Download hand hygiene - For Medical Professionals

AURORA VISITING NURSE ASSOCIATION OF WISCONSIN
CLINICAL PROCEDURES
Procedure No: 101
Revised/Reviewed: 10/95, 5/99, 8/01, 09/02,
04/03, 06/03, 08/03, 9/05, 6/07, 5/08, 1/09
MJ Sutton, B. Spitz/ck
HAND HYGIENE
I.
POLICY
The Aurora Visiting Nurse Association of Wisconsin provides evidence-based care that meets or
exceeds regulatory, accreditation, and professional standards of practice.
II.
PURPOSE
Clean hands reduce the transmission of pathogens between patients and home care staff.
Thorough hand hygiene is the most important factor in communicable disease control.
III.
CONSIDERATIONS
For routine decontamination of hands in the clinical setting, use an alcohol-based waterless
antiseptic. Hand washing with soap and water is still required for specific situations, as described
below.
Artificial nails may not be worn by those providing direct patient care, i.e. acrylic, silk wrap, gels.
Natural nails may not be longer than 1/4 inch and polished in a conservative fashion.
Hand washing with soap and water (either non–antimicrobial or antimicrobial) is required if
contact with spores (e.g. C. difficile) is anticipated; Follow Special Handwashing Procedure. The
physical action of washing and rinsing hands under such circumstances is recommended because
alcohols, chlorhexidine, iodophors, and other antiseptic agents have poor activity against spores.
Antimicrobial-impregnated wipes (i.e., towelettes) are not as effective as alcohol-based hand rubs
or washing hands with an antimicrobial soap and water for reducing bacterial counts on the hands
of healthcare workers, they are not a substitute for using an alcohol-based hand rub or
antimicrobial soap. They may be considered as an alternative only to washing hands with nonantimicrobial soap and water
A.
When to perform hand hygiene:
1.
Before:
a.
Handling any equipment/supplies
b. Any patient contact, including when moving from a contaminated body site to a
clean body site during patient care
c.
Entering the clean section of the home care worker’s bag
d. Handling medication or preparing food
e.
Leaving the home
2.
After:
a.
Assisting with toileting or handling related equipment, i.e. catheters, bedpans
b. Giving direct care, including personal care
c.
Administering a treatment
d.
e.
f.
g.
g.
h.
i.
IV.
Assisting a patient where there has been any contact with blood, body fluids,
excretions, mucous membranes, non-intact skin, wound dressings, or other
surfaces contaminated with blood/body fluids
Removing gowns
Removing gloves
Contact with inanimate objects (including medical equipment) in the immediate
vicinity of the patient
Between glove changes
Whenever hands look or feel dirty
Handling linens
EQUIPMENT
Antibacterial hand gel or Soap (antimicrobial or antibacterial), liquid in a pump or dispenser.
DO NOT USE BAR SOAP!
Running water (if available).
Paper towels
Waste basket
V.
HAND HYGIENE USING SOAP/WATER:
NOTE: Soap/Water handwashing should be done after 10-15 uses of antimicrobial hand gel.
Use enough soap to produce lots of lather.
Rub skin against skin to create friction.
Rinse thoroughly, allowing water to flow away from fingertips.
A.
PROCEDURE:
1.
2.
3.
4.
5.
6.
7.
VI.
Assemble equipment
Wet hands first with warm water.
Apply 3-5 ml of soap to hands .
Rub hands together vigorously for at least 15 seconds covering all surfaces of the
hands and fingers.
Rinse hands with warm water.
Dry thoroughly with disposable towel.
Use dry towel to turn off the faucet.
HAND HYGIENE WITH ANTIMICROBIAL HAND GEL:
A.
EQUIPMENT
An approved antimicrobial hand gel
B.
PROCEDURE
1.
2.
3.
Apply one pump of product to palm.
Rub hands together covering all surfaces, including nails, until product evaporates.
After every 10-15 uses of alcohol-based waterless antiseptic, hands should be
washed with soap and water, to remove build-up of emollients and thickeners.
References:
Centers for Disease Control and Prevention. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the
Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task
Force. MMWR 2002;51(No. RR-16).
World Alliance For Patient Safety (April 2006). WHO Guidelines On Hand Hygiene In Health Care (Advanced Draft) Global
Patient Safety Challenge 2005–2006: “Clean Care Is Safer Care”. Available from
http://www.who.int/patientsafety/information_centre/ghhad_download_link/en/
ch 1 Hand Hygiene NP 011
Page 2 of 2