HAND Hygiene Module PDF

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notes from hand hygiene module for week 1 notes...

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HAND HYGIENE MODULE- INFECTION CONTROL Healthcare Associated Infections Healthcare associated infections: infections acquired in healthcare facilities and infections that occur as a result of healthcare interventions, which may only be noticeable after people leave the healthcare facility. Healthcare associated infections can cause patients pain and suffering, with their management using valuable healthcare resources. Healthcare associated infections can cause significant harm to patients, some of whom die as a result. They can also prolong hospital stay, and create additional work for clinicians. Healthcare associated infections are a potentially preventable ‘adverse event’. Prevention of healthcare associated infections is the responsibility of all healthcare workers. Many studies have identified that microorganisms implicated in healthcare associated infections can be isolated from the normal intact skin. These can be microorganisms present on the skin as resident flora, which live long term under the superficial cells of the epidermis. More commonly, they are part of the transient flora on the skin surfaces, which include bacteria, viruses and fungi that are acquired through direct skin contact (between patients, staff or visitors), or contact with contaminated environmental surfaces (shared patient equipment, curtains etc). These microorganisms can be easily transmitted from the hands of healthcare workers to patients or their environment. Microorganisms exist everywhere in the environment, but not all cause infection. Colonisation is the sustained presence of replicating microorganisms on or in the body without the production of an immune response (infection) or disease, and is a potential source of transmission. Infection is the successful transmission of microorganisms to the host with subsequent multiplication, colonisation and invasion. Infection may be clinical or subclinical and may not produce identifiable disease. Patients particularly vulnerable to colonisation and healthcare associated infections include those with severe underlying medical disease, recent surgery or indwelling devices, such as urinary catheters or endotracheal tubes.

Infection Prevention - Standard Precautions Standard precautions are work practices that provide a first-line approach to infection prevention in the healthcare environment. Standard precautions apply to all patients in all healthcare settings, regardless of suspected or known infection status. They are based on the principle that all blood and body fluids, secretions and excretions, may contain transmissible microorganisms. It is essential that standard precautions are applied at all times as: people may be placed at risk of infection from others who carry microorganisms people may be infectious before signs or symptoms of disease are recognised or detected people may be at risk from microorganisms present in the surrounding environment, including environmental surfaces or from equipment there may be an increased risk of transmission associated with specific procedures and practices Standard precautions include:         

hand hygiene, before and after every episode of patient contact the use of personal protective equipment the safe use and disposal of sharps routine environmental cleaning reprocessing of reusable medical equipment and instruments respiratory hygiene and cough etiquette aseptic technique waste management appropriate handling of linen

Transmission of microorganisms by hands Transmission of healthcare associated microorganisms from one patient to another via healthcare workers' hands requires 5 sequential steps (1): 1. Organisms are present on the patient's skin, or have been shed onto inanimate objects immediately surrounding the patient 2. Organisms must be transferred to the hands of the healthcare workers 3. Organisms must be capable of surviving for at least several minutes on healthcare workers' hands 4. Hand washing or hand rubbing by the healthcare worker must be inadequate or entirely omitted, or the agent used for hand hygiene inappropriate 5. The contaminated hand or hands of the healthcare workers must come into direct contact with another patient or with an inanimate object that will come into direct contact with the patient

Hand hygiene targets the following : -

cross-colonisation of patients endogenous and exogenous infection in patients infection in HCWs cross-colonisation of the healthcare environment including HCWs.

Healthcare workers can unknowingly transmit microorganisms they have picked up on their hands from a previous patient contact or contact with the environment, to the next patient What is Hand Hygiene? Hand hygiene is the single most effective action to reduce healthcare associated infections. Hand hygiene is a general term referring to any action of hand cleansing. Hand hygiene includes: Applying an alcohol-based hand rub to the surface of the hands (including liquids, gels and foams) Or Washing hands with the use of water and soap or a soap solution, either non-antimicrobial or antimicrobial When performed correctly, hand hygiene results in a reduction of microorganisms on hands. Who should perform Hand Hygiene? Everyone should perform hand hygiene, whether at home, in hospital, or in the community. It is especially important that everyone who enters a healthcare facility performs hand hygiene. It’s not only the Nurses or Doctors who need to perform hand hygiene regularly, but everyone who works, or volunteers in a healthcare facility, including patients and visitors. However, it is the healthcare workers who are more likely to transfer infections as they have regular and prolonged contact with multiple patients and many pieces of shared equipment. Yet, ANYONE who visits multiple patients' bedsides, or passes items to multiple patients can do similar harm. Bed Making  Bring everything you need to bedside e.g., linen basket, clean sheets o Fold sheets inwards to minimise spread of germs  Start from bottom of bed  Make sure two creases run down lateral sides of the mattress  Fold sheet under bottom of mattress

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Take corner and make a triangle, folding it flat on top of bed o Tuck left over bottom part under bed Fold and tuck triangle part over that Leave loose side hanging...