HAND DECONTAMINATION
Hands should be decontaminated before every instance of direct patient contact and after any activity that may lead to contamination.
WHEN TO PERFORM HAND HYGIENE?
The moment of care is crucial for hand hygiene as it is when there is the highest risk of transferring microorganisms between healthcare workers and patients. The World Health Organization has identified 5 critical moments for hand hygiene that should be adhered to. For instance, hand hygiene should be conducted not only before patient contact (Moment 1) like touching a patient's hand but also before conducting a clean or aseptic procedure (Moment 3) on the same patient. These 5 moments are applicable across all care settings.
Additionally, it is vital to decontaminate hands before and/or after various activities such as preparing or consuming food, using the toilet, handling contaminated waste, entering or leaving isolation rooms, starting or finishing work, donning or doffing Personal Protective Equipment (PPE) like aprons and gloves, and whenever hands are visibly soiled.
CHOICE OF HAND CLEANSING AGENTS AND TYPES OF HAND DECONTAMINATION
It depends on the situation and the level of decontamination needed. There are four main types of cleansing agents: soap and water, alcohol-based hand rub, hand wipes, and antiseptic cleansing agents. Three methods of hand decontamination include social, antiseptic hand decontamination, and surgical scrub techniques.
Social hand decontamination is suitable for most daily activities and can be done using soap and water, alcohol-based hand rub, or hand wipes. Soap and water are adequate for routine daily tasks or when hands are visibly soiled. In clinical areas, liquid or foam soap should be used and stored in well-maintained wall-mounted dispensers. Alcohol Hand Rub (AHR) is effective when hands are visibly clean and have not been in contact with bodily fluids. It should be applied to all hand surfaces for about 30 seconds and should be available at the point of care. Hand wipes are only for patient hand hygiene when self-care is challenging, not for staff use.
Antiseptic hand decontamination is necessary in high-risk areas before invasive procedures, while surgical scrub is essential for greater hand and forearm disinfection before invasive surgery. Antiseptic liquids like povidone-iodine or chlorhexidine 4% scrub should be used for surgical scrub, following local departmental policies.
While routine hand washing is typically done in a few simple steps, here is a more detailed 12-step guide for a thorough hand wash:
1. Wet your hands with clean, running water (warm or cold) and apply soap.
2. Rub your palms together to create a lather.
3. Rub the back of each hand with the palm of the other hand with fingers interlaced.
4. Rub your palms together with fingers interlocked.
5. Interlock your fingers and rub the backs of them against your palms.
6. Clasp your left thumb with your right hand and rub in a rotational motion, then switch hands and repeat.
7. Rub the tips of your fingers in the opposite palm in a circular motion.
8. Rub your wrist with your opposite hand.
9. Rinse your hands thoroughly under clean, running water.
10. Dry your hands with a clean towel or air dry them.
11. Use a towel or your elbow to turn off the faucet to avoid recontaminating your hands.
12. Apply hand lotion to keep your skin moisturized, especially if frequent hand washing leads to dryness.
Following these 12 steps for hand washing can help ensure that you clean all areas of your hands thoroughly and reduce the risk of spreading germs and infections. It is important to wash hands regularly, especially before and after certain activities like preparing food, caring for someone who is sick, or treating a wound. In addition to routine hand washing, using hand sanitizers with at least 60% alcohol can also help kill germs when soap and water are not readily available.
Here are some links to guidelines on routine hand hygiene in laboratories:
1. CDC Guidelines for Hand Hygiene in Healthcare Settings: https://www.cdc.gov/handhygiene/guidelines.html
2. WHO Guidelines on Hand Hygiene in Health Care: https://www.ncbi.nlm.nih.gov/books/NBK144035/
Please note that specific guidelines may vary depending on the type of laboratory and the nature of the work being conducted. It is important to follow the guidelines provided by your institution or regulatory body.