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Importance of Hand
Hygiene Practices
Today`s Topic!
Ideal Tools for Hand Hygiene
Improving Hand Hygiene Compliance
About Myself
Name: Kelvin Lim
Age: 37
Nationality: MALAYSIAN, living in Kuala
Lumpur
Company: Saraya Hygiene Malaysia
Hobbies: Futsal, Running & Washing Car
Interests: Infection Control (Hospital)
Fundamentals of Hand
Hygiene
Contact
Influenza,
Whooping
cough, Rubella
Mumps
Norovirus,
Varicella
Measles
Droplet
Tuberculosi
s
Airborne
Importance of Hand
Hygiene
CDC,APIC,SHEA:How-to Guide: Improving Hand Hygiene A Guide for Improving Practices among Healt
Transient Flora
Resident Flora
Skin
Visible Soiling
Soap and Running Water
No Visible Soiling
Quick Drying Alcohol Hand Disinfectant
Liquid Exposure
Risk Point
Care Area
Patient Zone
The Patient and the Items and
Environment Surrounding
Environment and Items Surrounding
All surfaces accessible to the patient and touching the
patients body.
Environmental Surfaces
Bed rails, table, linens, tubes, other medical devices)
Items touched and used by Medical Staff.
(Monitor, handles, buttons, doorknobs)
Patient Zone
Care Area
All areas outside the Patient Zone
In other words
Another Patient Zone
The Greater Hospital Environment
Before
Patient
Contact
After Body
Fluid Exposure Risk
After
Touching a
Patient
After touching a
patients
surroundings
Tips on Gloves
When gloves are required, always
disinfect hands before doning if a hand
hygiene moment is expected.
Disinfect hands after removing gloves
when a hand hygiene moment
occurred during care.
When a hand hygiene moment
occurred while doning gloves, remove,
toss, disinfect and re-don.
GLOVES ARE NOT A REPLACEMENT FOR HAND
HYGIENE!
Alcohol Hand
Disinfectant
The best way to prevent
healthcare associated infections
Palms
Finger Tips
Dorsal surface
Wrists
Effect of Hand
Contamination
Ever touch your head at work?
Without Noticing?
Contaminating Hands
After Disinfection
Disinfection Touching
Hair
Consensus was based on speed of
action and applicability in clinical
setting
x1000
99.0 2.0
x100
90.0 1.0
x10
0.0 0.0
Baseline
EN 1500:1997
Alcohol-based handrub
(70% Isopropanol)
Antimicrobial soap
(4% Chlorhexidine)
Plain soap
Adapted from: Rotter ML. Hosp Epidemiol Infect Control, 2nd Edition, 1999.
Limitations of scrubs
Lower efficacy + longer duration of the procedure of scrubs
tested by EN 1500
Active agent
exposure (s)
Propan-1-ol/
Propan-2-ol
15
20
conc. (%)
lg
reduction
4.2
30/45
30
4.3
4.9
Propan-1-ol
20
70
4.3
Ethanol
30
75
4.8
Chlorhexidin
based detergent
60
3.1
Triclosan based
detergent
60
0.1
2.8
Pittet et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000; 356: 1307-12
Saraya Automatic
Dispenser
Sensor Activated Hand Hygiene
GUD-1000
No cross contamination
Intuitive support for increased
compliance
Disposable pump system
0.15
0.85
0.70
NS
1.80
Hand Care
No Effect on Sebum
g/cm2
g/cm
2
Absorption of Alcohols
Investigation after excessive hygienic and surgical hand disinfection
alcohol-based hand sanitizer rubs or gel under identical test conditions
with the same test persons to determine the application security
Risk Assessment
Apple juice contain up to 2 g ethanol/l 1
0.5 l
apple juice resulted in an ethanol level for
Male (75 kg)
0.17
Female (60 kg)
0.25
~ 10-fold higher than after an excessive
surgical hand disinfection
Conclusion
Absorption of all 3 alcohols < 0.03 (under real
conditions ~ 0,003 )
no systemic risk
however the exposure duration should be limited to the
time period which is necessary for the disinfection
effect, because:
- skin tolerability
- compliance
- systemic tolerance