Sunday, January 6, 2013

Back To Basics Handwashing

The WHO and the CDC recommend established best practices for hand hygiene. According to the WHO, there are five key moments when a healthcare worker should engage in hand hygiene:
- before touching the patient
- after touching a patient
- before touching an area of at risk of infection
- after body fluid exposure risk
- after touching the patient environment
Hand hygiene should also be practiced after touching wound dressings and before handling medication or preparing food. Hand hygiene is also needed before putting on gloves to insert an invasive device, such as a catheter. After removing sterile or non-sterile gloves, hand hygiene should also be practiced. The CDC says that bacteria linger on the hands of healthcare workers after they remove gloves. It is thought pathogens penetrate glove defects or hands get contaminated when healthcare workers remove their gloves. Depending on the procedure, hand hygiene is also recommended before wearing gloves.
Alcohol handrubs and soaps should not be used at the same time. Here is a review of the appropriate times for each:
Handwashing:
- Wash with soap and water after using the restroom, before eating and when hands are visibly contaminated. It is also recommended when multi-resistant spores are present. The mechanical friction of handwashing helps remove the spores and should be practiced in conjunction with wearing gloves. Medicated soap does make a difference in this case.
- Wash hands for 40 to 60 seconds and avoid hot water because it increases skin irritation
- Pat hands dry using paper towels or use hand driers to reduce the risk of recontamination. Patting hands dry reduces hand irritation. Hand dryers should dry hands quickly without aerosolizing pathogens.
- Use a paper towel to turn off the tap to avoid recontamination.
Alcohol-based handrub:
- Use alcohol-based handrubs for hand hygiene at every other hand hygiene opportunity when handwashing is not recommended.
- Use a palm full of alcohol handrub and cover hands completely. Rub hands until dry, this should last between 20 seconds to 40 seconds. If it takes less than 15 seconds you should use more of the product.

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