Beruflich Dokumente
Kultur Dokumente
H Y GIEN E
Jerome H.
Mamaril RN
OBJECTIVES
OUTLINE
HISTORY OF
HANDWASHING
A French Pharmacist
demonstrated that
solutions containing
chloride of lime or soda
could eradicate the foul
odor associated with
human corpses and be
used as disinfectants
and antiseptics
182
HISTORY OF
HANDWASHING
Ignaz Philipp
Semmelweis insisted
that physicians cleanse
their hands with chlorine
solution between
patients. Thereafter, the
maternal mortality rate
in the First Clinic
dropped dramatically.
184
(CDC,
HISTORY OF
HANDWASHING
The U.S. Public Health Service
recommendations directed
personnel to wash their
hands with soap and water for
1 to 2 minutes before and
after patient
contact. Rinsing hands with an
antiseptic agent was believed to
be less effective than hand
washing with plain soap and
was recommended only in
emergencies or in areas where
sinks were not available.
196
HISTORY OF
HANDWASHING
Guidelines on hand washing
practices in hospitals were published
by CDC. They recommended hand
washing with plain soap between
patients and
washing with antimicrobial
products before and after
performing invasive procedures.
Waterless antiseptic agents such as
alcohol-based solutions were
recommended only in situations
where sinks were not
available.
1975 &
1985
HISTORY OF
HANDWASHING
Healthcare Infection Control
Practices Advisory Committee
(HICPAC) recommended that upon
leaving the rooms of patients with
multi-drug resistant pathogens
such as methicillin-resistant
Staphylococcus aureus (MRSA),
caregivers use either antimicrobial
soap or a waterless antiseptic
agent to cleanse their hands. These
guidelines also recommended
hand washing and hand antisepsis
for routine patient care.
1995 &
HISTORY OF
HANDWASHING
200
HISTORY OF
HANDWASHING
World Health Organization (WHO)
reaffirmed the recommendation to
wash hands with soap and water
when visibly dirty, soiled with blood
or other body fluids, or exposed to
potential spore-forming
pathogens, such as Clostridium
difficile.
When hands are not visibly soiled,
the WHO recommended the use of
alcohol-based hand rubs as the
preferred means for routine
hand antisepsis
200
(WHO,
HISTORY OF
HANDWASHING
Although the guidelines of all these
healthcare organizations have been
adopted by the majority of
hospitals, adherence by healthcare
providers to recommended hand
washing protocols remains low. For
this reason, various professional
groups have undertaken studies to
identify factors that improve
adherence to hand hygiene
protocols.
201
SOURCES &TRANSMISSION OF
PATHOGENS
SOURCES &TRANSMISSION OF
PATHOGENS
Patient
Inanimate
Objects
SOURCES &TRANSMISSION OF
PATHOGENS
HAND HYGIENE
PRODUCTS
HAND HYGIENE
PRODUCTS
IODINE AND
IODOPHORS
WHO,
2012
Missed Spots in
Washing Hands
Webs of
fingers
Thumbs
Palms
Nails
Backs of
fingers &
hands
Running
Water
Soa
p
Liqui
d
Soap
Sanitiz
er
1
Palm to palm
Base of thumbs
Paper
Towel
2
Back of hands
Between fingers
Fingernails
Wrists
Towel
Sink
WASTE BIN
Back of fingers
1. Remove
hand /wrist
jewelries, watch
2. Keep
your nails
short
X
3. Avoid nail
polish and
artificial nails
HAND HYGIENE
PROCEDURE
HAND HYGIENE
PROCEDURE
1 ) PALM TO PALM
2 ) R i g h t Palm over
dorsum and vice
versa
3 ) Palm t o palm,
fingers
interlaced
4 ) Back of fingers t o
opposing Palms, fingers
interlocked
5 ) Rotational r u b b i n g of r i g h t t h u m b
clasped i n l e f t p alm and vice
versa
BARRIERS TO HAND
HYGIENE
Inaccessible hand hygiene supplies
Skin irritation caused by hand hygiene agents
Hand washing and hygiene products thought to
be harmful to the skin
Priority of care (the patients need takes
priority over hand
hygiene)
Lack of knowledge of the guidelines
Lack of feedback to encourage compliance
Insufficient time for hand hygiene
Forgetfulness
High workload and understaffing
Lack of scientific information about healthcare-
REFEREN
CES