Date post: | 14-Nov-2014 |
Category: |
Documents |
Upload: | vijay-pratap-raghuvanshi |
View: | 18 times |
Download: | 0 times |
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Washing hands reduces Washing hands reduces hospital-acquired hospital-acquired
infectioninfection
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
How disease spreadsHow disease spreads
Infectious diseases can spread in Infectious diseases can spread in a variety of ways. a variety of ways.
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Why is Hand washing Why is Hand washing Important?Important?
Routine Hand washing prevents the Routine Hand washing prevents the spread of disease!spread of disease!
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Few Infectious PlacesFew Infectious Places
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Hand hygiene productsHand hygiene products Alcohol-based (hand)rub :Alcohol-based (hand)rub : An alcohol-containing preparation An alcohol-containing preparation
(liquid, gel or foam). (liquid, gel or foam). Antimicrobial (medicated) soap :Antimicrobial (medicated) soap : Soap (detergent) containing Soap (detergent) containing
an antiseptic agent at a concentration an antiseptic agent at a concentration Antiseptic agent :Antiseptic agent : An antimicrobial substance which reduces or An antimicrobial substance which reduces or
inhibits the growth of microorganisms on living tissues. inhibits the growth of microorganisms on living tissues. Detergent (surfactant) :Detergent (surfactant) : They are composed of a hydrophilic They are composed of a hydrophilic
and a lipophilic part and can be divided into four groups: anionic, and a lipophilic part and can be divided into four groups: anionic, cationic, amphoteric, and non-ionic. cationic, amphoteric, and non-ionic.
Plain soap :Plain soap : Detergents that do not contain antimicrobial agents, Detergents that do not contain antimicrobial agents, or that contain very low concentrations of antimicrobial agents or that contain very low concentrations of antimicrobial agents effective solely as preservatives.effective solely as preservatives.
Waterless antiseptic agent :Waterless antiseptic agent : An antiseptic agent that does not An antiseptic agent that does not require the use of exogenous water. After application, the require the use of exogenous water. After application, the individual rubs the hands together until the agent has dried. The individual rubs the hands together until the agent has dried. The term includes different types of handrubs (liquid formulations, term includes different types of handrubs (liquid formulations, gels, foams).gels, foams).
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Why is compliance with Why is compliance with recommended handwashing recommended handwashing
so poor?so poor?Here are some reasons why healthcare workers do not wash their hands as often as they should:
•Heavy workloads (too busy)
•Sinks are poorly located
•Skin irritation caused by frequent exposure to soap and water
•Hands don’t look dirty
•Handwashing takes too long
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Proper hand washing with Proper hand washing with soap and watersoap and water
Follow these instructions for Follow these instructions for washing with soap and water:washing with soap and water:
Wet your hands with warm, running Wet your hands with warm, running water and apply liquid or clean bar soap. water and apply liquid or clean bar soap. Lather well. Lather well.
Rub your hands vigorously together for Rub your hands vigorously together for at least 15 seconds. at least 15 seconds.
Scrub all surfaces, including the backs Scrub all surfaces, including the backs of your hands, wrists, between your of your hands, wrists, between your fingers and under your fingernails. fingers and under your fingernails.
Rinse well. Rinse well. Dry your hands with a clean or Dry your hands with a clean or
disposable towel. disposable towel. Use a towel to turn off theUse a towel to turn off the tap. tap.
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
When should you wash When should you wash your hands?your hands?
Although it's impossible to keep your hands germ-Although it's impossible to keep your hands germ-free, times exist when it's critical to wash your free, times exist when it's critical to wash your hands to limit the transfer of bacteria, viruses and hands to limit the transfer of bacteria, viruses and other microbes.other microbes.
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Health care workersHealth care workers
Nurses, doctors Nurses, doctors and other and other healthcare healthcare workers can get workers can get 100s or 1000s 100s or 1000s of bacteria on of bacteria on their hands by their hands by doing simple doing simple taskstasks
Culture plate showing growth of bacteria 24 hours after a nurse
placed her hand on the plate
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
What is the single most What is the single most important reason for important reason for healthcare workers to healthcare workers to
practice good hand practice good hand hygiene?hygiene? To remove visible soiling from handsTo remove visible soiling from hands
To prevent transfer of bacteria from the To prevent transfer of bacteria from the home to the hospitalhome to the hospital
To prevent transfer of bacteria from the To prevent transfer of bacteria from the hospital to the home hospital to the home
To prevent infections that patients To prevent infections that patients acquire in the hospitalacquire in the hospital
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Colonized or Colonized or Infected:Infected:
What is the What is the Difference?Difference?
People who carry bacteria without People who carry bacteria without evidence of infection (fever, increased evidence of infection (fever, increased white blood cell count) are white blood cell count) are colonizedcolonized
If an infection develops, it is usually from If an infection develops, it is usually from bacteria that colonize patientsbacteria that colonize patients
Bacteria that colonize patients can be Bacteria that colonize patients can be transmitted from one patient to another by transmitted from one patient to another by the hands of healthcare workersthe hands of healthcare workers
~ Bacteria can be transmitted even if the patient is not infected ~
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
The Iceberg Effect
Infected
Colonized
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
How often do you clean your How often do you clean your hands after touching a hands after touching a
PATIENT’S INTACT SKINPATIENT’S INTACT SKIN
1.1. AlwaysAlways
2.2. OftenOften
3.3. SometimeSometimess
4.4. NeverNever
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Which method do you use Which method do you use to clean your hands at to clean your hands at
work?work?1.1. Plain soap and waterPlain soap and water
2.2. Antimicrobial soap and waterAntimicrobial soap and water
3.3. Alcohol-based handrubAlcohol-based handrub
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Efficacy of Hand Hygiene Efficacy of Hand Hygiene Preparations in Killing Preparations in Killing
BacteriaBacteria
Good Better Best
Plain Soap Antimicrobial soap
Alcohol-based handrub
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Ability of Hand Hygiene Ability of Hand Hygiene Agents to Reduce Bacteria on Agents to Reduce Bacteria on
HandsHands
Adapted from: Hosp Epidemiol Infect Control, 2nd Edition, 1999.
0.0
1.0
2.0
3.0 0 60 180 minutes
0.0
90.0
99.0
99.9log%
Ba
cte
ria
l R
ed
uct
ion Alcohol-based handrub
(70% Isopropanol)
Antimicrobial soap(4% Chlorhexidine)
Plain soap
Time After Disinfection
Baseline
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
How much time would an ICU How much time would an ICU nurse save during an 8 hour nurse save during an 8 hour
shift by using an alcohol-shift by using an alcohol-based handrub instead of based handrub instead of
soap and water?soap and water?1. 15 minutes
2. 30 minutes
3. 1 hour
4. 2.5 hours
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
How often do you clean your hands after touching an
ENVIRONMENTAL SURFACE near a patient?
1. Always
2. Often
3. Sometime
4. Never
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Use of artificial nails by Use of artificial nails by healthcare workers poses healthcare workers poses
no risk to patients.no risk to patients.
1. Strongly agree
2. Agree
3. Don’t know
4. Disagree
5. Strongly disagree
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Glove use for all patient care contacts is a useful
strategy for reducing risk of transmission of
organisms.1. Strongly agree
2. Agree
3. Don’t know
4. Disagree
5. Strongly disagree
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
The following list gives some The following list gives some examples when hands should be examples when hands should be
washedwashed Before preparing, handling or eating foodBefore preparing, handling or eating food After visiting the toiletAfter visiting the toilet Whenever hands are visibly dirtyWhenever hands are visibly dirty After bed makingAfter bed making After Removing GlovesAfter Removing Gloves Before wearing sterile gloves.Before wearing sterile gloves. Before and after administering medicationBefore and after administering medication After any possible microbial contaminationAfter any possible microbial contamination Any situation which involves direct patient/client contact e.g. Any situation which involves direct patient/client contact e.g.
bathing, assisting to movebathing, assisting to move Before and after handling wounds, urethral cathetersBefore and after handling wounds, urethral catheters After handling contaminated laundry and waste.After handling contaminated laundry and waste. Before and after emptying urine drainage bags for susceptible Before and after emptying urine drainage bags for susceptible
patientspatients
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
How to wash How to wash HandsHands
Handwashing Handwashing Remove jewelry before hand wash procedureRemove jewelry before hand wash procedure Rinse hands under running water.Rinse hands under running water. Lather with soap and, using friction, cover all Lather with soap and, using friction, cover all
surfaces of the hands and fingers.surfaces of the hands and fingers. Rinse and dry with disposable towelRinse and dry with disposable towel Use towel to turn off taps (if not elbow)Use towel to turn off taps (if not elbow)
HandrubsHandrubs Apply to palm of one hand, rub hands together Apply to palm of one hand, rub hands together
covering all surfaces until dry covering all surfaces until dry Application is key: Let It Dry!Application is key: Let It Dry!
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Education/Motivation Education/Motivation ProgramsPrograms
Monitor healthcare workers (HCWs) Monitor healthcare workers (HCWs) adherence with recommended hand adherence with recommended hand hygiene practices and give feedback hygiene practices and give feedback
Implement a multidisciplinary Implement a multidisciplinary program to improve adherence to program to improve adherence to recommended practices recommended practices
Encourage patients and their families Encourage patients and their families to remind HCWs to practice hand to remind HCWs to practice hand hygienehygiene
Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
Proposed Strategies to Improve Hand Washing Proposed Strategies to Improve Hand Washing Technique and ComplianceTechnique and Compliance
ObstacleObstacle StrategyStrategy
Lack of Lack of knowledgeknowledge
Education with supportive literature, videotaped instructions, hand washing Education with supportive literature, videotaped instructions, hand washing demonstrations; frequent refreshers; involvement of personnel in education demonstrations; frequent refreshers; involvement of personnel in education and feedbackand feedback
Lack of Lack of motivationmotivation
Direct observation and feedback on regular basis; role models; involvement ofDirect observation and feedback on regular basis; role models; involvement of
staff in studies; application of new technologiesstaff in studies; application of new technologies
Programs on hand hygiene for patients and familiesPrograms on hand hygiene for patients and families
Availability of Availability of hand hand washing washing facilitiesfacilities
Hand washing facilities conveniently located throughout the health care settingHand washing facilities conveniently located throughout the health care setting
A sink accessible to personnel in or just outside every room; more than one A sink accessible to personnel in or just outside every room; more than one sink per room may be necessary if a large room is used for several individuals.sink per room may be necessary if a large room is used for several individuals.
Hand washing facilities in or adjacent to rooms where health care procedures Hand washing facilities in or adjacent to rooms where health care procedures are performedare performed
Accessible, adequately supplied and proper functioning soap and towel Accessible, adequately supplied and proper functioning soap and towel dispensers or hand dryersdispensers or hand dryers
Faucets with foot, wrist or knee operated handles; faucets with an electric eye Faucets with foot, wrist or knee operated handles; faucets with an electric eye arealso desirable.arealso desirable.
Waterless antiseptic agents readily available in wall mounted dispensers, or Waterless antiseptic agents readily available in wall mounted dispensers, or insmall containers for mobile care such as home care and for emergency insmall containers for mobile care such as home care and for emergency responders.responders.
Hand Hand washing washing productproduct
Hand washing products that have a high level of acceptability to staff, with Hand washing products that have a high level of acceptability to staff, with appropriateness, cost, supply, etc., being taken into considerationappropriateness, cost, supply, etc., being taken into consideration
DermatitisDermatitis Lotions to prevent skin drynessLotions to prevent skin dryness
Lotion supplied in small, non-refillable containersLotion supplied in small, non-refillable containers
Compatibility between lotion and antiseptic products and effect on glove Compatibility between lotion and antiseptic products and effect on glove integrityintegrity
Lotions approved by personnel in infection control and occupational healthLotions approved by personnel in infection control and occupational health
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
PREVENTIONIS PRIMARY!
Protect patients…protect healthcare personnel…
promote quality healthcare!
Vijay Pratap Raghuvanshi Vijay Pratap Raghuvanshi
M.Phil & MHA M.Phil & MHA ( Hospital & Health ( Hospital & Health
Administration)Administration)
How clean are How clean are you???you???