NEO111M. Jorgenson, RN BSN

Personal Hygiene &

Protective Equipment

Hand Hygiene

the single most effective way to help prevent the

spread of infections agents. (CDC, 2002.)

Consistency & Compliancy

50% of hospital employees are not compliant with the hand washing

policies of their facilities. (IHI, 2006)

The Joint Commission

• 2010 Patient Safety Goal to “prevent infection”

• “Speak Up” program

When Should You Clean Your Hands?

• Before and after contact with each patient• Before putting on sterile gloves• Before performing any invasive procedure• After accidental contact with body fluids

or excretions, mucous membranes, non-intact skin and wound dressings, even if hands are not visibly soiled

• When moving from a contaminated body part to a clean body part

• After removal of gloves

Hand Hygiene• According the CDC, Hand Hygiene is

either:

– Washing hands with plain soap and water

– Using antiseptic hand rubs including alcohol-based products

– Surgical hand antisepsis

Lathering Hands With Soap and Rubbing With Firm Circular Motion

Washing Areas Between Fingers

Washing to 1 Inch Above the Wrist

Using Fingernails to Clean Under Nails of

Opposite Hand

Rinsing Hands Under Running Water With

Water Flowing Toward Fingertips

Techniques for Effective Hand Hygiene

Soap & Water• Wet Hands (leave water running)• Apply Soap

– Cover Surfaces• Rub Hands

– Palm to Palm– Palm to back of hand

• Rub Fingers– Thumbs– Interlocking– Backs of fingers to palm– Tips to Palm

• Rinse Hands• Dry Hands• Turn of water with paper towel.

Techniques for Effective Hand Hygiene

Alcohol-based Hand Gels• Apply Gel

– Cover Surfaces• Rub Hands

– Palm to Palm– Palm to back of hand

• Rub Fingers– Thumbs– Interlocking– Backs of fingers to palm– Tips to Palm

Soap & Water instead of Alcohol-based Hand Gel

• When hands are visibly dirty• After using the restroom• Before eating• After exposure to certain

organisms

Caregiver Hygiene Guidelines

• Finger Nails—harbor harmful bacteria and may cause microabrasions – Nail length—no more than ¼ inch – No artificial nails– No nail polish

• Avoid wearing perfumes and heavy scents

• Maintain a clean appearance• Piercings and tattoos—follow facility

policy

Personal Protective Equipment

Personal Protective Equipment

“PPE”

Standard Precautions• Follow hand hygiene techniques• Wear clean, nonsterile gloves when

touching body fluids• Wear personal protective equipment

during care activities likely to generate splashes or sprays of blood

• Avoid recapping used needles• Handle used patient care equipment

appropriately• Ensure routine care, cleaning, and

disinfection procedures are followed• Review room assignments carefully

Transmission Based Precautions

• Applies to patients with known or suspected infectious diseases– Contact

• Enteric precautions—(Used to specify fecal infections)

– Droplet– Airborne

• Tuberculosis (TB) Isolation

Infection Control Measures

• Identifying the infection• Preventing infection

– Breaking the chain of infection• Controlling infection

– Minimizing complications– Reducing adverse outcomes

• Teaching the patient about infection

Practice of Asepsis• Medical asepsis (clean technique)

– Involves procedures and practices that reduce the number and transfer of pathogens

• Surgical asepsis (sterile technique) – will discuss further in Lab #4– Includes practices used to render and

keep objects and areas free from microorganisms

Basic Principles of Medical Asepsis

• Practicing good hand hygiene• Carrying soiled items away from the

body• Keeping soiled items off the floor• Avoiding having patients cough,

sneeze, or breeze on others• Moving equipment away when

cleaning articles• Avoiding raising dust• Cleaning least soiled areas first

Basic Principles of Medical Asepsis (cont.)

• Disposing of soiled or used items in appropriate containers

• Pouring discarded liquids directly into the drain

• Sterilizing items suspected of containing pathogens

• Using personal grooming habits that prevent the spread of microorganisms

• Following guidelines for infection control or barrier technique

Putting on Goggles

Ensuring Gloves Cover Gown Cuffs

Transmission-Based Precautions: Airborne

• Use for patients who have infections spread through air

• Place patient in private room with monitored negative air pressure

• Use respiratory protection when entering the patient’s room

• Transport patient out of room only when necessary; place surgical mask on patient

• Consult CDC guidelines for prevention strategies for tuberculosis

Transmission-Based Precautions: Droplet

• Use for patient with infection spread through droplets

• Use a private room (door may remain open)

• Wear a mask when working within 3 feet of the patient

• Transport the patient out of the room only if necessary; place surgical mask on patient

• Keep visitors 3 feet from patient

Transmission-Based Precautions: Contact

• Use for patients infected by a microorganism spread by direct or indirect contact

• Place patient in private room if available• Wear PPE when entering the room for all

interventions involving contact with the patient; change infected gloves and remove PPE before leaving the room

• Wash hands with antimicrobial or waterless antiseptic agent

• Wear gown if in contact with infectious agent

• Limit movement of the patient out of the room

• Avoid sharing patient care equipment

Guidelines for Effective Use of PPE

• Put on PPE before contact with the patient

• Choose appropriate PPE based on type of exposure

• When wearing gloves, work from clean to dirty areas

• Touch as few surfaces and items with PPE as possible

• Avoid touching or adjusting other PPE• Keep gloved hands away from the face• Remove and replace torn or heavily soiled

gloves• Do not substitute goggles with personal

glasses

Questions?