Improving Hand Hygiene after a Cerebral Vascular Accident

Slides:



Advertisements
Similar presentations
Safe Surgery Dr. Mohamed Selima. The problem: Complications of surgical care have become a major cause of death and disability worldwide. Data from 56.
Advertisements

Centre for Clinical Guidelines National Danish Clearinghouse for Nursing, Aarhus University Clinical Guidelines – How can we link research and practice.
Essential Steps A Simple Guide…….. Alison Harvey Senior Infection Prevention and Control Nurse.
-George Kresovich -Justin Goodridge
Small steps to healthy feet
Key words in Health and Social Care. People’s rights Choice Confidentiality Protection Equality Consultation.
 TRY TO DISTRACT THE PERSON FROM THE BAD BEHAVIOR  MAINTAIN THE PERSON’S DAILY SCHEDULE AS MUCH AS POSSIBLE  SIGNAL LIGHT WITHIN REACH  ELIMINATION.
Personal Footcare Education Programme Sections Developed by the Scottish Government Personal Footcare Working Group, January With acknowledgment.
Engineering Ergonomics Safety Training Office of Engineering Safety Texas Engineering Experiment Station (TEES) & The Dwight Look College of Engineering.
Overview of services provided in Fareham and Gosport by Southern Health NHS Foundation Trust Fareham and Gosport Voluntary Sector Health Forum May 2015.
Rheumatoid Arthritis By, Marissa Miuccio.
KIGALI HEALTH INSTITUTE FACULTY OF ALLIED HEALTH SCIENCES DENTAL DEPARTMENT LEVEL2 Group work: Management of soft tissue injury Done by: AHSL2/o6/ 0486.
Hand Protection. Gloves  Minimize the risk of acquiring infections from patients  Prevent microbial flora from being transmitted from dental health.
Personal Footcare Education Programme Sections 1- 5 Developed by the Scottish Government Personal Footcare Working Group, January With acknowledgment.
Body Mechanics Positions and movements used to maintain proper posture and avoid muscle and bone injuries. Back injury is the number one injury experienced.
RMI REPETITIVE MOTION INJURIES. What is RMI They are injuries caused by REGULARLY REPEATED MOVEMENTS.
Don’t get too spaced out, but, it’s time for a warm- up activity. Today, we are studying cerebral palsy. Partner up with one other student and, for 4-
H.C.A TRAINING WOUND MANGEMENT Sally Panto Aug
BASIC PRINCIPLES IN OCCUPATIONAL HYGIENE Day ERGONOMICS.
ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute.
Hand Hygiene. Why Is Hand Hygiene Important?  Hands are the most common mode of pathogen transmission.
Diabetes Leading Cause of Blindness 30. Diabetes- A chronic disease that affects the way body cells convert food into energy.
What you will learn in this session 1.The importance and general principles of infection prevention and control 2.The nature of Healthcare Associated.
Holistic Assessment Rapid Investigation
SECTION 14 Skin care and hygiene.
 is most effective way to control infection  Hand Hygiene a general term that applies to routine hand washing, antiseptic hand wash, antiseptic hand.
WOUND ASSESSMENT Lesley Wayne Chapter 31. Introduction This presentation explores the history, ‘red flags’ and examinations pertaining to wound assessment.
DRAFT Prevention of Pressure Ulcers - A Patient Guide There are many ways of reducing the risk of pressure ulcers.
Medical condition that affects control of muscles Cerebral: head Palsy: anything wrong with control of the with control of the muscles or joints in the.
MANUAL HANDLING AWARENESS TRAINING COURSE FOR STAFF.
Children’s Therapy Services. Who are Children’s Therapy Services CEAS - Children’s Equipment and adaptations OT - Occupational Therapy Physio - Physiotherapy.
1 Module 11 The Eating Process Geriatric Aide Curriculum NC Division of Health Service Regulation.
Neglecting a Pressure Ulcer The consequences could result in damaging deeper layers of tissue, damage to muscle and bone (Fig 1 illustrates a grade 4 pressure.
Improvements needed in the care of people living with Dementia.
Fit and Well to Care Aids to Good Practice Eat Well and keep hydrated Keep Physically Active Care for Yourself Get Involved and Make a Contribution Take.
Unit 8 Professional Practice Portfolio 1
Cost Improvements: What goes? What stays? Strengthening the OT Role in the Current Climate Background In the current health care climate driven by key.
Measuring and Reviewing Performance
Bloodborne Pathogen Training
Assisting with the Nursing Process
Rehabilitation and Restorative Care
Dementia Care Managing pain and symptom control
World Health Organization
prof elham aljammas APRIL2017
Developing MSK Services in Southern Derbyshire
Level 2 Diploma in Health and Social Care
INFECTION CONTROL.
BASIC PRINCIPLES IN OCCUPATIONAL HYGIENE
Prevention of Amputation
Chapter 12 Health Facility Settings
Public Information Leaflet
Temporary Works Co-ordination
RMI REPETITIVE MOTION INJURIES
DIABETIC FOOT CARE CARING FOR AND TREATING FOOT AND ANKLE CONDITIONS RELATED TO DIABETES.
Health Risks of Computer Work
Physical Health and Dementia, Delirium and Pain
ECHO 3 Working with GPs
Proprioceptive neuromuscular facilitation (PNF)
Preventing Medication Errors and Omissions
Unit 2: Working in Health and Social Care
Hospital Acquired Pressure Ulcers among SPINAL CORD INJURY PATIENTS
Exercise & fitness instruction BTEC Level 2 in Sport Carlos Munoz.
Preventing Work Related Contact Dermatitis in Catering Workers
PALLIATIVE CARE FOR HEALTHCARE ASSISTANTS YOUR ROLE
Table 1: Analyses of predictors of health care hassles
Prevention of Amputation
Neuro Oncology Therapy Update March 2019
Initial screening procedures
PCA TRAINING PROGRAM.
MODERATE Risk 1 RISK FACTOR PRESENT Deformity OR Neuropathy OR Peripheral arterial disease No other risk factors x6 more likely to ulcerate Annual assessment.
Presentation transcript:

Improving Hand Hygiene after a Cerebral Vascular Accident Elizabeth Carr elizabeth.carr@boltonft.nhs.uk October 2016 Stroke Specialist Nurse 17.10.16

The Black Hole Literature about hand washing of patients is scant There is even less information on care of finger nails Many agencies and NHS discourage staff from cutting finger nails and suggest referral to podiatry Great confusion (podiatry don't cut finger nails either)

5 Key Points Hand washing and nail care are basic, but essential task Spasticity after a neurological diagnosis can make opening the hand difficult Clear care planning and a consistent approach to hand care are needed Specialist training to improve confidence and skill in this area Commissioned care should include time for this task to be carried out as part of holistic intervention

What is spasticity ? Spasticity is a symptom of upper motor neurone damage. Muscles involuntarily tighten and, in the upper limb, a common pattern is of a flexed elbow, flexed wrist and clenched hand and fingers. If not managed correctly, the tight muscles of spasticity can cause problems.

Spasticity Problems Difficulty opening the hand Clenching causing pressure areas between the fingers or on the palm Changed nail growth Muscle shortening Hypersensitivity Pain These problems can lead to eventual changes in the joints and tendons(Bandi and Ward,2010).

Duke L et al (2015) Suggested that caring for hands tightened by spasticity after a stroke ,brain injury or other neurological conditions can be challenging for care staff. Opening and cleaning the hand ,managing pressure areas, cutting nails and reducing pain become more complex if muscles are tight and short Hand hygiene is key for staff but literature on patients hand and nail care is lacking.

Role of Care Staff Health professionals hand-washing compliance is globally accepted as the most important procedure in preventing infection. (National Institute for Health and Care Excellence,2014;Dougherty and Lister,2011) That means our patients hands too.

The Importance of hand hygiene Good skin care involves four processes being carried out on a regular basis: Cleaning Hydrating Protecting Replenishing (Voegeli,2008) Absence of any one of the processes increases the risk of skin damage

Factors affecting hand care Pain Anxiety Limited communication and understanding Cognitive impairment Lack of inhibitory control Overstimulation Mental health issues(Bowers,2010).

Basic hand care advice Explain procedure Gain consent or establish that what you are doing is in the patient`s best interest Visually inspect the hand for any skin/nail damage Report any problems to nurse in charge/line manager/inform GP. These may include; skin breaks, maceration, fungal infections,ingrowing nails, thickened nails or exudate.

Washing Hands Do not force the hand open or move the finger quickly. Use slow, but firm movements. Immerse in a basin /bowl of warm soapy water (check temperature first) The use of non-perfumed aqueous cream can help to lift any dried/dead skin or use hand wipe You may need two people if the hand is very tight-one to hold the hand and distract the patient and one to wash

Washing Hands Dry the hand thoroughly (using clean towel or paper towel) Apply hand cream if the patient wishes and has no relevant allergies Document and report what you have done and any problems encountered

Keep nails short If the patient has a diagnosis of diabetes, rheumatoid arthritis, HIV, or is prescribed anticoagulation medication, do not start nail care without discussing the patients care plan with the nurse or doctor /manager in charge. Perform regular nail care Visually inspect the nails and surrounding skin, check under the nails Clean under the nail

When possible, use single-use nail file or disposable emery board to keep nails short; this reduces need for scissors Shape and shorten the nail following natural shape Dispose of, or clean any equipment used Document and report what you have done. Before using scissors training in general nail care is required and needs to be discussed with line manager

Stretching the hand Needs to be discussed with the occupational therapist or physiotherapist You need to be competent and confident Identify training needs If competent and stated in care plan Continue Take your time

Stretching the hand Gain consent or act in best interest and as care plan Open the hand slowly Use techniques (as trained) for example gently bending the wrist to gain more access to the palm of the hand Carry out stretching/opening of the hand regularly Use hand splint/palm protectors, if provided, for the recommended time scale Monitor the fit, observing for pressure ulcers, reporting any problems to person in charge Hold the hand open with other options, for example a roll of bandage Do not force the hand open or move fingers quickly Do not allow the hand to be unopened for a long period of time

Remember If in doubt give the stroke team a shout Base: Crompton Health Centre Telephone: 01204 46 35 50

Any questions