Hand Hygiene The 5 Moments CAC 11-10-15

Nothing’s Changed: Hand Hygiene is Still Important! It protects the patient, yourself and the health-care environment from harmful germs carried on your hands  Hand hygiene is the #1 way to prevent the spread of infections!

Overview The Five Moments Patient Zone Observations Accountability Immediate Feedback

The World Health Organization’s 5 Moments of Hand Hygiene

Background Why 5 Moments? Focus on moments when pathogen transmission occurs Best practice, best for patients Build awareness Regulatory citations Best practice – per WHO and CDC recommendations cite Regulatory citations: focus on point of care/5 moments.. Cite based on BJH HH policy MD needs a case study

*In accordance with patient zone Moment 1*: When: Clean your hands before touching a patient or their immediate surroundings Immediate surroundings Bedside table Chair Bed rails Linens & etc Activities Physical exam Device manipulation Assisting with patient movement *In accordance with patient zone

Moment 2: When: Clean your hands immediately before performing any clean/aseptic procedures inserting/removing IV wound care (ex: dressing change) drawing labs inserting/removing foley before meds before accessing any line

Moment 3: When: Clean your hands immediately after exposure to blood or bodily fluids obtaining specimens manipulating lines in any way [including insertion and removal] wound care invasive procedures

*In accordance with patient zone Moment 4*: When: Clean your hands after touching a patient physical exam handshake moves blood pressure ambulation clinical patient care *In accordance with patient zone

*In accordance with patient zone Moment 5*: When: Clean your hands after touching the patient’s immediate surroundings bed rails over-bed table chair linens door handles light switches, chairs, etc. *In accordance with patient zone

Understanding the Patient Zone Perform hand hygiene prior to touching the patient or their environment (ie: something located within the patient zone) Move freely between the patient and their environment i.e. May touch immediate surroundings and then touch patient without performing hand hygiene, or vice versa Hand hygiene should still be performed: Before clean/aseptic tasks After exposure to blood Perform hand hygiene prior to exiting the space i.e. After touching the patient or their surroundings

Patient Zone The patient zone includes the patient and their immediate surroundings Private room/bay = anything with the room/bay Shared spaces = anything which is currently dedicated to that specific patient Overbed tables, bed rails, WOWs, PCAs, chair, etc. What is not in the patient zone? Items/areas that are likely to be contaminated w/ more than just that patient’s germs Ex: Computers shared between multiple patients at the same time or located in common areas; door handles; curtains

Understanding the Patient Zone

A Tricky Component: Gloves Hand hygiene should be performed before donning gloves to complete “before” moments Includes prior to entering the room Glove changes require hand hygiene if one of the 5 moments are encountered AND Hand hygiene is still required upon removal of gloves to complete the “after” moment Hand hygiene is always required prior to donning sterile gloves Hand hygiene should be donned prior to donning gloves at room entry, always.

Observations- what has changed? Direct observations of hand hygiene practices Observers will observe in patient rooms, during patient care activities Immediate feedback provided to HCW Observers will give feedback on what they observed to the HCW whenever possible. Feed back will be provided outside of the patient room, not in the presence of patients or visitors When feed back is delivered from an observer, the appropriate response is “Thank you” Any questions or concerns should be directed to Infection Prevention Hand hygiene should be donned prior to donning gloves at room entry, always.

The first step is getting everyone to do hand hygiene.. Another day.. ..but of course, how we perform hand hygiene is also important..

THANK YOU for your commitment to patient safety! #wuCares #accountability #everyhandeverytime THANK YOU for your commitment to patient safety!