Hand Washing Techniques Infection Control Management

Hand Washing Techniques

Hand washing is the most important and effective universal precaution for infection control
Purpose

1. To remove dirt and/or to reduce the level of organisms present on the hand.
2. To prevent hospital-acquired infection.

Policy
Hand washing technique should be adhered to for following

1. Prior to and after handling patient, particularly those infected or colonized with highly resistant bacteria.
2. Prior to and after performing aseptic techniques or any nursing procedure.
3. After handling contaminated material/substances such as secretions/excretions and blood and body fluids.
4. On arrival for, and prior to departure from duty.
5. Before and after using the toilet/bathroom, before going to the cafeteria and after completing duty.
6. Before and after touching wounds and dressings of any type.
7. Before preparing or serving food.
8. After touching hair, nose, mouth or handkerchief.
9. Prior to and after contact with patients susceptible to infections.
10. After touching sources likely to be contaminated with significant microorganisms such as urine measuring devices, suction bottles, and sputum collection pots.
11. Before and after wearing gloves. Gloves should not be used as substitute full hand washing.
12. Attendants and visitors to specialized areas should be instructed on the importance of hand washing and should be encouraged to do correctly.

Equipment

1. Sink with elbow operated taps.
2. Liquid soap or antiseptic solution in the dispenser — CHLORHEXIDINE GLUCONATE 0.5-2.5 % E T H Y L A L C O H O L 70% (MICROSHIELD HAND RUB).
3. Disposable paper towels in the dispenser.
4. Waste container with a foot pedal.

Procedure

• Roll up sleeves well above elbow particularly in critical care areas and remove wristwatch and rings.
• Turn on the taps with the elbows to reduce the risk of contamination, and adjust Water to a comfortable temperature.
• Wet hands and forearms with running water.
• Use elbow to depress the arm of the soap / antiseptic solution Dispenser. and allow a sufficient quantity of solution onto the hand to produce visible lather on all surfaces.
• Allow the water to run continuously and do not allow hands to touch any part of the taps or sink throughout the procedure.

1. Lather hands using a friction motion ensuring that all parts of the hands and wrists are covered.
2. Palm to palm
3. Right palm over left dorsum and left palm over right Dorsum.
4. Palm to palm fingers interlaced.
5. Back of fingers to opposing palms with fingers interlocked.
6. Rotational rubbing of right thumb clasped in left palm and Vice versa.

• Rinse hands thoroughly under running water, starting first with the fingers, palms, and wrists.
• Drain excess water by a downward shaking motion from fingers to wrist. Let water drip off well above the washbasin.
• Dry hands completely with a paper towel, and then proceed to the wrists.
• Turn taps off using either the elbows or the used paper towel. Dispose of the used paper towel in the foot operated pedal bin provided at all sinks.
• Care must be taken to avoid excessive splashing on clothes, floor, and adjacent equipment.

Note : An alternative method of hand washing is the application of 3 - 5ml of A L C O H O L I C hand rub [containing 2% glycerin] covering all surfaces. This method provides a convenient, rapid and effective alternative to hand washing in situations where there is no gross soiling of the hands and where no sink is readily available.

The Methods of Hand Washing

A. Social Hand Washing

Social hand washing will render hands socially clean and remove transient microorganisms provided that an effective technique is used. Special attention should be paid to the tip of the fingers, the thumbs and other areas of the hand likely to come in contact with contaminated sites.

Hands should be washed when soiled, after handling patients, after visiting the toilet, before handling food, before starting and leaving work, after cleaning sessions or after handling infected waste.

1. Use liquid soap or an antiseptic hand wash.
2. Wet hands and forearms. Rub vigorously to from lather on the surface of hands for at least 15-20 seconds. Rinse thoroughly and dry well using a good quality paper towel.

B. Antiseptic Hand Washing

Antiseptic hand washing should be used before aseptic procedures, before contact with the susceptible patient and after contact with infected patients or contaminated material or equipment.

1. Use an antiseptic hand-wash preparation — CHLORHEXIDINE GLUCONATE / A L C O H O L, skin antiseptic.
2. Wet hands and forearms, using 3-5 ml of antiseptic solution, rub vigorous to form lather on all surface of the hands and forearms for at least one minute.
3. Rinse thoroughly and dry well.

C. Surgical Hand Washing

Surgical hand washing requires the removal of transient microorganisms and a substantial reduction and suppression of the resident flora. This is performed prior to surgery to ensure that a high level of skin disinfection is achieved.

1. Fingernails should be kept short and clean and nail varnish, wristwatch, or jewelry should not be worn.
2. Turn on the taps using the elbow and adjust the flow and temperature of water. Wet hands and forearms. Apply antiseptic hand wash preparation from elbow operated pump dispenser.
3. Lather hands, wrist and forearms for the minute keeping them above elbow level and rinse thoroughly. Clean the nails with a sterile nailbrush at the beginning of the operating list.
4. The hand washing procedure is then repeated for two minutes. The hand's wrists and forearms are then rinsed thoroughly under running water, still keeping the hands above elbow level and the excess water is gently shaken off.
5. The technique of drying the hands is very important. A separate paper towel is used for each arm, moving from fingertips to elbow using a dabbing action.
6. The paper towel is discarded and the procedure repeated for the other arm. When hands wrists and forearms are thoroughly dry, the individual is ready to gown and glove.

Note : Hands must be washed after removing gloves. Wearing gloves does not obviate the need for hand washing.

Important
Hand washing agents may give rise to skin irritation or induce sensitivity. To minimize this, it is important that hands are rinsed well and dried thoroughly. Should skin irritation or sensitivity occur, please seek advice from Staff Clinic. Some types of hand creams may interact with antiseptics, both reducing the effect of antiseptic and giving rise to skin irritation only hand cream approved should be used.

INFECTION CONTROL HAND WASHING TECHNIQUE

HAND WASHING IS THE MOST IMPORTANT EFFECTIVE UNIVERSAL PRECAUTION FOR INFECTION CONTROL

The 10 most important carriers of cross infection are your 10 fingers. Practice and Preach Hand Washing

Protection against blood Borne diseases

Introduction
Bloodborne infections such as human immunodeficiency virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) have caused serious concern to health care workers exposed to blood, body fluids and other potentially infectious material that may contain bloodborne pathogens. The risk of blood-borne infection following percutaneous exposure is >30% for HBV, 3- 10% for HCV and 0.38% for HIV. However, the risk of HBV infection may be virtually zeroed if the victim is immune.

Definitions
A blood or body fluid exposure is defined as a needle stick or sharp puncture wound, a splash to mucous membrane or contact with skin that has an open cut or abrasion. Blood means human blood, its blood products or blood components. Other potentially infectious materials include human body fluids, such as semen, vaginal secretions, saliva in dental procedures and any body fluids visibly contaminated with blood.
The “At Risk” healthcare workers are:

1. Medical practitioners (Surgeons and physicians)
2. Dentists and Dental employees
3. Nurses and Phlebotomists
4. Laboratory technologists
5. CSSD workers and technicians
6. Housekeeping personnel
7. Laundry workers
8. Paramedics
9. Medical Orderlies

Prevention Strategies

Screening patients for blood-borne infections for infection control purposes are no longer acceptable. Most authorities now advise applying universal precautions (UP). when performing a high-risk procedure, because it is impossible to identify many virus carriers on the basis of clinical inquiries.

Detection of infection may be missed while patients are incubating or carrying the HIV, HTLV - 1, syphilis, HBV or HCV or other blood-borne diseases. Furthermore, some blood-borne infections such as Hepatitis other than B and C and HIV - 1 subtype O are not detectable by serology. It has been shown that HIV testing alone would detect only 24% of infected patients.

• See Also: How To Take Care Of Feet And Hands?

Therefore, blood and blood containing fluids from all patients should be presumed to be infectious and should be considered an Occupational hazard and a system of universal precautions has to be established when dealing with blood and body fluids. This involves the identification of high-risk procedures rather than high-risk individuals. The universal precautions are designed to protect staff from risks such as sharps injuries and body fluid spillage and patients from cross infection.