Clean Hands Across Newfoundland and Labrador Hand Hygiene

Objectives To provide a consistent provincial approach to hand hygiene education Components include: Hand hygiene guidelines Hand hygiene education module Hand hygiene auditor education

Hand Hygiene: Key Concepts During healthcare delivery, there are four moments when it is essential that you perform hand hygiene. It is essential that everyone perform hand hygiene using the appropriate technique and time duration in order for it to be effective. Alcohol-based hand rub is the preferred method of Hand Hygiene

Hand Hygiene: WHY ? Hand hygiene is the single most effective way to prevent the transmission of healthcare-associated infections. Good hand hygiene saves lives and reduces the strain on our healthcare system. 1 It takes less than one minute to properly wash hands using soap and water and less than 30 seconds to properly clean hands with alcohol-based hand-rub. Both methods are effective. 1 Roth, Virginia, MD, FRCPC “Hands that harm, hands that heal” November 2006 PowerPoint presentation, slide 31

Hand Hygiene: Importance Did you know that As a health care provider (HCP) you are also a vehicle for carrying around infectious organisms 80% of staff who dressed MRSA infected wounds carried the organism on their hands for 3 hours afterwards Within ½ hour of contact with the environment of a patient with Clostridium difficile, 60% of the hands of staff were contaminated without even touching the patient Performing hand hygiene with soap and water in these cases virtually eradicated these organisms! Stone, S.P. JR Soc Medicine 2001: 94(6); 278-281. Cited in Mitka, M. JAMA 2009: 302(17) reprinted.

Hand Hygiene: Who ? Who is a health care provider? A health care provider is a person delivering care to a client, patient or resident. This may include a volunteer. Staff –people conducting activities in a setting where health care is provided, including but not limited to health care providers.

Hand Hygiene: When The Four Moments of Hand Hygiene have been identified as critical to the prevention of transmission of infections during healthcare delivery. Ontario’s Ministry of Health adapted this WHO’s 5 Moments of Hand Hygiene

Four Moments of Hand Hygiene Before patient / patient environment contact 2. Before aseptic procedure 4. After patient/patient environment contact 3. After body fluid Exposure/ risk

Hand Hygiene: Where Hand Hygiene must be performed at Point of Care Point of Care – the place where three elements come together The patient The healthcare provider The care or treatment involving contact with the patient or his/her surroundings/environment

Definition of Patient’s Environment Single room – everything in the patient’s room Multi-bed room – everything in immediate proximity to the patient

Hand Hygiene: Time Optimal hand hygiene using an alcohol-based hand rub takes 20-30 seconds Minimum time is 15 seconds Optimal hand hygiene using soap and water takes 40 to 60 seconds Both are effective methods Alcohol-based hand rub is the preferred method of Hand Hygiene

To effectively reduce the growth of germs on hands, handrubbing must be performed by following all steps illustrated on the left. Please click here to watch the how to hand rub video.

To effectively reduce the growth of pathogens on hands, handwashing should be performed by following all steps illustrated on the left. Please click here to watch the how to hand wash video.

Hand Hygiene: Obstacles Too busy High workload and understaffing Patient needs perceived as priority Interference with worker/patient relation It is essential that you make time Skin irritation Use lotions & hand rub appropriately Glove use Not a substitute for hand hygiene Not a spontaneous habit Hand Hygiene needs to become as spontaneous as using aseptic technique and all other safety strategies

Effective Hand Hygiene Nails must be kept clean and short Nail polish must not be worn Artificial nails or nail enhancements must not be worn Rings are not worn during Hand Hygiene Arm jewelry, including watches and medical alert bracelets, must be removed or pushed up

Effective Hand Hygiene Gloves do not replace the practice of hand hygiene Let hands dry completely before donning gloves Wear gloves only when indicated Avoid hand washing immediately before or after using an Alcohol Based Hand Rub Use warm water Use hand lotions and creams approved by your RHA Use alternative products if allergic