Hand hygiene is the simplest, most effective measure for preventing the transmission of microorganisms causing infections in the healthcare setting. It is the principal element of Standard Precautions for all patient care activities. However, many studies show that adherence to recommended hand hygiene practices is unacceptably low among healthcare workers, presenting a risk to patients. Hand hygiene is, therefore, an important component of risk management and should become part of a culture of patient safety.
The spread of infection via hands is well established. The current spread of antibiotic-resistant organisms can be attributed, at least in part, to a failure by health care professionals to comply with hand hygiene either as often or as efficiently as the situation requires. Hands are the principal route by which cross-infection occurs. They have even been implicated in the indirect spread of both enteric and respiratory viral infections to both patients as well as healthcare workers themselves.
Below is a guide on how to achieve hand hygiene appropriately which is widely in use within the NHS. All clinical staff including phlebotomists should abide by the following rules.
Also, have a look at areas commonly missed during hand hygiene
Alcohol hand rub Vs Liquid soap and water
Although alcohol hand rubs do not remove dirt and organic material, they provide rapid hand disinfection when the hands are not visibly contaminated and are recommended for routine care. Hand rubs have been found to increase hand hygiene compliance. They are available in free-standing and wall-mounted pump containers and normally contain emollients to prevent skin drying. Hands will need to be washed with soap and water after several applications of alcohol hand rub to prevent the build-up of emollients on the skin. It must be remembered that alcohol is not a cleansing agent and is not recommended in the presence of physical dirt. Alcohol solutions may not be effective against enter viruses due to the relatively short exposure time of the agent on the hands. For this reason washing with soap and water is needed after handling bedpans from patients with gastroenteritis. There is no evidence that alcohol hand rubs are effective in killing Clostridium difficile spores on hands. Health care professionals must wash their hands with liquid soap and water when C. difficile infection is suspected or confirmed.
Liquid Soap and Water Washing hands with soap and water are only necessary when hands are visibly soiled, or if there is potential exposure to spore-forming microbes and after using the toilet. Hand washing with soap suspends transient micro-organisms in solution, allowing them to be rinsed off effectively (mechanical removal). The more important aspects in removing bacteria from the hands are the contact time and the friction applied during hand washing. Wall-mounted liquid soap dispensers should be used in clinical settings. They should be operated on using the wrist or elbow. The healthcare professional in charge is responsible for daily checking and replenishment of liquid soap dispensers.
Dr. Malcolm Petrovsky
MSc, PhD
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