Chapter 1. Infection Control Show
Hand HygieneHand hygiene is the most important part of practice for health care workers and is the single most effective way to stop the spread of infections; failure to properly perform hand hygiene is the leading cause of HAIs and the spread of multi-drug-resistant organisms (MDROs) (BC Centre for Disease Control, 2014; WHO, 2009a). Hand hygiene is a general term used to describe any action of hand cleaning and refers to the removal or destruction of soil, oil, or organic material, as well as the removal of microbial contamination acquired by contact with patients or the environment. Hand hygiene may be performed using an alcohol-based hand rub (ABHR) or soap and water. A surgical hand scrub is also a method of hand hygiene (WHO, 2009a). To break the chain of infection, there are five key moments at which to perform hand hygiene when working in health care, as outlined in Checklist 2 and illustrated in Figure 1.1. Checklist 2: Five Key Moments in Hand Hygiene
Safety Alert: Factors that Reduce Hand Hygiene Effectiveness
How to Wash Hands: Types of Hand HygieneTwo types of hand hygiene are commonly used in the health care setting: hand hygiene with an alcohol-based hand rub (see Figure 1.2) and hand hygiene with soap and water. Figure 1.2 Alcohol-based hand rubAlcohol-based hand rub (ABHR) is a product containing 60% to 90% alcohol concentration and is recommended for hand hygiene in health care settings (CDC, 2012). ABHR is the preferred method of hand hygiene and is more effective than washing hands with soap and water (WHO, 2009a). ABHRs:
See Checklist 3 for the steps to take when washing hands with ABHR. Checklist 3: Hand Hygiene with ABHR
Hand Hygiene with Soap and WaterHand hygiene with water requires soap to dissolve fatty materials and facilitate their subsequent flushing with water. Soap must be rubbed on all surfaces of both hands followed by thorough rinsing and drying, Water alone is not suitable for cleaning soiled hands (WHO, 2009a). The entire procedure should last 40 to 60 seconds and should use soap approved by the health agency. See the steps in Checklist 4.
Non-sterile (Clean) GlovesBoth hand hygiene and clean glove use are strategies to prevent transmission of infections through hand contact. In the context of patient care, it makes sense to think of glove use and hand hygiene as complementary strategies to prevent transmission of pathogens. Gloves are critical to prevent the transmission of organisms when hand hygiene alone is not enough in an outbreak such as Clostridium difficile or the norovirus, or when a patient has a suspected or known pathogen. Studies have shown that gloves reduce transmission of microbes from the hands of health care workers (PIDAC, 2012). Non-sterile gloves are single use and should be applied:
Non-sterile gloves should be removed:
See Checklist 5 for steps on how to apply non-sterile gloves. Checklist 5: Applying Non-Sterile Gloves
Latex Allergies and Non-sterile (Clean) Glove UseA latex allergy is a reaction to the proteins in natural rubber latex (American Academy of Allergy, Asthma and Immunology, 2014). When people come in contact with latex, an allergic reaction may occur. Most reactions are mild (asthma-like symptoms or contact dermatitis), but there are some rare severe cases (reactions). Many hospitals have moved away from using latex gloves, but latex is commonly used in many health care products such as IV tubing, urinary catheters, syringes, dressings, and bandages. People at risk for developing a latex allergy are:
Note that powdered latex gloves have also been associated with latex allergies. If an allergy to latex exists, the best treatment is to avoid latex and use a medical alert bracelet to inform others of the allergy (PIDAC, 2012).
Why are paper towels most appropriate for drying hands in health care facility?The proper drying of hands after washing should be an essential component of effective hand hygiene procedures. Most studies have found that paper towels can dry hands efficiently, remove bacteria effectively, and cause less contamination of the washroom environment.
Which of the following practices is essential to ensure effective hand washing technique?"Good" hand washing techniques includes using an adequate amount of soap, rubbing the hands together to create friction for at least 20 seconds, and rinsing under running water. Wearing gloves is not a substitute for hand washing, and hand washing is often required before and after wearing gloves.
What are two important factors in performing an effective hand wash?What are the two important factors in performing an effective hand wash? Friction and running warm water. sanitization.
What is the proper action to take if blood is splashed on a countertop during a procedure?Put on disposable gloves. Wipe up the spill as much as possible with paper towel or other absorbent material. Gently pour bleach solution – 1 part bleach to 9 parts water – onto all contaminated areas. Let bleach solution remain on contaminated area for 20 minutes and then wipe up remaining bleach solution.
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