Hand Hygiene. Clinical Skills. Hand Hygiene. Sian Williams (Clinical Skills Tutor/Manager)

Transcription

1 Clinical Skills Hand Hygiene Sian Williams (Clinical Skills Tutor/Manager)

2 Aims and Outcomes Aims and Outcomes The aim of this module: To facilitate learning regarding the purpose and procedure of Hand Hygiene At the end of the module the student should be able to: Recognise the need for effective hand hygiene within the health care setting Appreciate when to use methods of hand hygiene in the health care setting Effectively carry out the process of effective hand hygiene within the simulated setting then on a ward or other care environment

3 Introduction (1 of 3) Introduction Health Care Staff have the greatest potential to spread the micro organisms that cause infection. Hands can. Transfer the patients own micro organisms into sterile areas of the patients body during care or treatment Transfer micro organisms from one patient to other patients Transfer micro organisms from the environment and equipment to a patient Acquire micro organisms as a result of the contact with patients which places health care staff at risk of infection National Patient Safety Agency (NPSA) (2008)

4 Introduction (2 of 3) Introduction Health Care Associated Infection (HCAI) is a critical patient safety issue. At any one time up to eight per cent of inpatients in England and Wales have HCAI (Smythe et al 2008). Statistics for England and Wales show that 5,109 deaths involved MRSA and 13,189 involved Clostridium difficile during the period in patient care establishments (NPSA, 2008). Evidence shows that improving Hand Hygiene contributes significantly to the reduction of HCAI.

5 Introduction (3 of 4) Health care associated infection( HCAI) Introduction - Definition Health Care Associated Infection (HCAI) Also referred to as nosocomial or hospital infection An infection occurring in a patient during the process of care in a hospital or other health-care facility which was not present or incubating at the time of admission. This includes infections acquired in the health-care facility but appearing after discharge, and also occupational infections among health-care workers of the facility (World Health Organisation, (WHO)2009).

6 Introduction (4 of 4) Remember Introduction Remember! Hand hygiene is one of the single, most important things you can do to help reduce the spread of infections.

7 The golden rules for hand hygiene WHO The WHO golden rules for hand hygiene Hand hygiene must be performed exactly where you are delivering health care to patients (at the point-of-care) During health care delivery, there are 5 moments (see next slide ) when it is essential that you perform hand hygiene To clean your hands, you should prefer hand rubbing with an alcohol-based formulation, if available. Why? Because it makes hand hygiene possible right at the point-of-care, it is faster, more effective, and better tolerated. You should wash your hands with soap and water when visibly soiled You must perform hand hygiene using the appropriate technique and time duration

8 The 5 Moments WHO The 5 moments

9 Examples of Hand Hygiene Products Easily Accessible at the Point-of-Care Examples of Hand Hygiene Products Easily Accessible at the Point-of-Care Examples of hand hygiene products easily accessible at the point-of-care (WHO, 2009)

10 Hand Gelling Steps Hand Gelling Steps

11 Hand Gelling Steps Hand Gelling Steps

12 Hand washing - Before you start Hand washing - Before you start Attend to your personal needs Remove all hand jewellery Check fingernails-they should be clean and short Check if liquid soap or alcohol gel are available NB: The following procedure applies to hand hygiene in most health care environments. If you are in theatre, scrub procedures would be longer and involve more steps (see Handwashing. Gloving & Gowning module (opens in a new window)). The procedure shown in the following slides is carried out using a scrub sink but would normally be at a hand washing sink in the majority of clinical areas.

13 Procedure - Hand Hygiene (1 of 15) Procedure - Hand Hygiene Open a sterile brush if using, and lie it on a flat surface within the opened packet. Only use a brush on the nails. It can be detrimental to scrub the skin.

14 Procedure - Hand Hygiene (2 of 15) Procedure - Hand Hygiene Get water running to a reasonable flow and temperature.

15 Procedure - Hand Hygiene (3 of 15) Procedure - Hand Hygiene Apply a generous (5ml) amount of liquid soap or antiseptic hand wash.

16 Procedure - Hand Hygiene (4 of 15) Procedure - Hand Hygiene Lather up the hands thoroughly.

17 Procedure - Hand Hygiene (5 of 15) Procedure - Hand Hygiene If using a sterile brush, scrub fingernails thoroughly.

18 Procedure - Hand Hygiene (7 of 15) Procedure- Hand Hygiene First rub hands palm to palm.

19 Procedure - Hand Hygiene (8 of 15) Procedure- Hand Hygiene Right palm over left dorsum and fingers interlaced and vice versa.

20 Procedure - Hand Hygiene (9 of 15) Procedure - Hand Hygiene Palm to palm with fingers interlaced.

21 Procedure - Hand Hygiene (10 of 15) Procedure- Hand Hygiene Backs of fingers to opposing palms with fingers interlaced.

22 Procedure - Hand Hygiene (11 of 15) Procedure - Hand Hygiene Rotational rubbing of left thumb clasped in right palm and vice versa.

23 Procedure - Hand Hygiene (12 of 15) Procedure - Hand Hygiene Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa.

24 Procedure - Hand Hygiene (13 of 15) Procedure - Hand Hygiene Wash the wrists by rotational rubbing with opposing hands.

25 Procedure - Hand Hygiene (14 of 15) Procedure - Hand Hygiene Rinse thoroughly. Be careful to ensure the water runs away from the finger tips towards the wrist.

26 Procedure - Hand Hygiene Procedure - Hand Hygiene Dry the hands thoroughly using a paper towel, then turn off the tap using the paper towel if at an ordinary sink or with your elbow at a scrub sink.

27 Procedure - Hand Hygiene Procedure - Hand Hygiene Dispose of used towel in an ordinary pedal waste bin. If leaving an infected patient use an orange bag or follow local policy.

28 Hand Washing Summary from WHO Hand Hygiene Hand Washing Summary from WHO

29 Hand Washing Summary from WHO Hand Hygiene Hand Washing Summary from WHO

30 Helpful Links References and Helpful Links WHO (2009). WHO Guidelines on Hand Hygiene in Health Care: a Summary. Geneva. WHO Press. Smyth et al (2008.) Journal of Hospital Infection. 69: National Patient Safety Agency (NPSA) (2008). Sourced at : Bandolier provides evidenced based thinking about Healthcare A link to a WHO summary document on Hand Hygiene in Health Care April Sian Williams