
amphoteric, and nonionic detergents. Although products used for
handwashing or antiseptic handwash in health-care settings represent
various types of detergents, the term “soap” is used to refer to such
detergents in this guideline.
Hand antisepsis. Refers to either antiseptic handwash or antiseptic
hand rub.
Hand hygiene. A general term that applies to either handwashing,
antiseptic handwash, antiseptic hand rub, or surgical hand antisepsis.
Handwashing. Washing hands with plain (i.e., non-antimicrobial) soap
and water.
Persistent activity. Persistent activity is defined as the prolonged
or extended antimicrobial activity that prevents or inhibits the
proliferation or survival of microorganisms after application of the
product. This activity may be demonstrated by sampling a site several
minutes or hours after application and demonstrating bacterial
antimicrobial effectiveness when compared with a baseline level. This
property also has been referred to as “residual activity.” Both
substantive and nonsubstantive active ingredients can show a
persistent effect if they substantially lower the number of bacteria
during the wash period.
Plain soap. Plain soap refers to detergents that do not contain
antimicrobial agents or contain low concentrations of antimicrobial
agents that are effective solely as preservatives.
Substantivity. Substantivity is an attribute of certain active
ingredients that adhere to the stratum corneum (i.e., remain on the
skin after rinsing or drying) to provide an inhibitory effect on the
growth of bacteria remaining on the skin.
Surgical hand antisepsis. Antiseptic handwash or antiseptic hand rub
performed preoperatively by surgical personnel to eliminate transient
and reduce resident hand flora. Antiseptic detergent preparations
often have persistent antimicrobial activity.
Visibly soiled hands. Hands showing visible dirt or visibly
contaminated with proteinaceous material, blood, or other body fluids
(e.g., fecal material or urine).
Waterless antiseptic agent. An antiseptic agent that does not require
use of exogenous water. After applying such an agent, the hands are
rubbed together until the agent has dried.
References
To access the CDC’s hand hygiene guidelines in their entirety, see the
CDC website at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm;