INFECTION CONTROL

Nirupama Sahoo
ICN
 HAND WASHING IS IMPORTANT
BECAUSE…
• 80% of disease is spread by your
hands.

• Hand washing is the most effective

way to prevent the spread of illness.

• Some germs can live on dry surfaces

for several hours and moist surfaces
like, sinks for 3 days.

WHEN TO WASH HANDS

• 5 Golden moments
Apollo Hospitals, Bhubaneswar
HAND WASHING
Duration:
20-30 sec for HR
40-60 sec for HW
HAND WASHING
five moments for hand hygiene :-two moments before
and three moments after touching the patient.
HOSPITAL HAND HYGIENE PICTURE

2-B &3 –A
 Before touching a patient
 Before clean/aseptic procedure
 After exposed of blood & body
fluid.
 After touching patient.
 After touching patient surrounding.

This is 5 golden
moment of hand
hygiene
When and why – follow World Health Organizations
(WHO′s) five moments for hand hygiene 
Before touching a patient – to protect the patient from
harmful germs carried on your hands
Before aseptic procedures – to protect the patient against
harmful germs, including the patient's own germs
After body fluid exposure/risk – to protect yourself and the
health care environment from the harmful patient's germs
After touching the patient – to protect yourself and the
health care environment from the harmful patient's germs
After touching the patient's surrounding – to protect
yourself and the health care environment from the harmful
patient's germs.
 Indications..
Moment-1 and 4 : Before and
after touching a patient
Before and after
• Shaking hands
• Helping a patient to
move around, get
washed
•Applying oxygen mask
• Giving physiotherapy
•Taking pulse, blood
pressure,
• Auscultation and
palpation
• Recording ECG
Moment-2 and 3: Before and after Moment-5: After touching patient
aseptic procedure/body fluid exposure surroundings
Skin lesion care and Wound After contact with
dressing • Perfusion speed
• Subcutaneous injection adjustment
• Catheter insertion •Monitoring alarm
• Opening a vascular access • Patient records
system or a draining system, •Holding a bed rail
secretion aspiration • Leaning against a bed
•Instilling eye drops, • Clearing the bedside table
pharmaceutical products, • Changing bed linen, with
sterile materials etc. the patient out of the bed,
•Handling an invasive device etc.
for patient care, regardless of • After removing sterile or
whether or not gloves are used non-sterile gloves
•Moving from a contaminated
body site to another body site
during care of the same patient
Hand hygiene methods
Indications for using
hand rub:
•Followed during the five
moments of hand
hygiene .
•During routine clinical
rounds and handling the
patient .
• Emergency where no
time or lack of facility for
hand wash
• Hands are not visibly
dirt, blood, or body fluids
Indications for using hand Indications for
wash using hand scrub
• Visible dirt, blood or body Prior to any
fluids surgical procedure
•Potential exposure to spore
forming organisms (e.g.,
Clostridium difficile ); non
enveloped viruses (e.g. Noro
virus, rotavirus, entero viruses)
•Handling patients having
diarrhea
• After using restroom
• Before handling medication or
food
Hand hygiene products
Questions
1. How antibiotic-registant pathogenes are most
frequently spread from one patient to another in
health care settings ?
2. What types of microbes can spread due to lapses in
hand hygiene ?
3. Can wearing gloves be a substitute for hand washing ?
4. Which is better, washing or disinfecting your hands ?
OCCASION OF HAND WASHING/HAND RUB
 Hand hygiene Audit
Hand hygiene audit is the process of making sure that
hand hygiene techniques being practiced in healthcare
follow recommended guidelines. Hand hygiene audit
aims to prevent the spread of infection between
healthcare workers and patients through observational
inspections of handwashing techniques.
Hand hygiene Exercise
A nurse working in an intensive care unit goes to
patient –(A), check the pulse performs hand rub and
then she adjust the o2 flow and she informs the doctor
about the patient.
Q.How many moments of hand hygiene were available ?
Ans: 3
Q.How many moments of hand hygiene were followed?
Ans: 1
Q.What is the overall HHAR?
Ans:1/3*100=33.3%
Hand hygiene Exercise
The doctor decides to draw blood sample of patient –
(A).He explains the procedure to the patient-(A) while
feeling for the radial artery on the right arm.The doctor
draws the blood sample with gloved hand. After
drawing blood, he performs handrub.
Q.How many moments of hand hygiene were available ?
Ans: 3
Q.How many moments of hand hygiene were followed?
Ans: 1
Q.What is the overall HHAR?
Ans:1/3*100=33.3%
What is the single most important reason
for healthcare workers to practice good
hand hygiene?

1. To remove visible soiling from hands

2. To prevent transfer of bacteria from the
home to the hospital
3. To prevent transfer of bacteria from the
hospital to the home
4. To prevent infections that patients acquire in the
hospital
How often do you clean your hands
after touching a PATIENT’S INTACT
SKIN (for example, when measuring a
pulse or blood pressure)?

1. Always
2. Often
3. Sometimes
4. Never
Which hand hygiene method
is best at killing bacteria?
1. Plain soap and water
2. Antimicrobial soap and water
3. Alcohol-based handrub
THANK YOU