hand hygiene
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Indications
- hand hygiene is the cornerstone of any infection-control program
- increasing hand hygiene compliance in associated with fewer nocosomial infections[4]
Procedure
- hands must be decontaminated immediately before direct patient contact & after any contact that could potentially result in hands becoming contaminated
- hands that are visibly soiled, or potentially grossly contaminated with dirt or organic material, must be washed with liquid soap & water
- hand antiseptic is generally superior to handwashing unless hands are visibly soiled or patient has C difficile
- alcohol-based antiseptics for hand hygiene are insufficient for infection control associated with C difficile
- it does not eradicate C difficile spores[5][6]
- all wrist & hand jewelry should be removed prior to hand decontamination
- cuts & abrasions must be covered with waterproof dressings
- fingernails should be kept short, clean, & free from nail polish
- an emollient hand cream should be applied regularly to protect skin from the drying effects of regular hand decontamination
- additional specific recommendations[3]
- soap & alcohol-based hand rubs should be conveniently located for routine hand hygiene in all areas where patients are seen
- healthcare workers should wash their hands with soap & water or use alcohol-based hand rubs
- before direct patient contact (WHO)
- preparing or handling patients' medications
- moving from a contaminated body site to a clean body site
- before clean or aseptic procedure (WHO)
- before & after using an invasive device
- after contact with bodily fluids (WHO_
- after direct contact with a patient (WHO)
- after contact with a patient's surroundings (WHO)
- hand washing with soap & water is recommended
- after toileting
- when hands are visibly soiled with feces or other bodily fluids (even if gloves are worn)
- possible contact with C difficile[6]
- soaps containing triclosan should be avoided due to risk for antimicrobial resistance.
- adherence to hand hygiene should be monitored[3]
Notes
- video cameras improve compliance[2]
More general terms
More specific terms
Additional terms
References
- ↑ Harris BD et al Strict Hand Hygiene And Other Practices Shortened Stays And Cut Costs And Mortality In A Pediatric Intensive Care Unit Health Aff September 2011 vol. 30 no. 9 1751-1761 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21900667 <Internet> http://content.healthaffairs.org/content/30/9/1751.abstract
- ↑ 2.0 2.1 Armellino D et al. Using high-technology to enforce low-technology safety measures: The use of third-party remote video auditing and real-time feedback in healthcare. Clin Infect Dis 2012 Jan 1; 54:1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22109950
Palmore TN and Henderson DK. Big brother is washing . . . video surveillance for hand hygiene adherence, through the lenses of efficacy and privacy. Clin Infect Dis 2012 Jan 1; 54:8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22109949 - ↑ 3.0 3.1 3.2 Ellingson K et al SHEA/IDSA Practice Recommendation. Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. Infection Control and Hospital Epidemiology. July 16, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25026608 <Internet> http://www.jstor.org/stable/10.1086/677145
- ↑ 4.0 4.1 Sickbert-Bennett EE, DiBiase LM, Schade Willis TM et al Reduction in healthcare-associated infections by exceeding high compliance with hand hygiene practices. Emerg Infect Dis. 2016 Sep <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27131129 <Internet> http://wwwnc.cdc.gov/eid/article/22/9/15-1440_article
- ↑ 5.0 5.1 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Leffler DA, Lamont T. Clostridium difficile infection N Engl J Med 2015;372(16):1539-1548 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25875259 - ↑ 6.0 6.1 6.2 McDonald LC, Gerding DN, Johnson S et al Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018 Mar 19;66(7):987-994. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29562266