CRITICAL CARE NURSING SKILL

HAND HYGIENE IN HEALTH CARE SETTINGS

Hands are the most common vehicle to transmit health care-associated pathogens.
Hand hygiene is the single most effective measure to reduce HCAI (health care-
associated infections).

Golden rules for Hand Hygiene

• Hand hygiene must be performed at the point of care .

• Hand rubbing with an alcohol-based formulation is preferred.
• When visibly soiled, wash your hands with soap and water.
• Appropriate technique and time duration must be followed for hand
hygiene.
• Remove all jewelry and watches.
• Move sleeves up.
• Water should be running water; hands must be rinsed thoroughly and dried.
• Hands should be dried by using paper or cloth towel/towels should be
placed near the sink.
• Basin used for no other purpose.
• Keep nails short & rounded.
• Types of Hand Hygiene
HAND WASH = 40 – 60 Seconds
HAND RUB = 20-30 Seconds
HAND SCRUB = 5 MINUTES (first wash of the day)
2-3 minutes (in between operations)

The “My 5 Moments for Hand Hygiene” Approach

1. BEFORE PATIENT CONTACT:

Some examples may be:
• shaking hands, stroking an arm
• helping a patient to move around, get washed, giving a massage
• taking pulse, blood pressure, chest auscultation, abdominal palpation

2. BEFORE ASEPTIC TASK

Some examples may be:

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 • Oral/dental care, giving eye drops, secretion aspiration
• skin lesion care, wound dressing, subcutaneous injection
• catheter insertion, opening a vascular access system or a draining system
• preparation of food, medication, dressing sets

3. AFTER BODY FLUID EXPOSURE RISK

Some examples may be:
• oral/dental care, giving eye drops, secretion aspiration
• skin lesion care, wound dressing, subcutaneous injection
• drawing and manipulating any fluid sample, opening a draining system,
endotracheal tube insertion and removal
• clearing up urines, faeces, vomit, handling waste (bandages, napkin, incontinence
pads), cleaning of contaminated and visibly soiled material or areas (lavatories,
medical instruments)

4. AFTER PATIENT CONTACT

Some examples may be:
• shaking hands, stroking an arm
• helping a patient to move around, get washed, giving a massage
• taking pulse, blood pressure, chest auscultation, abdominal palpation

5. AFTER CONTACT WITH PATIENT AND SURROUNDING

Some examples may be:
• changing bed linen
• perfusion speed adjustment
• monitoring alarm
• holding a bed rail
• clearing the bedside table

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 STEPS OF HAND WASHING - CHECK LIST

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