1. Hand Hygiene Unfashionable & Undervalued but Important Hilary Humphreys Royal College of Surgeons in Ireland (RCSI) & Beaumont Hospital, Dublin

2. Costs of Surgical Site (Wound) Infection 4.5 year study in Valencia, Spain 4.5 year study in Valencia, Spain 14 days extra hospital stay 14 days extra hospital stay $3,753 per SSI patient $3,753 per SSI patient Direct cost of Direct cost of - prolonged stay 36% - prolonged stay 36% - antibiotics 6% - antibiotics 6% - other hospital costs 43% - other hospital costs 43% - primary care 14% - primary care 14% Wound Rep Reg 2007; 15: 474-481

3. Maternal Mortality Rates, General Hospital, Vienna 0 2 4 6 8 10 12 14 16 18 18461847184818491850 Semmelweis IP, 1861 Intervention = Hand Hygiene May 15, 1847 Percentage Hands scrubbed in a chlorinated lime solution before every patient contact and particularly after leaving the autopsy room. …. mortality rate dropped dramatically to 3% in the clinic most affected.

4. Beaumont Hospital Hand Hygiene Audit Sept 2009 Mean score for hand hygiene was 59% Individual wards results ranged from 41% to 77% Would you get on a plane where important processes are carried out only 60% of the time?

5. Surgical Audit Seamus McHugh

7. The 5 Moments for Hand Hygiene

8. HIQA Infection Prevention & Control Standards 12 standards 1. Governance1. Governance 2. Implementation of IPC2. Implementation of IPC 3. Infrastructure3. Infrastructure 4. HR4. HR 5. Communication5. Communication 6. Hand hygiene6. Hand hygiene 7. Prevention of cross infection7. Prevention of cross infection 8. Invasive medical devices8. Invasive medical devices 9. Microbiology laboratories9. Microbiology laboratories 10. Outbreak management 11. Surveillance 12. AMR.

9. How to Clean Your Hands –Alcohol-based handrub, preferred routine method if hands are not visibly soiled –Handwashing with soap & water – essential when When hands are visibly dirty or visibly soiled, e.g. visible body fluids)When hands are visibly dirty or visibly soiled, e.g. visible body fluids) Exposure to C. difficile is suspected or provenExposure to C. difficile is suspected or proven

10. Gloves & Handwashing The use of gloves does not replace the need to clean your hands! GLOVES PLUS HAND HYGIENE = CLEAN HANDS GLOVES WITHOUT HAND HYGIENE = TRANSMISSION

11. This takes only 20–30 seconds! But I am too busy?

12. Pittet D et al. The Lancet Infect Dis 2006 Lets avoid this….