Hand hygiene

• On average, 8.7% of hospital patients suffer nosocomial infections.
• Hospital infections are a leading cause of death in some parts of the world.
• Most patient deaths and suffering attributable to health care-associated infections can be prevented.
• The costs of health care-associated infections vary by country and institution. 
• The single most important measure to prevent and control health care -associated.

Benefits of hand washing are,

• Reduces nosocomial infections
• Preventing cross transmission of multi-resistant organisms
• Preventing and control epidemics
• Cost saving
• Reduces morbidity and mortality

• Microbiology of hands,
• Bacteria present in healthy skin.
• Resident flora
• Transient flora

Hand washing is to remove visible and invisible dust and to inhibit or destroy ‘potentially pathogenic bacteria’ present on the hands of the staff.

• Types of hand washing,

         Social hand washing

• Use of non-medicated soap or detergent and water

         Hygienic hand washing

• Use of antiseptic-detergent preparation

         Surgical hand disinfection

•  Use of antiseptic – detergent preparation for a longer application time

 When to wash,

• Before and after having direct contact with patients. 
•  Before handling an invasive device (regardless of whether or not gloves are used) for patient care.
• After contact with body fluids or excretions, mucous membranes, non-intact skin, or wound dressings.
• If moving from a contaminated body site to a clean body site during patient care.
•  After contact with inanimate objects (including medical equipment) in the immediate vicinity of the patient.
•  Before leaving the work place.
• 05 steps for hand washing,

1. Wet hands with warm water.
2. Apply a few drops of liquid soap (or foam) or a bar of soap.
3. Scrub for 20 seconds – include the area between fingers, wrists and around nails.
4. Rinse thoroughly with warm water.
5. Dry hands on a disposable paper towel.

• Benefits of hand rub,
• Availability of alcohol-based hand rubs is critical to promote effective hand hygiene practices, in particular in settings without access to running water.
•  Introduction of an alcohol-based hand rub has led to increased hand hygiene compliance among healthcare workers and Decreased health care-associated infections.
• Require less time
• Acts fast
• More accessible than sinks
• Most efficacious agent to reduce number of bacteria than soap
• Easy access to hand hygiene materials could help improve adherence to hand washing practices.

• Agents,

   Alcohol based antiseptics

• 70% ethanol
• 60% isopropanol

    Non-alcohol based antiseptics

• 4% chlorhexidine-detergent
• 7.5% povidone-iodine