Importance of HAND HYGIENE

in healthcare settings

Presented by

Dr. Garima Aggarwal

Today lets start with discussing some common

KILLERS

Oops ….wrong killers!!!At PCH, the killers we need to more seriously worry about are…..

Our AIM today To get a better understanding of why, healthcare

workers MUST NOT – Exhibit poor personal hygiene Wear stoned rings, bracelets, wrist watches Have long nails, dirty nails, or wear nail varnish, or wear

any kind of artificial nail attachments Know when and how to wash hands and its importanceif they are involved with DIRECT PATIENT CARE.

Apply the knowledge gained to inform your colleagues who might still be wearing excessive jewellery or have long nails.

Why should you care???

Because

we have the facts!!

to prove just how much danger we are putting our patients lives in, by refusing to make these small lifestyle changes.

Whats the harm with long nails, artificial nails or nail paint/varnish?

Inhibits good hand hygiene May reduce your grip or speed while doing

various manipulations May tear or puncture gloves. May interfere with

putting on gloves Can become caught in beddings, dressings and

even machinery Long nails and artificial nails are a breeding

ground for various DISEASE CAUSING MICRO ORGANISMS AND FUNGI

Before we discuss the facts, let me tell you a story…

Evidence supporting the claim-

o Outbreak of pseudomonas infection in a Neonatal Intensive Care Unit

Casuality- 46 patients were affected, 16 diedCause- growth found in fingernails of staff

o Haemodialysis related BactereamiaCasuality- 5 haemodialysis patients found to have

bactereamic sepsisCause- Growth of Serattia Marcescens found in the long

fingernails of HCW involved. HCW admitted to not washing her hands and having long nails during detaching lid from heparin vial

o Outbreak of Candida osteomyelitis in patients post spinal surgery

Casuality- 3 patients post surgery found to have surgical wound infections due to Candida Albicans

Cause- A single scrub nurse who had worn artificial nails during the 2 month period when the patients had surgery

o In a hospital in Australia, Bacteria was cultured from the nail varnish of an ot nurse after she had scrubbed, the nail paint may chip and fall during surgery!

Our patients Our long nails, artificial

nails, nail varnish!!

Jewellery or weapons of mass destruction, in a healthcare setting???

Whats the harm with wearing rings or other Hand jewellery? Higher Bacterial colonisation is seen on the hands of

healthcare worker with rings, than one without Rings may interfere with thorough hand washing May cause gloves to tear Wearing a single ring or a simple band found to be much

LESS dangerous than wearing multiple rings or large rings with multiple stones or detailed scrollwork!

Elaborate hand jewellery, bracelets or bangles known to interfere with active patient intervention.

HCWs who took off their rings/jewellery just before a surgical procedure had higher bacterial counts than control even after hand scrub.

So who is most AT RISK?

Evidence suggests that the risk groups are-

NeonatesPost surgical patientsPatients on dialysis Immunocompromised

patients ICU patients

How clean are your hands today??

HAND WASH

Hand washing prevents the spread of diease!

Hands must be washed for atleast 20-25 seconds.

Even intact skin of patients and healthcare workers can be colonised with disease causing bacteria!

My 5 moments of HAND WASH

According to WHO, the five moments you must remember to wash your hands after

Before Patient contact Before aseptic task After body fluid exposure After Patient contact After contact with patient’s surroundings

So isn’t hand washing the answer to all these problems! thats what I thought…

World Health Organisation guidelines on hand hygiene state that poor nail hygiene, long nails and jewellery can contribute to nails remaining contaminated with pathogens even after use of soap and water or alcohol based antiseptics

NO!!

I hope after today, all of us will do our bit to protect our patients and have them leave Pushpanjali Medical Centre,

healthy and happy!

Thank you.

Any questions?