SAVE LIVES

Clean Your Hands

By the end of this presentation you will be able to:

• Describe what hand hygiene is

• Explain why hand hygiene is important
• Identify who should practice hand hygiene
• Identify where hand hygiene practice should take place
• Describe when hand hygiene is to be performed
• Describe how to perform hand hygiene using various
methods
• Describe tips for effective of hand hygiene
WHAT
HAND HYGIENE is…..
a general term referring to any action of hand cleansing

Handwashing Handrubbing
WHY
Importance of Hand Hygiene.....

• Hand hygiene is the most important way to

prevent the spread of microorganisms
• Helps reduce the number of microorganisms on
your hands
• Prevents contamination of the patient’s, client’s,
or resident’s environment
WHO
EVERYONE
WHERE
OPTIMAL HAND HYGIENE SHOULD BE PERFORMED

AT THE
POINT-OF-CARE
POINT-OF-CARE

■ refers to the place where three

elements occur together:
1. patient
2. healthcare worker
3. care or treatment involving patient
contact (within the patient zone)
POINT-OF-CARE
■ The concept embraces the need to perform hand hygiene
at recommended moments exactly where care delivery
takes place
■ This requires that a hand hygiene product (e.g. alcohol-
based handrub, if available) be easily accessible and as
close as possible (e.g. within arm’s reach), where patient
care or treatment is taking place.
■ Point-of-care products should be accessible without
having to leave the patient zone
POINT-OF-CARE
■ This enables health-care workers to quickly and easily
fulfil the 5 indications (moments) for hand hygiene
■ Availability of alcohol-based handrubs in point-of-care
is usually achieved through health-care worker-carried
handrubs (pocket bottles), wall-mounted dispensers,
containers fixed to the patient’s bed or bedside table or
handrubs affixed to the patient’s bed or bedside table or to
dressing or medicine trolleys that are taken into the point-
of-care
Examples of hand hygiene products
easily accessible at the point-of-care
 ZONES
HEALTH-CARE AREA

PATIENT ZONE
Critical site with
infectious risk
for the patient

Critical site
with body fluid
exposure risk
ZONES
■ Focusing on a single patient, the health-care setting is
divided into two virtual geographical areas, the patient
zone and the health-care area
PATIENT ZONE
■ it includes the patient and some surfaces and items
that are temporarily and exclusively dedicated to the
patient such as all inanimate surfaces that are touched by
or in direct physical contact with the patient (e.g.
bed rails, bedside table, bed linen, chairs, infusion tubing,
monitors, knobs and buttons, and other medical
equipment)
HEALTHCARE AREA
■ it contains all surfaces in the health-care setting
outside the patient zone.
It includes:
- other patients and their patient zones
- the wider healthcare facility environment
WHEN
5 Moments for Hand Hygiene
 5 MOMENTS

• broken black lines

• position of the arrows
 The 5 moments poster
broken black lines represent
the virtual Patient Zone

position of the arrows indicate

when hand hygiene should
occur e.g.
•Moment 1 – clean you hands as
you enter the patient zone before
touching the patient
•Moment 4 – clean your hands after
touching the patient as you leave the
patient zone
•Moment 2 – clean your hands
before
a clean or aseptic procedure in the
patient zone
Your 5 Moments for Hand Hygiene

Clean your hands

immediately before
accessing a critical site with
infectious risk for the patient!
Clean your hands when leaving To protect the patient against
the patient’s side, after touching harmful
Clean yourgerms,
handsincluding
as soon the
as
Clean your hands after touching any
aClean your
patient andhands
his/her immediate a patient’s own, entering
task involving exposure risk
before
object touching
or a in the patient’s
furniture tohis/her body!has ended (and
body fluids
surroundings, To protect yourself
patient whensurroundings, when leaving
immediate after glove removal)!
and the health-care environment
approaching
without havinghim/her!
touched the patient!
from harmful germs! To protect yourself and the
To
Toprotect
protectthe patient
yourself and the health-care health-care environment from
against harmful
environment germsgerm spread!
against harmful germs!
carried on your hands!
BEFORE touching a patient
Why?
BEFORE touching a patient
Why?
To protect the patient against harmful germs carried on your
hands
Can you identify some examples of this indication
during your everyday practice of health care?

Situations illustrating direct contact:

 shaking hands, stroking a child’s forehead
 helping a patient to move around, get
washed
 applying oxygen mask, giving
physiotherapy
 taking pulse, blood pressure, chest
auscultation, abdominal palpation,
recording ECG
BEFORE clean/aseptic procedures
Why?
BEFORE clean/aseptic procedures
Why?
To protect the patient against harmful germs, including the
patients own, from entering his/her body
Can you identify some examples of this indication
during your everyday practice of health care?

Situations illustrating clean/aseptic

procedures:
 brushing the patient's teeth,
instilling eye drops
 skin lesion care, wound dressing,
subcutaneous injection
 catheter insertion, opening a vascular
access system or a draining system,
secretion aspiration
 preparation of food, medication,
pharmaceutical products, sterile material.
AFTER body fluid exposure risk
Why?
AFTER body fluid exposure risk
Why?
To protect yourself and the health-care environment from
harmful patient germs
Can you identify some examples of this indication
during your everyday practice of health care?

Situations illustrating body fluid exposure

risk:
 brushing the patient's teeth, instilling
eye drops, secretion aspiration
 skin lesion care, wound dressing,
subcutaneous injection
 drawing and manipulating any fluid
sample, opening a draining system,
endotracheal tube insertion and removal
 clearing up urines, faeces, vomit, handling
waste (bandages, napkin, incontinence
pads), cleaning of contaminated and
visibly soiled material or areas (soiled bed
linen lavatories, urinal, bedpan, medical
instruments)
AFTER touching a patient
Why?
AFTER touching a patient
Why?
To protect yourself and the health-care environment from
harmful patient germs
Can you identify some examples of this indication
during your everyday practice of health care?

Situations illustrating direct

contact :
 shaking hands, stroking
a child forehead
 helping a patient to move
around, get washed
 applying oxygen mask,
giving physiotherapy
 taking pulse, blood pressure,
chest auscultation,
 abdominal palpation,
recording ECG
AFTER touching patients surroundings
Why?
AFTER touching patients surroundings
Why?
To protect yourself and the health-care environment from
harmful patient germs
Can you identify some examples of this indication
during your everyday practice of health care?

Situation illustrating contacts with patient

surroundings:
 changing bed linen, with the patient
out of the bed
 perfusion speed adjustment
 monitoring alarm
 holding a bed rail, leaning against
a bed, a night table
 clearing the bedside table
The 5 Moments apply to any setting where healthcare
involving direct contact with patients takes place
HOW
The golden rules for hand hygiene
1. Hand hygiene must be performed exactly where you are delivering
health care to patients (at the point-of-care)
2. During health care delivery, there are 5 moments (indications) when it
is essential that you perform hand hygiene ("My 5 Moments for Hand
Hygiene" approach)
3. To clean your hands, you should prefer handrubbing with an
alcohol-based formulation, if available. Why? Because it makes hand
hygiene possible right at the point-of-care, it is faster, more effective,
and better tolerated.

4. You should wash your hands with soap and water when visibly soiled

5. You must perform hand hygiene using the appropriate technique and
time duration
 How to Wash Hands Correctly:
1 2 3

Palm to palm. Right palm over left dorsum Palm to palm

and left palm over right dorsum. fingers interlaced.

4 5 6

Backs of fingers to opposing palms Rotational rubbing of right thumb Rotational rubbing, backwards and
with fingers interlocked. clasped in left palm and vice versa. forwards with clasped fingers of right
hand in left palm and vice versa.
5.3
TIPS
“Handy” Tips
• Artificial nails, gel nails or extenders are not to be worn
by staff who have direct patient contact
• Contaminated surfaces or objects should not be touched
after performing hand hygiene
• Avoid touching your face, especially your eyes and nose
• Fingernails should be kept short - no longer than ¼” or
0.635 cm long
• Nail polish may be worn, but should be removed when
chipped
• Do not “top up” a partially-used hand hygiene product
dispenser
“Handy” Tips
• If re-usable dispensers are used they must be
emptied, washed and dried prior to being refilled.
Hand lotion bottles must not be re-used
• Include frequently missed areas when performing
hand hygiene such as thumbs, palms, web
spaces, under nails and the backs of fingers and
hands
• Use supplied lotions that are compatible with
hand hygiene products and gloves to minimize
skin irritation that can occur with frequent hand
hygiene
• Wearing hand and wrist jewelry is not
recommended