Hand Hygiene Policy January 2011 1
Introduction People s hands are the most common way in which micro organisms, particularly bacteria, might be transported and cause infection, especially to those who are most susceptible to infection. In order to prevent the spread of micro organisms to those who might develop serious infections through this route while receiving care, hand hygiene must be performed adequately. This is considered to be the single most important practice in reducing the transmission of infectious agents during delivery of care. The hand hygiene procedure being under taken should consider the actual hazards that have or might be encountered, the subsequent potential and/or actual contamination of hands, and the risks which may present as a result. The nature of the worker - patient/ client interaction will often determine this. It must, however, always be assumed that every person encountered could be carrying potentially harmful micro organisms that might be transmitted and cause harm to others. For this reason, hand hygiene is one precaution which must be applied as standard. Hand hygiene is one of the nine elements of Standard Infection Control Precautions which are particularly concerned with the spread of organisms that might be present in blood or other body fluids. This policy contains information on: page Why perform hand hygiene? 3 What are the underpinning elements to ensure adequate hand hygiene? 3 Care of nails Why care for fingernails? 5 How to care for fingernails? 5 Hand hygiene and jewellery Why consider jewellery when performing hand hygiene? 5 What to do with jewellery when performing hand hygiene? 5 When to perform hand hygiene? 6 How to perform hand hygiene? Why consider the correct hand hygiene facilities? 7 What factors to look for in hand hygiene facilities? 7 What solution to use to perform hand hygiene? 8 How long to take to perform hand hygiene? 9 What are the steps to performing adequate hand hygiene (washing) at a sink? 9 Hand drying Why consider hand drying in the hand hygiene process? 10 How to dry my hands adequately? 10 The use of alcohol based hand decontamination products Why use alcohol based products for hand hygiene? 10 When to use alcohol based products for hand hygiene? 10 How to use alcohol based products to perform hand hygiene? 11 Hand care Why consider hand care in the hand hygiene process? 11 How to care for my hands? 11 Hand hygiene step by step images 12 2
All of these steps aid the process of ensuring hands are free from contamination and are therefore not a factor in causing infection. The term hand hygiene used in this document refers to all of the processes, including hand washing and hand decontamination achieved using other solutions, e.g. alcohol based products. For further background information, see associated literature review on the elements of hand hygiene Hand Hygiene Policy - Why perform hand hygiene? By following all steps included within the hand hygiene process, e.g. preparation for hand hygiene (care of nails and jewellery), hand drying and hand care, ensure potentially harmful micro organisms are not a factor in the spread of infectious agents Hand hygiene can reduce the spread of healthcare associated infections. NB The terms social hand hygiene, hygienic hand hygiene and surgical scrub are further discussed in the section entitled When to perform hand hygiene? Hand Hygiene Policy - What are the underpinning elements to ensure adequate hand hygiene? Responsibilities: Everyone has a responsibility to ensure that they undertake adequate hand hygiene and to encourage others delivering care to do so. This applies to all disciplines of staff that provide care or are associated with care environments / items within it Managers have the responsibility to ensure that local risk assessments related to all elements included within hand hygiene processes are carried out where necessary, that safe practices are adhered to, including the provision of resources to ensure adequate 3
hand hygiene and any incidents that occur in relation to inadequate hand hygiene practices, including the lack of resources to do so, are reviewed and subsequent actions taken where appropriate Training should be provided for all those who deliver care, and should include information on all of the aspects of hand hygiene (i.e. as included in this policy). Managers have the responsibility to ensure training is available for staff and staff have the responsibility to attend such training sessions Staff have the responsibility to ensure posters featuring the steps included in the hand hygiene process are displayed in relevant, prominent areas support from infection control staff may be sought for this). General good practice: All of the steps included in hand hygiene processes, as described in this policy, are important and must be considered in order to avoid or reduce the transmission of infectious agents. Patient / client hand hygiene is also essential, and facilities for them to perform this must be offered / made available. When considering the principles of Standard Infection Control Precautions, i.e. exposure to blood or other body fluids, it may also be appropriate to offer / encourage relatives / visitors to undertake hand hygiene when in care settings The use of particular solutions for performing hand hygiene should be considered to ensure they are effective and suitable for the situation and for use by the majority (e.g. do not cause skin irritation) Control of Substances Hazardous to Health (COSHH) sheets and product data sheets should be referred to ensure safe use of / exposure to products being used for hand hygiene Other health and safety issues, related to staff, patients / clients, should also be considered in relation to products used for hand hygiene, e.g. drips or spillages from alcohol based products and any risks of slips or falls from these, risk of ingestion of products by particular patient / client groups. Risk assessments should be carried out locally to highlight / manage relevant issues Incident reporting: Any incidents where failure in hand hygiene processes have occurred or where problems with products being used have occurred should be reported, as per local reporting procedures. This is important, particularly in relation to incidents that are related to supplies / facilities for undertaking hand hygiene, in order to ensure that transmission of infectious agents does not occur, health and safety is not breached, and that incidents can be avoided in the future, e.g. by having adequate and appropriate supplies / facilities to perform adequate hand hygiene. 4
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NB One of the differences between social hand hygiene, hygienic hand hygiene and surgical scrub, besides when to apply these techniques, is the solution that can be used to perform the decontamination process (see How to perform hand hygiene?). These techniques apply to patients/clients of all ages. 6
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