moments of hand hygeine
The link between hand washing and contact transmission of infection was first established by Oliver Wendell Holmes in the US (1843) and in Europe by Semmelweiss (1861) (Horton, 2002). It was again well supported by Larson (1981). They both showed a drop in the rate of puerperal sepsis and its associated mortality when medical staff washed their hands between examining women during childbirth. Hands are the principle route by which cross infection occurs (Elliot, 1992). The Strategy for the Control of Antimicrobial Resistance in Ireland (SARI) was launched in 2001 and is available in the Mercy University Hospital Library and the Health Protection Surveillance Centre (01) 876 5300 Comparison of Different Hand Washing Techniques to Control Transmission of Microorganisms.
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Micro-organisms found on the skin include two categories:
These are usually deep seated in the epidermis, are not readily removed and do not readily cause infections. However, during surgery/invasive procedures, they may enter deep tissues and establish an infection.Comparison of Different Hand Washing Techniques to Control Transmission of Microorganisms.
These are organisms that are not part of the normal flora and represent recent contamination, that usually survives for a limited period of time. They are easily removed by a good hand washing technique. They include most of the organisms responsible for cross infection, e.g. Gram-negative bacilli (E.coli, Klebsiella, Pseudomonas spp, Salmonella spp.), Staph aureus, MRSA and viruses e.g. rotaviruses (Damani, N.N. (1997)).Comparison of Different Hand Washing Techniques to Control Transmission of Microorganisms.
There are three recommended levels of Hand Hygiene to ensure that the hand hygiene performed is suitable for the task being undertaken. The efficacy of hand hygiene will depend on application of an adequate volume of a suitable hand hygiene agent with good technique for the correct duration of time, and finally ensuring that hands are dried properly.Comparison of Different Hand Washing Techniques to Control Transmission of Microorganisms.
The aim of social (routine) hand washing with soap and warm water is to remove dirt and organic material, dead skin and most transient organisms. On visibly clean hands it can be undertaken using an alcohol hand rub, and this will remove transient organisms.Comparison of Different Hand Washing Techniques to Control Transmission of Microorganisms.
Antiseptic hand disinfection with an antiseptic hand wash agent i.e. Hydrex is generally carried out for aseptic procedures on the ward and for areas of Isolation. Hygienic hand disinfection will remove and kill most transient micro- organisms- indications for use
Surgical hand washing requires the removal and killing of transient micro-organisms and substantial reduction and suppuration of the resident flora of the surgical team for the duration of the operation, in case a surgical glove is punctured/torn. Ensure that fingernails are kept short and clean. Wrist watches and jewellery MUST be removed before surgical hand disinfection (Bernthal E, 1997). Comparison of Different Hand Washing Techniques to Control Transmission of Microorganisms.
Hand washing with a good technique covering all surfaces of the hands at the right time is more important than the agent used or the length of time of hand washing. Do not use nail-brushes on the wards. Nail-brushes (soft, sterile) used only for Surgical Scrub.