Effective Handwashing

Agenda
Why A

Should We Wash Our Hands?

Should We Wash Our Hands? and Gloves

Few Definitions Should We Wash Our Hands? Gels

When How

Handwashing Alcohol

Source
APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings
Elaine L. Larson, RN, PhD, FAAN, CIC Printed in the American Journal of Infection Control Vol. 23, No. 4, pp 251-269, August 1995

WHY Should We

Wash Our Hands?

Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

It is known that handwashing causes a significant reduction in the carriage of potential pathogens on the hands.
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Handwashing can result in reductions in patient morbidity and mortality from nosocomial infection.
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Definitions
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Handwash(ing):
A process for the removal of soil and transient microorganisms from the hands.

Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Hand Antisepsis:
A process for the removal or destruction of transient microorganisms.

Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Plain or Nonantimicrobial Soap:

Detergent-based cleansers in any form (e.g. bar, liquid, etc.) used for the primary purpose of physical removal of dirt and contaminating microorganisms. Work principally by mechanical action and have no bacterial activity.

Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Antimicrobial Soap:
A

soap containing an ingredient with invitro and in-vivo activity against skin flora.

Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Health Care Personnel Handwash:

A

broad-spectrum, antimicrobial preparation that is fast-acting, non-irritating, and designed for frequent use that reduces the number of transient flora on intact skin to a baseline level.
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Transient Flora:
Microorganisms

isolated from the skin but not demonstrated to be consistently present in the majority of persons.
contaminating flora or noncolonizing flora.

A.K.A.

Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Resident Flora:

Microorganisms persistently isolated from the skin of most persons. These microorganisms are considered permanent residents of the skin and are not readily removed by mechanical friction. A.K.A. colonizing flora
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

WHEN Should We
Wash Our Hands?
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

WHEN Should We Wash Our Hands?

The decision regarding when handwashing should occur depends on:

The intensity of contact with patients. The degree of contamination that is likely to occur with that contact. The susceptibility of patients to infection. The procedure to be performed.
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

WHEN Should We Wash Our Hands?

Hands must be washed thoroughly with soap and water . . .
When visibly soiled Before and after patient contact After contact with a source of microorganisms After removing gloves

Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

WHEN Should We Wash Our Hands?

Before the performance of invasive procedures. When persistent antimicrobial activity on the hands is desired. When it is important to reduce numbers of resident skin flora in addition to transient microorganisms.
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

HOW Should We
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Wash Our Hands?

HOW Should We Wash Our Hands?

Wet hands with running water. Apply soap. Thoroughly distribute soap over all hand surfaces. Vigorously rub hands together for 10-15 seconds. Rinse soap. Dry hands with a disposable towel. Turn water off using a disposable towel (unless foot operated).

Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

A Few Helpful Tips . . .

Be sure to thoroughly wash all skin surfaces. Pay close attention to hard-to-reach areas:
Between the fingers Finger tips Under the nails

Use a nail brush if necessary

Use

warm water not too hot, not too cold

Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

A Few Other Suggestions . . .

Lotions
Lotions may be used to prevent skin dryness.

Jewelry
Total bacterial counts are higher when rings are worn.
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Handwashing and Gloves

Soap and water handwash or an antiseptic handrub should be used after glove removal.
Compatibility between lotion and antiseptic products on the integrity of gloves should be considered
Source: APIC Guideline for Handwashing and Hand Antisepsis in Health Care Settings

Alcohol Gels

Alcohol Gel Waterless Hand Antiseptics

Use

high concentrations of alcohol to provide hand antisepsis

Usually 60-65% ethyl alcohol

Do

not require water Do not require hand drying with a towel

Alcohol Gel Waterless Hand Antiseptics

May

provide a way to achieve hand antisepsis

Effective Quick Convenient Portable
Usually available in small bottles Ready when you are!

Alcohol Gel Waterless Hand Antiseptics

BUT
A

complement for regular soap and water, NOT a replacement recommended when hands are soiled with dirt and/or organic material

Not

Questions?

Good Luck and Good Handwashing!

Effective Handwashing

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