Hand Hygiene Unfashionable & Undervalued but Important Hilary Humphreys

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 • 14 days extra hospital stay • $3,753 per SSI patient Direct cost of - prolonged stay 36% - antibiotics 6% - other hospital costs 43% - primary care 14% Wound Rep Reg 2007; 15: 474-481

3. Maternal Mortality Rates, General Hospital, Vienna Intervention = Hand Hygiene May 15, 1847 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. 18 16 14 12 10 Percentage 8 6 4 2 0 1846 1847 1848 1849 1850 Semmelweis IP, 1861

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

5. Surgical Audit Seamus McHugh

7. The 5 Moments for Hand Hygiene

8. HIQA Infection Prevention & Control Standards 12 standards • 1. Governance • 2. Implementation of IPC • 3. Infrastructure • 4. HR • 5. Communication • 6. Hand hygiene • 7. Prevention of cross infection • 8. Invasive medical devices • 9. 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) Exposure to C. difficile is suspected or proven

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

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

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