Infection

Prevention
and
Control
(IPC) Program

Dr. Omar Zaher

MSc., DIPC, DHM, DTOT, CGM
Module (3) Hand Hygiene
 Module (3) Topics
• Importance of Hand Hygiene.

• Hand Hygiene Prerequisites.

• Types of Hand Hygiene.

• 5 Moments For Hand Hygiene.

• Hand Hygiene and Medical Glove Use.

• Hand Care.

• Conclusion.
 Importance of Hand Hygiene
• Hand hygiene is a simple and effective method for preventing the
spread of pathogens by direct and indirect contact.

• The hands of staff members may become transiently contaminated

with pathogens after touching a resident or surfaces in their
environment.

• Staff members can transfer those pathogens to themselves and

they can also transfer those pathogens to other residents or
surfaces.

• Hands of staff members can even move a resident’s own pathogens

from a contaminated body site, such as a wound, to a clean site,
such as an intravenous, or IV, line. Performing hand hygiene
removes pathogens and protects both staff and residents.
 Hand Hygiene Prerequisites
➢ If hands are not visibly soiled, use an alcohol-based hand rub
for routine antisepsis. Rub till hands are dry.
➢ Wash your hands before starting work, before entering the OR,
before eating, after using a restroom and in all cases where
hands are visibly soiled.
 Hand Hygiene Prerequisites
➢ Keep nails short and clean.
 Hand Hygiene Prerequisites
➢ Do not wear artificial fingernails, nail polish or
Accessories (except the plain ring).
 Hand Hygiene Prerequisites
➢Multiple-use cloth towels are not recommended
for health care institutions.
Use Single use towels.
 Hand Hygiene Prerequisites
➢ liquid soap detergents in dispensers are preferred.
➢ To prevent contamination, do not add soap to a partially
empty liquid soap dispenser. Empty the dispenser
completely and clean it thoroughly before refilling.
 WHY ?
Ignaz Semmelweis (1818 – 1865)

He was a doctor working in Vienna General Hospital.

He is known as the father of hand hygiene.
In 1846, he noticed that the women giving birth in the
medical student/doctor-run maternity ward in his
hospital were much more likely to develop a fever and die
compared to the women giving birth in the adjacent
midwife-run maternity ward.
He decided to investigate, seeking differences between
the two wards.
He noticed that doctors and medical students often
visited the maternity ward directly after performing an
autopsy.
Semmelweis imposed a new rule mandating hand washing with chlorine for doctors.
The rates of death in his maternity ward fell dramatically.
This was the first proof that cleansing hands could prevent infection
 WHY ?

Florence Nightingale (1820 – 1910)

She was an English social reformer and the founder of modern nursing.
She serving as a manager of nurses during the Crimean War (1854), where she organized
the care of wounded soldiers.
She found that Ten times more soldiers were dying of diseases such as typhus, typhoid,
cholera, and dysentery than from battle wounds.
The result of her concern with sanitation and its relation to mortality.
She put a plan to decrease the high mortality rate, one of these solutions was Hand Hygiene
 WHY ?
➢ Thousands of people die every day around the world
from infections acquired while receiving health care.

➢ Hands are the main pathways of germ transmission

during health care.

➢ Hand hygiene is therefore the most important measure

to avoid the transmission of harmful germs and prevent
health care-associated infections.

© World Health Organization 2009

 WHO ?
➢ Any health-care worker, caregiver or person
involved in direct or indirect patient care needs
to be concerned about hand hygiene and should
be able to perform it correctly and at the right
time.
 HOW & WHEN ?
Routine hand washing
Wash your hands with soap and water
➢ When hands are visibly dirty or visibly soiled with
blood or other body fluids.
➢ After using the toilet.
➢ Before each work shift.
➢ Before and after eating.
➢ After handling wastes.
➢ After cleaning clinical areas.
➢ If exposure to potential spore-forming pathogens
is strongly suspected or proven, including
outbreaks of Clostridium difficile.
 Antiseptic alcohol based hand rub
Clean your hands by rubbing them with an alcohol-based
formulation, if hands are not visibly soiled.

➢ Faster.
➢ More effective (60% to 95% alcohol).
➢ Better tolerated than routine hand washing.
➢ No need to wash hands with soap and water after several uses of
ABHR
 Antiseptic alcohol based hand rub
▪ Alcohol based hand rub is the recommended products for
ensuring effective hand hygiene in all patient care situations
except:
✓ Hands are visibly soiled.
✓ The patient is vomiting or diarrhea.
✓ Direct hand contact with any body fluids.
✓ There is an outbreak of diarrheal illnesses.
 Hand Scrub
• Preoperative hand scrub shall be practiced using
antiseptic agents for 2 – 5 minutes. All bracelets
and rings shall be removed before scrubbing.

• Nails shall be kept short not extending past finger

tips.

• Finger nails shall be free of polish or artificial

covering. Sterile surgical brush impregnated with
detergent and topical antiseptic.
 Hand Scrub

• Use: (Soap product + Alcohol based product),

for 5 minutes.

• Soap products: Povidine Iodine 7.5%

(Betadine) or Chlorohexidine 4% (MedScrub),
3 Min.

• Alcohol based products: Chlorohexidine 0.5%

+ Ethanol 70% (Virusan), 2 Min.
Hand Scrub
5 MOMENTS FOR HAND HYGIENE
 Before direct contact with a patient

• Before assisting a patient with personal care.

• Before taking a patient 's vital signs.
 Before Clean or Aseptic Procedures
• Before preparing or administering an injection.
• Before inserting an indwelling urinary catheter.
• After removing and discarding a soiled brief and before
assisting the resident to put on a clean gown.
 After Body Fluid Exposure Risk
• After contact with blood, body fluids or excretions, mucous
membranes, nonintact skin, or wound dressings.
• After personal protective equipment (PPE) removal.
After the following:
• Assisting a resident with toileting.
• Performing wound care.
 After Touching a Resident
• After direct contact with a patient, even if PPE is worn.
• After touching a patient in a group session in a physical
therapy gym.
• While leaving a patient 's room after a care activity that
involved direct contact with a patient.
 After Touching patient Surroundings

• After contact with inanimate objects (including medical

equipment) in the immediate vicinity of the patient.
• After repositioning a bedside table.
• In multi-resident rooms, after contact with one patient’s
equipment before caring for a different patient or leaving the
room.
 Hand Hygiene and Medical Glove Use
➢ The use of gloves does not replace the need for hand
hygiene.
➢ Hand hygiene must be performed before donning gloves
and After removing gloves.
➢ Discard gloves after each task and clean your hands.
➢ Wear gloves only when indicated according to Standard
and Contact Precautions.
Otherwise they become a major risk for germ transmission
 Hand care
➢ Don't Neglect Your Hands, Take care of your hands by
regularly using a protective hand cream or lotion, at least
daily.

➢ Do not routinely wash hands with soap and water

immediately before or after using an alcohol-based hand
rub.

➢ Do not use hot water to rinse your hands.

➢ After hand rubbing or hand washing, let your hands dry

completely before putting on gloves.
 World Hand Hygiene Day Event

Every Year (5, May)