1. Hand Hygiene What should you do and what do we do?

2. When should I wash my hands with Soap and Water? Soap and water –It takes approximately three minutes to wash and dry your hands effectively. –Use when the hands are visibly soiled. The soap and water will wash away the contamination. –Use when in contact with a patient who has diarrhoea - alcohol gel won’t work. –Use if the gel starts to feel ‘sticky’ on your hands. Alcohol gel –Very quick and effective. –Use between patients. –Use when entering or leaving a ward. –Use after removing gloves –Doesn’t work against Clostridium difficile or any of the diarrhoea causing viruses. Use soap and water instead. When should I wash my hands with Alcohol Gel?

3. Ability of Hand Hygiene Agents to Reduce Bacteria on Hands 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

4. When washing hands with soap and water use this technique

5. Handwashing - Techniques Always wet your hands before you put soap on – it will help to stop them getting dry Make sure you dry them properly so they don’t get chapped These are the areas of the hands that people usually miss

6. Alcohol Gel This kills 99.8% of bugs living on your hands The gel contains hand moisturisers to keep your hands in good condition – therefore using alcohol gel is much kinder to the hands than soap and water Alcohol gel should only be used on visibly clean hands. So if your hands look visibly dirty – wash them.

7. Use this technique to clean your hands when using alcohol gel Squirt once or twice into the palm of your left hand Dip your right hand fingers into the gel making contact with your left palm Transfer the remaining gel into your right palm Dip your left hand fingers into the gel making contact with the right palm Then rub the remaining gel all over your hands, make sure you rub the backs of your hands too. 123 456

8. We have been auditing our staff’s hand hygiene every month since 2005 We base our audit tool on the World Health Organisations’ (WHO) recommendations of when hospital staff should wash their hands: Our staff should clean their hands: 1.Before patient contact 2.Before an aseptic task 3.After body fluid exposure 4.After patient contact 5.After contact with the patient surroundings We conduct unannounced hand hygiene audits every month in all areas where patients are cared for. The audits last 20 minutes and are conducted by an army of trained auditors (more than 100). who are nurses, physios, radiologists and other healthcare staff. They feedback the audit results to the nurse in charge of each area. The results are also presented at key meetings, published in the Trust News and sent to all executives, general managers and senior nurses and doctors. WHO (2007)

9. This shows how the hand hygiene of our staff has improved over time… …but we could do better and we are continuing to work at it.