II. Background
- Semmelweis in 1847 Austria identified the importance of Hand Washing in reducing perinatal mortality
- Medical staff (esp. physician) compliance is low
- Despite the clear benefits of Hand Washing in Prevention of Healthcare Associated Infection
III. Epidemiology
-
Healthcare Associated Infection affects 1.7 Million patients per year in U.S. (10% of inpatients)
- Kills 90,000 patients per year
IV. Approach: Hand Hygiene
- See Dry Hand Management
-
General Measures
- Perform Hand Hygiene between every patient (make it a habit)
- Include Fingernails, palms, and the back of the hand
- Also foam over and around rings, watches as well as stethoscopes
- Keep Fingernails trimmed
- Avoid wearing shirt sleeves below the elbows
- Preparations
- Alcohol-based foams (minimum of 60% Ethanol or 70% isopropanol concentration)
- Effective and preferred in most instances
- Soap and Water
- Indicated when visible dirt is present, as well as after caring for patients with Diarrhea (esp. Clostridium difficile)
- Wash for 20 seconds (or sing Happy Birthday song twice)
- Alcohol-based foams (minimum of 60% Ethanol or 70% isopropanol concentration)
- Efficacy
V. Approach: Clothing and other Worn Items
- See Personal Protection Equipment
- See Respiratory Personal Protective Equipment
- See Donning and Doffing PPE
- White coats
- White coats harber Bacteria, especially resistant Bacteria (esp. at the cuffs) and even with frequent washing
- Banu (2012) J Clin Diagn Res 6(8): 1381-4 [PubMed]
- Neck ties
- Neckties frequently culture positive and easily transmit Bacteria to patients
- McGovern (2010) J Hosp Infect 75(2): 138-9 [PubMed]
- Weber (2012) J Hosp Infect 80(3): 252-4 [PubMed]
- Stethoscope
- Uniformly culture positive (clean them with foam or Alcohol wipes)
- Merlin (2009) Prehosp Emerg Care 13(1): 71-4 [PubMed]
- Lecat (2009) Am J Infect Control 37(3): 241-3 [PubMed]
- Rings
- Smooth rings are not typically a source of infection
- Al-Allak (2008) Ann R Coll Surg Engl 90(2): 133-5 [PubMed]
- Surgical Scrubs
- Easy to clean and typically washed after every use
- Patients do not perceive scrubs as unprofessional (preferred by patients over white coat, business clothing)
- Home washing surgical scrubs does not appear to increase infection risk
VI. Pearls: Cleaning Tips in Medical Care
- Clothing stains from blood
- Hydrogen Peroxide removes
- Bubble Gum in hair
- Peanut butter removes
- Corrosion metal contacts (battery compartments, connectors)
- Vinegar on cotton swab removes corrosive material
VII. Resources
- WHO Guidelines on Hand Hygiene in Health Care
VIII. References
- McCullum in Herbert (2019) EM:Rap 19(10):11-3
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MSH) | The act of cleansing the hands with water or other liquid, with or without the inclusion of soap or other detergent, for the purpose of destroying infectious microorganisms. |
| Concepts | Health Care Activity (T058) |
| MSH | D006235 |
| English | Disinfection, Hand, DISINFECT HAND, HAND DISINFECT, hand disinfection, Hand Disinfection |
| Czech | dezinfekce rukou |
| French | Désinfection des mains |
| German | Desinfektion, Hände- |
| Italian | Disinfezione delle mani |
| Spanish | Desinfección de las Manos, Desinfección de Manos |
| Polish | Dezynfekcja rąk, Odkażanie rąk |
| Russian | RUK SANITARNAIA OBRABOTKA, РУК САНИТАРНАЯ ОБРАБОТКА, OBRABOTKA RUK KHIRURGICHESKAIA, RUK MYT'E, ОБРАБОТКА РУК ХИРУРГИЧЕСКАЯ, RUK DEZINFEKTSIIA, РУК МЫТЬЕ, ДЕЗИНФЕКЦИЯ РУК, DEZINFEKTSIIA RUK, РУК ДЕЗИНФЕКЦИЯ |
| Portuguese | Desinfecção das Mãos, Higienização de Mãos Pré-Cirúrgica, Desinfecção de Mãos |
| Norwegian | Hånddesinfeksjon, Handdesinfeksjon |
| Dutch | Desinfectie, hand- |
Ontology: Handwashing (C0018581)
| Definition (MSH) | The act of cleansing the hands with water or other liquid, with or without the inclusion of soap or other detergent, for the purpose of removing soil or microorganisms. |
| Concepts | Activity (T052) |
| MSH | D006235 |
| Swedish | Handtvättning |
| Finnish | Käsienpesu |
| Japanese | 術前手洗い, 手の消毒, 手指消毒, 手洗い |
| English | handwash, handwashing, Hand Washing, Washing, Hand, Hand Washings, Washings, Hand, Handwashing, Hand washing |
| Czech | mytí rukou |
| French | Lavage des mains |
| German | Händewaschen |
| Italian | Lavaggio delle mani |
| Spanish | Lavado de Manos |
| Portuguese | Lavagem de Mãos |
| Norwegian | Handvask, Håndvask |
| Dutch | Handen wassen, Wassen, handen |
Ontology: Hand Hygiene (C3494474)
| Definition (MSH) | Practices involved in preventing the transmission of diseases by hand. |
| Concepts | Individual Behavior (T055) |
| MSH | D063373 |
| English | Hygiene, Hand, Hand Hygiene |
| Czech | ruce - hygiena, hygiena rukou |
| French | Hygiène des mains |
| German | Handhygiene |
| Italian | Igiene delle mani |
| Spanish | Higiene de las Manos |
| Polish | Higiena rąk |
| Russian | РУК ГИГИЕНА, RUK GIGIENA |
| Portuguese | Higiene das Mãos |
| Norwegian | Håndhygiene, Handhygiene |
Ontology: Hand washing education (C3697311)
| Concepts | Educational Activity (T065) |
| SnomedCT | 698608004 |
| English | Hand washing education, Hand washing education (procedure) |
| Spanish | educación sobre lavado de manos (procedimiento), educación sobre lavado de manos |
