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Hand Hygiene. Session 3: Infection Control Basics. Learning Objectives: . By the end of this session, participants will: Wash their hands more often on the job Remove germs when they do wash their hands. Vocabulary. Disinfectant - a germ killing substance

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hand hygiene

Hand Hygiene

Session 3: Infection Control Basics

learning objectives
Learning Objectives:

By the end of this session, participants will:

  • Wash their hands more often on the job
  • Remove germs when they do wash their hands
  • Disinfectant - a germ killing substance
  • Antiseptic - a disinfectant for use on skin
  • Microbes or germs - organisms too small to see including viruses, bacteria, and fungi etc.
  • Hand hygiene - all types of hand cleansing with and without water
  • HCW - health care worker, this includes contract workers, cleaners and aides
  • Invasive - entering the blood stream or the organs inside of the body
  • Mucous membranes - skin inside the mouth, nose, rectum, vagina, etc.
the goal of handwashing
The Goal of Handwashing:
  • To prevent the transfer of germs from your hands to patients
1 protect the patients
1. Protect the Patients
  • Handwashing helps stop the spread of germs between patients and between staff and patients
  • It protects both the patients and the caregivers
the expectation
The Expectation


An important matter is to wash your hands more often

can i make my patients sicker
Can I Make my Patients Sicker?
  • Every time you touch people or objects, your fingers leave germs on the skin and pick up new germs
  • Wet hands transfer more germs than dry hands. Always dry your hands after washing them
hand washing is important for patients and family too
Hand Washing is Important for Patients and Family Too
  • If patients wash their hands, they can remove hospital germs before the germs enter the body
  • Your supervisor should provide water, soap or ash, and towels for the patient and family members at convenient places for hand washing
doesn t skin protect people from germs
Doesn’t Skin Protect People from Germs?

Yes and No

  • Yes!
    • Skin is a good barrier and germs can be washed off when a patent bathes or washes hands
  • No!
    • Skin is a good thick barrier BUT germs on the skin can get inside the body where skin is thin or broken
    • Eyes, the inside of the nose, the mouth, vagina, and rectum have thin skin
    • Germs can pass through thin skin more easily than through than the thick skin on our feet and hands
germs can get inside through broken skin
Germs can Get Inside through Broken Skin

Germs get inside when we cut, or pierce the skin or touch open wounds:

  • Examples: surgery, injections, incisions to drain abscesses, biopsies, injections, changing dressings, childbirth
tubes can also carry germs into the body
Tubes can also Carry Germs into the Body

Germs get carried inside by tubes that go through the skin:

  • Example: urinary catheters, IV lines, intra-thoracic drains, suction catheters
  • Tubes are a like a metro system for easy transport through the body!

Wash your hands before and after you:

  • Touch the eyes, give eye drops
  • Touch the inside of the nose (NG tubes)
  • Assist with pelvic exams
  • Do colonoscopies or give enemas
  • Touch any item that touches thin skin (mucous membranes)
wash hands and wear gloves when opening tubes that enter the body
Wash Hands and Wear Gloves when Opening Tubes that Enter the Body
  • Even a few germs deposited inside the body can cause an infection
  • It is important to have as few germs on the hands and tools as possible
  • Opening a urinary catheter or intra-thoracic drain puts the patient at risk
  • Staff must do hand hygiene - WEAR GLOVES!
  • Always wash hands after removing gloves
  • Gloves are not a substitute for hand washing and need to be removed between patients
let s talk about three common techniques for hand hygiene
Let’s Talk about Three Common Techniques for Hand Hygiene:
  • Hand wash with soap and water
  • Alcohol hand rub without water
  • Surgical hand scrub
for all types of hand hygiene
For all Types of Hand Hygiene

Staff should:

  • Keep nails short (1-2mm)
  • Wear no nail polish
  • Remove jewelry, bracelets, wrist watches
routine hand wash
Routine Hand Wash
  • Use poured or running water; never dip hands in a bowl of water
  • Use hand soap, ash, or sand (none kill germs, all are equally effective)
  • Rub all surfaces on both hands and both wrists - front, back and between - for at least 15 seconds
  • Rinse under running water
  • Dry hands with a clean towel or air dry
soap bars can be contaminated
Soap Bars can be Contaminated
  • Soap doesn’t kill germs, so hands can easily contaminate it
  • Use very small bars of soap,or put soap on a string or rack to keep it dry
  • Refill containers with soap or antiseptics only after washing and drying
  • Remember, an antiseptic is a germ killing substance that is safe for use on human skin. The most common antiseptic is alcohol or chlorhexidine
antiseptics cont d
Antiseptics (cont’d)
  • There are other antiseptics that are used with water:
    • hexachloraphene
    • iodine
    • iodophors
    • para-chloro meta-xelenol
alcohol hand rub without water
Alcohol Hand Rub Without Water
  • Antiseptics kills germs
  • Alcohol hand rub can be used without water, and is practical for a busy ward
  • If hands have visible dirt, handwashing with soap/ash and water is necessary first
alcohol hand rub
Alcohol Hand Rub
  • Can replace routine handwashing, unless the hands are dirty
  • In addition, alcohol or other antiseptics should be used before placing IV, urinary catheters, doing dressing changes or other procedures requiring aseptic technique
danger danger
Danger! Danger!
  • Many other disinfectants are UNSAFE for for human skin
  • Methanol is dangerous: Methylated spirits (i.e. a small amount of methanol in ethyl alcohol or isopropyl alcohol) is safe
  • The label of FAMISOL says it is an antiseptic. This is not true. FAMISOL should not be used on skin
how to clean hands with alcohol if visible dirt is not present
How to Clean Hands with Alcohol if Visible Dirt is not Present
  • Place a 2 rupee size spot (3-5 ml) in the palm of one hand
  • Rub hands together, all sides, fingers, wrist until dry
how is the surgical hand scrub different
How is the Surgical Hand Scrub Different ?
  • The hands are wet and washed up to the elbow
  • A nail file is used to clean under the nails under running water
  • A long acting antiseptic is used, often (chlorhexidine, isodophors, sometimes with alcohol)
  • Hands are rubbed for 2-6 minutes and then washed under running water
  • Hands are dried on a sterile towel
hospital hand hygiene is different from cultural or social practises
Hospital Hand Hygiene is Different from Cultural or Social Practises
  • A hospital has more dangerous germs and more vulnerable people that settings at home
  • Teach the hospital cleaners, aides, support staff, servants and other kind souls who help us everyday to:
    • Wash both hands
    • Use soap or ash
    • Rub until both hands are clean
    • Rinse hands under running water
    • Dry their hands
the objective
The Objective
  • To encourage you to wash your hands more often, and to remove more germs when you do so
  • This is only possible if the hospital provides soap, water, alcohol rubs, towels, towels and other facilities that make it possible
  • The IC committee pledges to work to make it easier for you to protect your patients and yourself