CONCEPT OF HANDWASHING

NCMA113 LAB

INTRODUCTION
❖ Thousands of people die every day around the world from infections acquired
while receiving health care.
❖ Hands are the main pathways of microorganisms’ transmission during health
care. Hand hygiene therefore, the most important measure to prevent
transmission of harmful microbes & prevent Health-care Associated Infections.
(HAI)
❖ Any health-care worker, doctor or nurse involved in direct or indirect patient care
needs to be concerned about hand hygiene & should be able to perform correctly
at the right time.

WHAT IS HAND HYGIENE?

HAND HYGIENE is the simplest & most cost-effective way of preventing the
transmission of infection thus, reducing incidence of (HAI) health-care associated
infections.
3 TYPES OF HAND HYGIENE:
1. HANDWASHING – a medical hand hygiene with the use of plain soap & water
for 40 to 60 seconds of vigorous hand rubbing. Or also called hand disinfection
with the use of antiseptic agent that leads to reduction in the number of
microorganisms.
2. HAND RUB (WATERLESS HAND DISINFECTION) - use of 60 to 95% alcohol-
based formulation which has an excellent & rapid microbial action. Preferably
used in between patient care. Sanitized hands are visibly clean for 20 to 30
seconds. Alcohol Hand Sanitizers are available in liquids, gels & foam.
3. HAND SCRUB / SURGICAL SCRUN (SURGICAL HANDWASHING) - process of
mechanical hand washing & chemical antisepsis before participating in a
surgical procedure done at least 5 minutes for first procedure & 3-5 minutes
between subsequent procedures.
THREE ELEMENTS OF HANDWASHING:
1. Soap (plain or antiseptic)
2. Water
3. Friction

HAND HYGIENE: WHEN?

WHEN do you wash or sanitize your hands?
 • Whas your hands with soap & water when hands are visibly dirty or visibly
soiled with blood or other body fluids, or after using the toilet.
• Before, during & after food preparation, before eating.
• After blowing nose, or using tissue to wipe nose.
• After changing diapers.
• Before & after contact with each client.
PURPOSES OF HAND HYGIENE
1. To reduce the number of microorganisms of the hands.
2. To reduce the risk of transmission of microorganisms to client
3. To reduce the risk of cross-contamination among clients.
4. To reduce risk of transmission of infectious organisms to oneself.

HAND HYGIENE
WORL HEALTH ORGANIZATION campaign theme “SAVE LIVES: Clean your hands”, is
aligned with the “Year of the Nurse & the Midwife”, & aims to recognize nurses &
midwives as front-line heroes deserve acknowledge & appreciation, highlight their
critical roles in infection prevention. World Health Organization, Hand Hygiene
Campaign 5/2020
5 MOMENTS FOR HAND HYGIENE APPROACH – 2009
1. Before touching a patient
2. Before clean/aseptic procedures
3. After body fluid exposure risk
4. After touching a patient
5. After touching the patient’s surrounding

USE OF BARRIERS / PPE

PPE (PERSONAL PROTECTIVE EQUIPMENT) - special equipment worn by health care
workers to create a barrier for protection against infectious materials.
MOST COMMONLY USED PPE:
1. Mask – protect mouth/nose, should fit tightly to the face, to prevent fluid
penetration.
a. Respirator (N95 Mask) - protect respiratory tract from airborne infectious
agents. Should fit tightly to the face, covering the nose & mouth &
personally fit tested.
b. Qualitative fit testing is a pass/fail test method that uses the sense of
taste or smell, or your reaction to an irritant in order to detect leakage
into the respirator facepiece.
2. Gown / Apron – protects skin&/ or clothing, should be worn when healthcare
workers clothing is likely to be soiled by infected material. Use only once
&discard.
 3. Caps / Head Covers – a re used to cover the head
4. Gloves – protects hands from acquiring infective organism.
5. Goggles – protect eyes.
6. Face Shield – protect face, mouth, nose & eyes. It shields facial parts from
accidental exposure to contaminated body secretions.
7. Shoe Cover – special covers for shoes.

LEVELS OF PPE
1. LEVEL A – Self – rebreathing apparatus with garment totally encapsulated
chemical suit (gives highest protection)
2. LEVEL B – Positive Pressure Non – encapsulated chemical suit
3. LEVEL C – Air purifying respirator
4. LEVEL D – Standard work clothes without a respirator.

WASTE MANAGEMENT
WASTE MANAGEMENT – managing healthcare waste to minimize the risk of
hazardous sources & prevent transmission to patients, health care workers & the
environment.
Categories of Health Crae Waste:
1. Non-risk Health Care Waste or General Medical Waste – hygiene & offensive
waste, Domestic Waste – paper, plastic towel, etc. Unsuitable for recycling,
packaging. Recyclable materials – bottles, drinking cans, carboard.
2. Risk Health Care Waste / Hazardous Waste
a. Infectious Waste – blood & body fluids, pathology laboratory specimens,
lab cultures, contaminated equipment, food, infant & adult diapers.
b. Injurious Waste – sharps, needles, syringe, scalpel, blades, lancets, saws,
infusion sets, broken glass.
c. Pharmaceutical Waste – expired, unused & contaminated drugs &
vaccines, multiple active ingredients of highly specific medicines.
d. Pathological Waste (Anatomical Waste) - human tissues, body parts,
huma fetus, etc.
e. Chemical Waste – discarded solid, liquid & gaseous chemicals. Ex.
Disinfecting, Housekeeping & Cleaning Products, mercury in broken
thermometers & batteries.
f. Genotoxic Waste – includes vomitus, urine & feces from patients treated
with cytostatic drugs, chemical & radioactive materials.

DIFFERENT TYPES FAUCET:

1. Hand Operated Control Handle
2. Knee-Level Faucet Control
3. Foot Pedal Faucet Control
4. Elbow Control
5. Infrared or Touchless Faucet
 EQUIPMENT for HANDWASHING
1. Laboratory gown or apron (optional for procedures)
2. Antiseptic or
3. Plain, mild soap
4. Soap Dish
5. Orange wood stick or toothpick
6. Hand towel or tissue paper
7. Oil-free lotion (optional)
8. Receptable
9. Sink with faucet

MEDICAL HANDWASHING PROCEDURES

1. Perpare all equipment needed & assess your hands. Remove all jewelry (rings,
watches, bracelets). Nails should be cut short. Assess hands for breaks, cuts &
hangnails.
2. During each step keep hands below the elbows allowing water to drain away in
the fingertips, making sure to avoid splashing to uniform. Don laboratory gown
or apron if needed. Note: Each step of medical handwashing consists of five
quick strokes rubbing backwards & forwards for 40-60 seconds.
3. Stand back in front of the sink. Do not allow uniform to touch sink, flex knees
slightly if sink is low. Turn on water & adjust flow & temperature.
4. Wet hands & wrists, keeping hands low to allow water flow toward fingertips.
5. Use about 1-2 teaspoons of liquid soap from dispenser or lather thoroughly if
bar is used. Rinse bar soap & return to soap dish.
6. Rub hands palm to palm.
7. Rub the right palm over the back of the left & vice versa with the fingers
interlaced.
8. Rub hands palm to palm, with finger interlaced.
9. Perform rotational rubbing backwards & forwards with clasped fingers or
opposing fingers interlocked of the right hand into the left palm hand & vice
versa.
10. Perform rotational rubbing of the right thumb clasped in the left hand/palm &
vice versa
11. Rub the fingertips of the left hand on the palm of the right hand & vice versa.
12. Continue with the rotating action down opposing arms, working to just below
the elbows.
13. Clean finger nails using an orange wood stuck or toothpick. (Optional)
14. Rinse thoroughly using an upward motion from the fingertips down to the wrist.
15. Pat – dry the hands & wrists with a single – use hand towel.
16. Use paper towel to turn-off faucet.
17. Use oil free microbial lotion on hands if desired. (Optional)