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Handwashing Jayne Cutter HANDWASHING Handwashing is the single most effective step in the prevention of spread of infection Preventing the Spread of Infection Irrespective of the normal mode of spread of any given organism, it is known that over 90% of all infections are transmitted via the hands of health care workers. (Reybrouk, 1983) Purpose of handwashing • To remove dirt • To reduce the level of organisms present on the hands • To remove transient organisms and reduce the number of resident organisms on the hands • To reduce the risk of infection to vulnerable patients HANDWASHING HANDWASHING - removes dirt and reduces the levels of transient and resident bacteria TRANSIENT BACTERIA superficial readily transmitted RESIDENT BACTERIA found in the skin less readily transmitted significant for susceptible & vulnerable patients hospital flora easily removed defensive less easily removed Prevention of Spread - Handwashing • Between each patient contact • Before and after aseptic procedure • Before and after specimen taking • After removal of gloves • After any decontamination process • Before and after using the toilet • When hands become contaminated • On arrival in work and before leaving work • After using a handkerchief CHOICE OF HANDWASH/ AGENT Social - removal of transient organisms. Use soap & water Antiseptic - removal of transient organisms & reduction in level of organisms. Use detergent & antiseptic solution or alcohol rub - immunosuppressed patients - in critical care areas - invasive devices - outbreaks of infection - multi-resistant organisms Surgical removal of transient organisms & reduction in level of resident organisms. Use detergent & antiseptic solution or alcohol rub HANDWASHING Always wet your hands before applying soap. Froth & friction for mechanical removal of bacteria Cover all areas Time:15-30 secs. for social/antiseptic handwash 2-5 mins. for surgical scrub Rinse & dry thoroughly. Maintain skin integrity Keep nails short & clean. Do not use nail brushes routinely Wear only a wedding ring. Don’t wear wrist watches Avoid bar soap Factors inhibiting handwashing intrinsic • • • • • • Jewelry Skin conditions - eczema, dermatitis etc Bitten nails Long nails Damaged cuticles Nail varnish Factors inhibiting handwashingextrinsic • Bar soap • • • • • Poor quality liquid soap Lack of hot water Hot air dryers Communal towels Nail brushes Alcohol hand rub 70% alcohol solution is an effective alternative when soap and water is not available, however: • alcohol is not a cleaning agent and handwashing is always needed for physically soiled hands • alcohol based agents may not be effective against some viruses e.g. enteroviruses • alcohol has little or no residual activity