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Hand Hygiene in Health-care Facilities

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Hand Hygiene in Health-care Facilities The Importance of Proper Hand Hygiene for Health-care Workers How to Use Hand Rub properly Rub hands for hand hygiene but wash ... – PowerPoint PPT presentation

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Title: Hand Hygiene in Health-care Facilities


1
Hand Hygiene in Health-care Facilities
  • The Importance of Proper Hand Hygiene for
    Health-care Workers

2
  • Please Complete Your Pre-Test

3
Objectives
  • Learn the role hand hygiene plays in HAI
    prevention
  • Learn the right time and right way for Hand
    Hygiene
  • Review the proper use of gloves to prevent germ
    transmission
  • Learn to perform observational studies
  • Learn to evaluate your Hand Hygiene Program
  • Strategies for improvement

4
Hands and Germ Transmission
  • A health-care workers hands when not clean are
    the main route of cross-transmission of
    potentially harmful germs between patients in a
    health care facility

5
Lack of Hand Hygiene Patient Care Increased
Risks
  • Increased risk for
  • Hand contamination
  • Potential risk to patient safety

6
Hand Hygiene in Prevention of HAIs
  • Hand hygiene is the undisputed single most
    effective infection control measure in prevention
    of HAIs

7
Increased Compliance with Hand Hygiene means
  • Reduced numbers of patients acquiring HAIs
  • Decreased waste of resources
  • Saving lives

8
Hand Hygiene
  • right time
  • right way

9
Key Terms
  • The patient zone- includes the patient, surfaces
    and items that are temporarily and exclusively
    dedicated to him/her
  • The Health care area- all surfaces in the health
    care setting outside of the patient zone

10
The patient zone
  • The patient zone contains
  • Patient X
  • Immediate surroundings - surfaces that are
    touched by or in direct physical contact with the
    patient
  • -Bed rails
  • -Bedside tables
  • -Bed linens
  • -Tubing
  • -Medical equipment

11
The Patient zone is not a static geographical
area
  • Any item designed for reuse or temporarily
    exposed to the patient should be decontaminated
    when entering and leaving the patients
    surroundings
  • Things such as
  • - Computers
  • - Shared bathrooms
  • - Tables or equipment used for physical therapy
  • - Wheelchairs

12
The Health-care Area
  • Is everything outside of the patient zone
  • Hand hygiene while caring for patients helps to
    protect the wider health care environment from
    contamination by patients germs

13
Right Time
  • To avoid prolonged hand contamination
  • Perform hand hygiene when indicated

14
The 5 Moments for Hand Hygiene
  1. BEFORE touching a patient
  2. BEFORE clean/aseptic procedures
  3. AFTER a body fluid exposure risk
  4. AFTER touching a patient
  5. AFTER touching a patients surroundings

15
Your 5 Moments for Hand Hygiene
16
BEFORE touching a patient
  • Why?

17
BEFORE touching a patient
  • Why?
  • To protect the patient against harmful germs
    carried on your hands

18
BEFORE clean/aseptic procedures
  • Why?

19
BEFORE clean/aseptic procedures
  • Why?
  • To protect the patient against harmful germs,
    including the patients own, from entering his/her
    body

20
AFTER body fluid exposure risk
  • Why?

21
AFTER body fluid exposure risk
  • Why?
  • To protect yourself and the health-care
    environment from harmful patient germs

22
AFTER touching a patient
  • Why?

23
AFTER touching a patient
  • Why?
  • To protect yourself and the health-care
    environment from harmful patient germs

24
AFTER touching patients surroundings
  • Why?

25
AFTER touching patients surroundings
  • Why?
  • To protect yourself and the health-care
    environment from harmful patient germs

26
Your 5 Moments for Hand Hygiene Film
27
Right Way
  • To avoid prolonged hand contamination
  • Use the appropriate technique
  • Use an adequate quantity
  • Use for recommended length of time

28
How to Handwash
29
How to Handrub
30
Lets Practice!!!
31
Fingernails and Artificial Nails
  • Natural nail tips should be kept to ¼ inch in
    length
  • Artificial nails should not be worn when having
    direct contact with high-risk patients (e.g.,
    ICU, OR)

32
Understanding Medical Gloves and proper Glove use
  • Medical gloves disposable gloves used during
    medical procedures
  • They include
  • Examination gloves (non sterile or sterile)
  • Surgical gloves that have specific
    characteristics of thickness, elasticity and
    strength and are sterile

33
Gloves DO NOT take the place of hand hygiene
  • Glove use neither alters nor replaces the
    performance of hand hygiene
  • Gloves should be removed and hand hygiene
    performed when indicated by the 5 moments of hand
    hygiene and clean gloves put back on

34
Rationale for using medical gloves
  • Recommended for two reasons
  • To reduce the risk of contamination of
    health-care workers hands with blood and other
    body fluids
  • To reduce the risk of germ dissemination to the
    environment and of transmission from the
    health-care worker to the patient and vice versa,
    as well as from one patient to another

35
Inappropriate use of gloves
  • Use of gloves when it is not indicated is a
  • Waste of resources
  • Does not decrease cross-transmission of germs
  • May result in missed opportunities for hand
    hygiene
  • May actually result in germ transmission

36
The Glove Pyramid
37
  • And Now its time for the
  • GLOVE GAME !!!

38
GLOVE GAME
  • Assisting a patient with using the bedpan
  • Taking Vital Signs
  • Removing a dressing from a wound
  • Catheter insertion
  • Delivering food trays
  • Emptying emesis basin
  • Changing the linens for a patient with MRSA
  • Changing a central line dressing
  • Administering oral Medications
  • Emptying a Foley catheter bag

39
Evaluating Your Hand Hygiene Program
  • Why it is important
  • Measurement of the effectiveness of current
    practices
  • Identifying areas needing increased education
  • To be able to give feedback to employees on their
    performance

40
How to observe Hand Hygiene
  • Direct observation is the most accurate method
  • Observer must conduct the observation without
    interfering with ongoing work
  • Observer should be familiar with The 5 Moments
    for Hand Hygiene and the data collection tool
    that is being utilized
  • Identify opportunities for hand hygiene and then
    record if the worker being observed performed
    hand hygiene at that time

41
Sample observation tool
42
Sample Observational Tool
43
Calculating Compliance Rates
  • Total number of times hand hygiene was
    performed
  • _______________________________________
  • Total opportunities for hand hygiene
  • X100

44
Sample Observational Tool
45
Calculating Compliance Rates
  • Total number of times hand hygiene was performed
  • (4)
  • _______________________________________
  • Total opportunities for hand hygiene
  • (6)
  • 4/6 0.667
  • 0.667 x 100 66.7

46
Other Uses for Observational Tool
47
Feedback to Staff
  • Why it is important
  • Helps them recognize gaps in good practices and
    knowledge
  • Can help raise awareness and can convince them
    there is a problem
  • Ongoing feedback will demonstrate improvement and
    sustain motivation

48
Tips for Improving Hand Hygiene Compliance
  • Increase the availability of hand sanitizers
  • Implement a buddy system
  • Place signs near sinks and hand sanitizers with
    the 5 Moments for Hand Hygiene or other
    reminders
  • Internal Newsletters

49
Answers to Pre-test
  • Which of the following is the main route of
    cross-transmission of potentially harmful germs
    between patients in a health- care facility?
    (Pick one answer only)
  • Health- care workers hands when not clean
  • Air circulating in the facility
  • Patients exposure to colonized surfaces (i.e.,
    beds, chairs, tables, floors) between patients
  • Sharing non-invasive objects (i.e., stethoscopes,
    blood pressure cuffs, etc.) between patients

50
Answers to Pre-test
  • Which of the following is the main route of
    cross-transmission of potentially harmful germs
    between patients in a health- care facility?
    (Pick one answer only)
  • Health- care workers hands when not clean
  • Air circulating in the facility
  • Patients exposure to colonized surfaces (i.e.,
    beds, chairs, tables, floors) between patients
  • Sharing non-invasive objects (i.e., stethoscopes,
    blood pressure cuffs, etc.) between patients

51
Answers to Pre-test
  • Which hand hygiene actions prevent transmission
    of germs to the patient?
  • Washing hands before touching a patient Yes No

52
Answers to Pre-test
  • Which hand hygiene actions prevent transmission
    of germs to the patient?
  • Washing hands before touching a patient Yes

53
Answers to Pre-test
  • Which hand hygiene actions prevent transmission
    of germs to the patient?
  • Washing hands before touching a patient Yes
  • Washing hands immediately after a risk of body
    fluid exposure Yes No

54
Answers to Pre-test
  • Which hand hygiene actions prevent transmission
    of germs to the patient?
  • Washing hands before touching a patient Yes
  • Washing hands immediately after a risk of body
    fluid exposure No

55
Answers to Pre-test
  • Which hand hygiene actions prevent transmission
    of germs to the patient?
  • Washing hands before touching a patient Yes
  • Washing hands immediately after a risk of body
    fluid exposure No
  • Washing hands after exposure to the immediate
    surroundings of a patient Yes No

56
Answers to Pre-test
  • Which hand hygiene actions prevent transmission
    of germs to the patient?
  • Washing hands before touching a patient Yes
  • Washing hands immediately after a risk of body
    fluid exposure No
  • Washing hands after exposure to the immediate
    surroundings of a patient No

57
Answers to Pre-test
  • Which hand hygiene actions prevent transmission
    of germs to the patient?
  • Washing hands before touching a patient Yes
  • Washing hands immediately after a risk of body
    fluid exposure No
  • Washing hands after exposure to the immediate
    surroundings of a patient No
  • Washing hands immediately before a clean/ aseptic
    procedure Yes No

58
Answers to Pre-test
  • Which hand hygiene actions prevent transmission
    of germs to the patient?
  • Washing hands before touching a patient Yes
  • Washing hands immediately after a risk of body
    fluid exposure No
  • Washing hands after exposure to the immediate
    surroundings of a patient No
  • Washing hands immediately before a clean/ aseptic
    procedure Yes

59
Answers to Pre-test
  • What is the minimal time needed for alcohol based
    hand rub to kill most germs on your hands? (Pick
    one answer only)
  • 20 seconds
  • 3 seconds
  • 1 minute
  • 10 seconds

60
Answers to Pre-test
  • What is the minimal time needed for alcohol based
    hand rub to kill most germs on your hands? (Pick
    one answer only)
  • 20 seconds
  • 3 seconds
  • 1 minute
  • 10 seconds

61
Summary
  • Increased compliance with Hand Hygiene at the
    appropriate moment and in the appropriate way
    will lead to reduced numbers of patients
    acquiring HAIs and save lives
  • Observational studies are key to determining the
    effectiveness and direction of your hand hygiene
    education.

62
WHO Hand Hygiene Self-Assessment Framework 2010
  • WHO Hand Hygiene Self-Assessment Framework 2010
    worksheet
  • Answer the following based on practices at your
    facility
  • 3.4 and 3.5 from Evaluation and feedback
  • Entire section of 4 Reminders in the workplace
  • Entire section of 5 Institutional safety climate
    for hand hygiene

63
Discussion Questions (3.4)
  • Does your facility use WHO My 5 Moments for Hand
    Hygiene?
  • How frequently is direct observation of hand
    hygiene compliance performed at your facility?
  • What is the overall hand hygiene compliance rate
    in your facility?

64
Discussion Questions (3.5)
  • Do you use immediate feedback?
  • Describe your systematic feedback?
  • How often?
  • Audience?
  • Impact?

65
Discussion Questions (4)
  • Please share your experience with hand hygiene
    workplace reminders?
  • What has worked well?
  • Or not?
  • Types of reminders or promotions?

66
Discussion Questions (5)
  • Does anyone have experience with
  • Hand hygiene teams?
  • Visible support from leadership?
  • Hand hygiene champions or role models?
  • Patient involvement?
  • Continuous improvement activities?

67
References
  • Center for Disease Control (CDC)
  • World Health Organization (WHO)

68
Questions?
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