1. The Importance of Hand Hygiene Handwashing, Antiseptic Handwashing, & Alcohol-based Handrub Ms. Sheridan Put Your Hands Together: http://www.youtube.com/watch?v=ZlDqcmY_EV8

2. http://www.youtube.com/watch?v=PT45b7NLYCQ Eww! Only 5% of us wash our hands Correctly Nordqvist, C. (2013, June 12). "Only 5% Wash Their Hands Properly After Going To The Toilet." Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/261875.php. http://www.medicalnewstoday.com/articles/261875.php

3. Why all the Fuss About Hand Hygiene? Clean hands are the SINGLE most important factor in preventing spread of pathogens. Pathogen: Disease causing agent examples: bacteria, viruses, fungi

4. What happens if you don’t wash your hands frequently? You pick up germs from other sources and then you can infect yourself. One of the most common ways people catch colds is by rubbing their nose or their eyes after their hands have been contaminated with the cold virus.

5. What happens if you don’t wash your hands frequently? You can also spread germs directly to others or onto surfaces that other people touch. Before you know it, everybody around you is getting sick. The important thing to remember is that, in addition to colds, some pretty serious diseases like: hepatitis A, meningitis, MRSA and infectious diarrhea -- can easily be prevented if people make a habit of washing their hands.

6. Wash Your Hands! Before, during and after preparing food Before eating Before and after caring for someone who is sick After using the toilet After changing diapers After blowing your nose, coughing, or sneezing After picking up animal waste Before and after cleaning a wound or cut After handling or touching a pet/animal After touching garbage When in doubt, wash your hands!

7. Healthcare Workers and Hand Hygiene The CDC estimates that each year nearly 2 million patients in the USA get an infection in hospitals, and about 90,000 of these patients die as a result of their infections. Nosocomial: Hospital Acquired Infection

8. Semmelweis https://www.youtube.com/watch?v=wUp9mUyVIGA

9. Ignaz Semmelweis In 1846 Ignaz Semmelweis observed that women whose babies were delivered by students and physicians in the First Clinic at the General Hospital of Vienna consistently had a higher mortality rate than those whose babies were delivered by midwives in the Second Clinic. He noted that physicians who went directly from the autopsy suite to the obstetrics ward had a disagreeable odor on their hands despite washing their hands with soap and water upon entering the obstetrics clinic. His theory: puerperal fever, which was causing the deaths, was caused by “cadaverous particles” transmitted from the autopsy suite to the obstetrics ward via the hands of students and physicians.

10. Semmelweis’ Intervention: Handwashing with a solution of chlorinated lime Hand hygiene basin at the Lying-In Women’s Hospital in Vienna, 1847.

11. Hand Hygiene: Not a New Concept Semmelweis’ Hand Hygiene Intervention ~ Hand antisepsis reduces the frequency of patient infections ~ Adapted from: Hosp Epidemiol Infect Control, 2 nd Edition, 1999.

12. Colonized vs Infected: What is the Difference? People who carry bacteria without evidence of infection (fever, increased white blood cell count) are colonized. If an infection develops, it is usually from bacteria that colonize patients. Bacteria that colonize patients can be transmitted from one patient to another by the hands of healthcare workers. ~ Bacteria can be transmitted even if the patient is not infected ~

13. What We Know! Handwashing reduces the incidence of healthcare associated infections. Handwashing reduces transmission of pathogens. http://www.youtube.com/watch?v=tmMGwO4N0Vc

14. Ability of Hand Hygiene Agents to Reduce Bacteria on Hands Adapted from: Hosp Epidemiol Infect Control, 2 nd Edition, 1999. 0.0 1.0 2.0 3.0 060180minutes 0.0 90.0 99.0 99.9 log% Bacterial Reduction Alcohol-based handrub (70% Isopropanol) Antimicrobial soap (4% Chlorhexidine) Plain soap Time After Disinfection Baseline

15. Efficacy of Hand Hygiene Preparations in Killing Bacteria Good Better Best Plain Soap Antimicrobial soap Alcohol-based handrub

16. Epidermal water contentSelf-reported skin score Dry HealthyDry Healthy Effect of Alcohol-Based Handrubs on Skin Condition ~ Alcohol-based handrub is less damaging to the skin ~ Boyce J, Infect Control Hosp Epidemiol 2000;21(7):438-441.

17. Handwashing Review First wet your hands and apply soap. Next rub your hands vigorously together and scrub all surfaces. Don’t forget: wrists, nails, between the fingers, … Continue for 10 - 15 seconds or about the length of a little tune. It is the soap combined with the scrubbing action that helps dislodge and remove germs. Sing happy birthday twice! Rinse well and dry your hands with a clean towel.

18. Can a Fashion Statement Harm the Patient? ARTIFICIAL POLISHED NATURAL Edel et. al, Nursing Research 1998: 47;54-59 Avoid wearing artificial nails, keep natural nails <1/4 inch if caring for high risk patients (ICU, OR)

19. What is the Story on Moisturizers and Lotions? ONLY USE facility-approved and supplied lotions Because: Some lotions may make medicated soaps less effective Some lotions cause breakdown of latex gloves Lotions can become contaminated with bacteria if dispensers are refilled ~ Do not refill lotion bottles ~

20. What do you remember?

21. 1.Plain soap and water 2.Antimicrobial soap and water 3.Alcohol-based handrub Which hand hygiene method is best at killing bacteria?

22. 1.Plain soap and water 2.Antimicrobial soap and water 3.Alcohol-based handrub Which hand hygiene method is best at killing bacteria?

23. Which of the following hand hygiene agents is LEAST drying to your skin? 1.Plain soap and water 2.Antimicrobial soap and water 3.Alcohol-based handrub

24. Which of the following hand hygiene agents is LEAST drying to your skin? 1.Plain soap and water 2.Antimicrobial soap and water 3.Alcohol-based handrub

25. When a healthcare worker touches a patient who is COLONIZED, but not infected with resistant organisms (e.g., MRSA or VRE) the HCW’s hands are a source for spreading resistant organisms to other patients. 1.Strongly agree 2.Agree 3.Don’t know 4.Disagree 5.Strongly disagree

26. When a healthcare worker touches a patient who is COLONIZED, but not infected with resistant organisms (e.g., MRSA or VRE) the HCW’s hands are a source for spreading resistant organisms to other patients. 1.Strongly agree 2.Agree 3.Don’t know 4.Disagree 5.Strongly disagree

27. A co-worker who examines a patient with MRSA, then borrows my pen without cleaning his/her hands is likely to contaminate my pen with MRSA. 1.Strongly agree 2.Agree 3.Don’t know 4.Disagree 5.Strongly disagree

28. A co-worker who examines a patient with MRSA, then borrows my pen without cleaning his/her hands is likely to contaminate my pen with MRSA. 1.Strongly agree 2.Agree 3.Don’t know 4.Disagree 5.Strongly disagree

29. Use of artificial nails by healthcare workers poses no risk to patients. 1.Strongly agree 2.Agree 3.Don’t know 4.Disagree 5.Strongly disagree

30. Use of artificial nails by healthcare workers poses no risk to patients. 1.Strongly agree 2.Agree 3.Don’t know 4.Disagree 5.Strongly disagree

31. It is estimated that one out of three people do not wash their hands after using the restroom. and 95% of people wash their hands improperly. Do you????

32. The Power is in YOUR HANDS! Photo Credit: Plan Haiti

33. http://www.cdc.gov/handhygiene/training.html

34. https://www.youtube.com/watch?v=dyLEd9cng5U Proper Glove Removal