1

2 Despite all the new technology and products, hand hygiene remains the single most important thing YOU can do to prevent the spread of infection and disease. This course will review key concepts of both hand hygiene and Standard Precautions. Topics include: What are Standard Precautions? Why is hand hygiene important? Why are Standard Precautions important? What are some concerns surrounding Standard Precautions?

3 Standard Precautions are a set of infection prevention practices healthcare personnel use to reduce transmission of microorganisms in healthcare settings. Standard Precautions protect both healthcare personnel and patients from contact with infectious agents.

4 Hand hygiene (hand washing with soap and water or use of an alcohol-based hand sanitizer) before and after patient contact and after contact with the immediate patient care environment. Masks and eye protection – when splashes may occur. Gowns – when soiling of clothes may occur.

5 Standard Precautions should be used by healthcare providers caring for or around patients regardless of the patient’s diagnosis and whether or not the patient is known to have a communicable infection. Standard Precautions should be used for all patients, all the time.

6 Infections are a serious problem in healthcare facilities. Every year, an estimated 2 million patients acquire a hospital-related infection. 90,000 die from their infection. Many infections are transmitted from the hands of healthcare providers. Hand hygiene is a part of standard precautions. It can reduce the transmission of hospital associated infections to your patients - and to you.

7 Healthcare providers practice hand hygiene about half the time they should. Incidents where hand hygiene is often not practiced: Immediately before touching a patient, performing an invasive procedure, or manipulating an invasive device Immediately after touching a patient, or after removing gloves After touching items or surfaces in the immediate patient care environment, even if you didn't touch the patient

8 Whenever hands are visibly dirty or contaminated. Before: having contact with patients putting on gloves inserting any invasive device manipulating any invasive device After: having contact with a patient’s skin having contact with bodily fluids or excretions, non- intact skin, wound dressings, contaminated items having contact with inanimate objects near a patient removing gloves

9 Bacteria can survive for DAYS on patient care equipment and other surfaces. Surfaces in the patient care environment – including bed rails, IV pumps, and even computer keyboards – are often COVERED with bacteria. It’s important to practice hand hygiene after you leave the room, even if you only touched equipment or other surfaces.

10 Which hand hygiene method is more effective at killing bacteria?  Soap and water  Alcohol-based hand rub (foam or gel)

11 Which hand hygiene method is more effective at killing bacteria? Soap and water  Alcohol-based hand rub (foam or gel)

12 Which hand hygiene method is less damaging to your skin?  Soap and water  Alcohol-based hand rub (foam or gel)

13 Which hand hygiene method is less damaging to your skin? Soap and water  Alcohol-based hand rub (foam or gel)

14 Alcohol-based hand rubs (foam or gel) kill more effectively and more quickly than hand washing with soap and water. They are less damaging to skin than soap and water, resulting in less dryness and irritation. They require less time than hand washing with soap and water. Bottles/dispensers can be placed at the point of care so they are more accessible.

15

16 An alcohol-based hand rub is the preferred method for hand hygiene for most situations, except when hands are visibly dirty or after using the restroom.

17 HAND RUB (foam and gel) Apply to palm of one hand (the amount depends on specific hand rub product). Rub hands together, covering all surfaces, focusing on the fingertips and fingernails, until dry. Use enough rub to require at least 15 seconds to dry. HANDWASHING Wet hands with water. Apply soap. Rub hands together for at least 15 seconds, covering all surfaces, focusing on fingertips and fingernails. Rinse under running water and dry with disposable towel. Use the towel to turn off the faucet.

18 Colleagues and other staff watch what you do: Research has shown that the actions of clinicians influence the behavior of others. Show your colleagues that hand hygiene is an important part of quality care. Your patients watch you too: Your actions send a powerful message. Show your patients that you are serious about their health.

19 When appropriate, you should wear: Gloves Gowns Masks Eye protection Face shields

20 You should use gloves when hands may become contaminated with blood, body fluids, excretions, or secretions or when touching mucous membranes or non-intact skin, or contaminated surfaces or objects. Common problems with glove use are failure to: Wear gloves when touching open wounds or mucous membranes, such as the mouth and respiratory tract. Wear gloves when touching items that are likely to be contaminated, such as urinary catheters and endotracheal tubes. Change gloves between patients. Remove gloves after patient-care.

21 Put on new gloves before contact with non-intact skin or mucous membranes. Wear gloves during contact with bodily fluids or contaminated items. Remove gloves after caring for a patient - do not wear the same gloves for more than one patient. Do not reuse or wash gloves. Don’t forget hand hygiene after removing gloves – Gloves are NOT a replacement for hand hygiene.

22 Wear a mask and eye protection, or a face shield, during procedures that are likely to generate splashes or sprays of blood, bodily fluids, secretions, and excretions. Wear a gown during procedures that are likely to generate splashes or sprays of blood, bodily fluids, secretions, or excretions. Secure gown appropriately. Remove a soiled gown as soon as possible, and practice hand hygiene after removing the gown.

23 Standard Precautions include hand hygiene and appropriate use of personal protective equipment.

24 Hand lotions are important to prevent skin dryness and irritation. You should use only hospital-approved hand lotions. Other lotions may: make hand hygiene less effective cause breakdown of latex gloves become contaminated with bacteria if dispensers are refilled

25 Healthcare workers with direct patient contact must keep natural nail tips no longer than ¼ inch. Artificial nail enhancements are not permitted. This includes, but is not limited to; artificial nails, tips, wraps, appliqués, acrylics, gels and any additional items applied to the nail surface. Nail polish is permitted, but it must be in good condition with no visible chipping.

26 Improved adherence to hand hygiene has been shown to terminate outbreaks in health care facilities, to reduce transmission of antimicrobial resistant organisms (e.g. methicillin resistant staphylococcus aureus) and reduce overall infection rates. In addition to traditional hand washing with soap and water, CDC recommends the use of alcohol-based hand rubs by health care personnel for patient care because they address some of the obstacles health care professionals face when taking care of patients. Hand washing with soap and water remains a sensible strategy for hand hygiene in non-health care settings and is recommended by CDC and other experts.

27 When health care personnel's hands are visibly soiled, they should wash with soap and water. The use of gloves does not eliminate the need for hand hygiene. Likewise, the use of hand hygiene does not eliminate the need for gloves. Gloves reduce hand contamination by 70 percent to 80 percent, prevent cross-contamination and protect patients and health care personnel from infection. Hand rubs should be used before and after each patient just as gloves should be changed before and after each patient.

28 For More Information – See KSSH Policy Hand HygienePolicy Hand Hygiene

29 1.Hand hygiene is the single most important thing you can do to prevent the spread of infection and disease. True or False 2.Standard precautions should only be used with patients who are known to have communicable infections. True or False 3.Every year, an estimated total of 30,000 patients die from hospital related infections. True or False 4.Bacteria can survive for days on patient care equipment, such as bed rails, IV pumps, and even computer keyboards. True or False 5.When health care personnel's hands are visibly soiled, they should use soap and water. True or False

30 6. You should use gloves when touching mucous membranes. True or False 7. Any type of lotion may be used to prevent hands from becoming dry. True or False 8.Healthcare workers with direct patient contact must keep natural nail tips no longer than ½ inch. True or False 9.Healthcare workers with direct patient contact are not permitted to wear artificial nail enhancements. True or False 10. Improved adherence to hand hygiene has been shown to terminate outbreaks in health care facilities, reduce transmission of antimicrobial resistant organisms and reduce overall infection rates. True or False