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
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Vocabulary
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.
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Part I: Hand Washing Basics
The Goal of Handwashing:
To prevent the transfer of
germs from your hands to
patients
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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
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The Expectation
ACTION
An important matter is to wash your hands more
often
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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
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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
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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
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What Tasks Touch these Parts of
the Body?
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
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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!
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When do you Need to Wash your Hands?
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Important
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)
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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!
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Remember…
Always wash hands after removing gloves
Gloves are not a substitute for hand
washing and need to be removed between
patients
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Part II: Hand Washing Techniques
Let’s Talk about Three Common Techniques
for Hand Hygiene:
Hand wash with soap and water
Alcohol hand rub without water
Surgical hand scrub
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For all Types of Hand Hygiene
Staff should:
Keep nails short (1-2mm)
Wear no nail polish
Remove jewelry, bracelets, wrist watches
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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
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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
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Antiseptics
Remember, an antiseptic is a germ killing
substance that is safe for use on human skin. The
most common antiseptic is alcohol or
chlorhexidine
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Antiseptics (cont’d)
There are other antiseptics that are used with water:
hexachloraphene
iodine
iodophors
para-chloro meta-xelenol
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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
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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
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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
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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
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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
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Compare Hand Hygiene Methods
Routine hand wash Alcohol hand rub Pre-Surgery/Surgical
with soap and water scrub
• Can replace routine
• Only technique when hand wash if no visible • Done before surgery
hands have visible dirt on hands or procedures needing
dirt • Alcohol kills germs sterile technique
• Soap (or ash) and • Also done before • Antiseptic used to kill
water to remove procedures needing germs
germs aseptic technique
Clean under nails with
Wet hands to wrist Place 3-5 ml on dry stick
Use soap or ash hands Wet up to elbow
Rub for at least 15 Rub until dry Use antiseptic, long
seconds acting and rub all
Rinse with running water • No water or towels
surfaces for 2-6 minutes
Dry by air or single use Rinse with running water
needed Dry with sterile towel
towel
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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
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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
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Thank You!