Hand hygiene

Hand hygiene

1. Hand Hygiene and its role in COVID-19

2. WHAT IS HAND HYGIENE ? Hand hygiene is a way of cleaning ones hands that substantially reduces potential pathogens on hands Hand hygiene is the most effective measure for interrupting the transmission of microorganisms which cause infection both in the community and in the healthcare setting.

3. HISTORICAL PERSPECTIVES ON HAND HYGIENE Although hand washing has been considered a measure of personal hygiene for centuries, the specific link between hand washing and the spread of infectious diseases has been reported only during the last 200 years. Ritual hand washing was part of religious or cultural practice but cleaning hands was concerned with aesthetics rather than the prevention of infection.

4. Interestingly, during the Black Death in the 14th century , it was noted that Jews seemed to have a lower mortality rate than other groups The ritual hand washing of the Jewish faith probably protected Jews during the epidemic , though the focus of the ritual washing was spiritual rather than infection control . In 1846 , Semmelweis – Father of Hand hygiene reported a reduction in number of deaths from puerperal infection by implementation of hand hygiene. However the establishment of hand washing as an intervention to prevent the spread of infection did not occur for many more years and it is only during the last few decades that written guidelines for hand hygiene have emerged.

5. ROLE OF HAND HYGIENE IN COVID-19 COVID-19 virus primarily spreads through droplet and contact transmission. Contact transmission means by touching infected people and/or contaminated objects or surfaces. Thus, your hands can spread virus to other surfaces and/or to your mouth, nose or eyes if you touch them. Consequently, hand hygiene is extremely important to prevent the spread of the COVID-19.

6. TRANSMISSION OF HCAI THROUGH HANDS Organisms present on patient’s skin or have been shed into patients surroundings Transferred to the hands of HCWs Organism capable of surviving on HCWs hands for at least several minutes Handwashing or hand antisepsis by HCW - inadequate or omitted entirely or agent used for hand hygiene inappropriate Contaminated hands came into direct contact with another patient or with an inanimate object that will come into patient surroundings

7. LEVELS OF INTERVENTION

8. HAND HYGIENE AGENTS TYPES MECHANISM OF ACTION DURATION OF ENTIRE PROCEDURE Alcohol based hand rub ( Atleast 60% ) Denaturation of proteins 20-30 seconds Hand washing with soap and water Dissolution of lipid part of envelope and mechanical action 40-60 seconds Soap and alcohol-based handrub should not be used concomitantly

9. Hand rubs are preferred because Less time More accessible Less side effects like dryness More effective Hand rubs versus Hand washing Specific indications of Handwashing Visible hand contamination After use of restroom Exposure to spore forming pathogens

10. INDICATIONS OF HAND HYGIENE FOR HCWs Before and after touching the patient Before handling an invasive device for patient care, regardless of whether or not gloves are used After contact with body fluids ,mucousmembranes, non-intact skin, or wound dressings If moving from a contaminated body site to another body site during care of the same patient After contact with inanimate surfaces and objects(including medical equipment) in the immediate vicinity of the patient After removing sterile or non-sterile gloves

11. INDICATIONS OF HAND HYGIENE FOR PUBLIC

12. 5 MOMENTS OF HAND HYGIENE FOR HCW - WHO

13. COMPLIANCE OF HAND HYGIENE Despite the relative simplicity of hand hygiene procedures, overall compliance among HCWs remains poor. Compliance is most often less than 40% Duration of hand cleaning episodes ranged an average from as short as 6 seconds to 30 seconds

14. Why is compliance so low ? Forgetfulness/Not thinking about it Wearing of gloves/ beliefs that glove use obviates the need for hand hygiene Often too busy/ Insufficient time Lack of knowledge regarding guidelines Scepticism about the value of hand hygiene

15. STRATEGIES TO IMPROVE HAND HYGIENE COMPLIANCE HCWs’ education Audits of hand hygiene practices and performance feedback Reminders Improvement of water and soap availability, use of automated sinks, Intr oduction of an alcohol-based handrub

16. IMPACT OF HAND HYGIENE PROMOTION ON HCAI Failure to perform appropriate hand hygiene is considered to be the leading cause of HCAI and the spread of MDR organisms , and has been recognised as a significant contributor to outbreaks . There is convincing evidence that improved hand hygiene through multimodal implementation strategies can reduce HCAI rates.

17. COMPLICATIONS OF HAND HYGIENE Irritant dermatitis [ due to repeated use] Common symptoms : Dryness , Itching Cracking and bleeding Allergic Dermatitis [ rarely ] Flash fire [ due to static fire ]

18. How to prevent skin irritation? Use skin care products frequently(hand creams etc..) Favour the use of alcohol based hand rubs rather than soap. Avoid the use of hot water when hand washing. Refrain from using gloves unless specifically needed. Dry hands completely before donning gloves.

19. GLOVES Glove use does not replace the need to perform hand hygiene. When an in dication for hand hygiene occurs during glove use, the health care worker must remove the gloves, perform hand hygiene, and don another pair of gloves, if still indicated. Hand hygiene must always be performed after glove removal because gloves may have defects and because hand contamination may occur during re moval . Do not disinfect or reuse gloves , since alcohol may degrade glove material and lead to holes and leakage .

20. JEWELLERY AND FINGERNAILS Do not wear rings or bracelets during patient care, as they increase the bacterial load of the skin. Finger nails should be kept short (<0.2inches or 0.5cm in length) or nail extenders should not be worn as they are associated with cross-transmission and infection with resistant pathogens. Nail polish is acceptable, providing its integrity is preserved. Fingernail diseases such as onychomycosis should be treated properly as they reduce the efficacy of hand hygiene.

21. HAND HYGIENE DAY Celebrated every year on 5 May , Hand Hygiene Day mobilizes people around the world to increase adherence to hand hygiene in health care facilities, thus protecting health care workers and patients from infections. As part of the 2020 campaign, WHO and partners aim to: Make hand hygiene a global priority Inspire hand hygiene and behavior change Engage with health care workers in their role in clean care and the prevention of infectio ns .

22. SUMMARY H and hygiene is a procedure that should be mastered by all health care workers. Proper use of hand hygiene is a sign of competency, professionalism and respect. HAND HYGIENE IS NOT OPTIONAL- IT IS MANDATORY. It must be used conscientiously to decrease the occurrence of infections associated with health care and to increase patient safety However, Using hand hygiene as a sole measure to reduce infection is unlikely to be successful when other factors in infection control, such as environmental hygiene, crowding, staffing levels and education are inadequate. Hand hygiene must be part of an integrated approach to infection control.

23. Clean hands are safe hands THANK YOU