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�[1��'So Why All the Fuss About Hand Hygiene?�(P(��J��REvidence of Relationship Between Hand Hygiene and Healthcare-Associated Infections�SPS(���Substantial evidence that hand hygiene reduces the incidence of infections
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M��Q��p��:Self-Reported Factors for Poor Adherence with Hand Hygiene�;P;(���Handwashing agents cause irritation and dryness
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Performing handwashing, antiseptic handwash, alcohol-based handrub, surgical hand hygiene/antisepsis
Handwashing
Washing hands with plain soap and water
Antiseptic handwash
Washing hands with water and soap or other detergents containing an antiseptic agent
Alcohol-based handrub
Rubbing hands with an alcohol-containing preparation
Surgical hand hygiene/antisepsis
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Patient contact
Donning gloves when inserting a CVC
Inserting urinary catheters, peripheral vascular catheters, or other invasive devices that don t require surgery
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Contact with body fluids or excretions, non-intact skin, wound dressings
Removing gloves�`0U�0U0Ux0U � x��b��5Selection of Hand Hygiene Agents: Factors to Consider�6P6���Efficacy of antiseptic agent
Acceptance of product by healthcare personnel
Characteristics of product
Skin irritation and dryness
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Dispenser systems�FL0U270U2+0U2L 7+ ��d��9Efficacy of Hand Hygiene Preparations in Killing Bacteria�:P:��R��S�k7��6Time Spent Cleansing Hands:one nurse per 8 hour shift�"7P$���Hand washing with soap and water: 56 minutes
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���Provide healthcare workers with hand lotions or creams
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Wearing rings in healthcare settings�<�)0U2%0P2 <� ��Z��Gloving�P���Wear gloves when contact with blood or other potentially infectious materials is possible
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Do not wear the same pair of gloves for the care of more than one patient
Do not wash gloves��0U2� ��i��Education/Motivation Programs�P�� Monitor healthcare workers (HCWs) adherence with recommended hand hygiene practices and give feedback
Implement a multidisciplinary program to improve adherence to recommended practices
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��h��/Administrative Measures to Improve Hand Hygiene�0P0���Make improved hand hygiene an institutional priority
Place alcohol-based handrubs at entrance to patient room, or at bedside
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When washing hands with soap and water, wet hands first with water, apply the amount of soap recommended by the manufacturer, and rub hands together for at least 15 seconds, covering all surfaces of the hands and fingers. Rinse hands with water, dry thoroughly with a disposable towel, and use the towel to turn off the faucet.
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Performing handwashing, antiseptic handwash, alcohol-based handrub, surgical hand hygiene/antisepsis
Handwashing
Washing hands with plain soap and water
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Washing hands with water and soap or other detergents containing an antiseptic agent
Alcohol-based handrub
Rubbing hands with an alcohol-containing preparation
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Acceptance of product by healthcare personnel
Characteristics of product
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Rinse and dry with disposable towel
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Place alcohol-based handrubs at entrance to patient room, or at bedside
Provide HCWs with pocket-sized containers��0U2� ��o��Alcohol and Flammability�P���Alcohols are flammable
Alcohol-based handrubs should be stored away from high temperatures or flames
Europe: fire incidence low
U.S.: one report of flash fire
Application is key: Let It Dry!��0U2� ��j��Performance Indicators�P��Monitor and record adherence to hand hygiene by ward or service
Provide feedback to healthcare workers about their performance
Monitor the volume of alcohol-based handrub used per 1,000 patient days
Monitor adherence to policies on wearing artificial nails�0U2 ���>SummaryAlcohol-Based Handrubs: What benefits do they provide?� ?P $���Require less time
More effective for standard handwashing than soap
More accessible than sinks
Reduce bacterial counts on hands
Improve skin condition��0U2� ��u/������������
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A second slide set Hand Hygiene in Healthcare Settings-Supplemental which can be obtained at www.cdc.gov/handhygiene provides additional slides that may be used in conjunction with the core slide set.
The target audience for this slide set is healthcare workers in acute care hospitals.�J�0
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Historical study: Semmelweis
More recent studies: rates lower when antiseptic handwashing was performed� ��0�dU2��^
M��Q��p��:Self-Reported Factors for Poor Adherence with Hand Hygiene�;P;(���Handwashing agents cause irritation and dryness
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Lack of soap and paper towels
Too busy/insufficient time
Understaffing/overcrowding
Patient needs take priority
Low risk of acquiring infection from patients���0�dU2���H��Definitions����Hand hygiene
Performing handwashing, antiseptic handwash, alcohol-based handrub, surgical hand hygiene/antisepsis
Handwashing
Washing hands with plain soap and water
Antiseptic handwash
Washing hands with water and soap or other detergents containing an antiseptic agent
Alcohol-based handrub
Rubbing hands with an alcohol-containing preparation
Surgical hand hygiene/antisepsis
Handwashing or using an alcohol-based handrub before operations by surgical personnel�
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e(U5!V��L��Indications for Hand Hygiene�P���When hands are visibly dirty, contaminated, or soiled, wash with non-antimicrobial or antimicrobial soap and water.
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Patient contact
Donning gloves when inserting a CVC
Inserting urinary catheters, peripheral vascular catheters, or other invasive devices that don t require surgery
After:
Contact with a patient s skin
Contact with body fluids or excretions, non-intact skin, wound dressings
Removing gloves�`0U�0U0Ux0U � x��b��5Selection of Hand Hygiene Agents: Factors to Consider�6P6���Efficacy of antiseptic agent
Acceptance of product by healthcare personnel
Characteristics of product
Skin irritation and dryness
Accessibility of product
Dispenser systems�FL0U270U2+0U2L 7+ ��d��9Efficacy of Hand Hygiene Preparations in Killing Bacteria�:P:��R��S�k7��6Time Spent Cleansing Hands:one nurse per 8 hour shift�"7P$���Hand washing with soap and water: 56 minutes
Based on seven (60 second) handwashing episodes per hour
Alcohol-based handrub: 18 minutes
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Apply to palm of one hand, rub hands together covering all surfaces until dry
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Handwashing
Wet hands with water, apply soap, rub hands together for at least 15 seconds
Rinse and dry with disposable towel
Use towel to turn off faucet�n 0U2m0U20U2�0U2 m ���k�� Surgical Hand Hygiene/Antisepsis�!P!��>Use either an antimicrobial soap or alcohol-based handrub
Antimicrobial soap: scrub hands and forearms for length of time recommended by manufacturer
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���Provide healthcare workers with hand lotions or creams
Get information from manufacturers regarding effects that hand lotions, creams, or alcohol-based handrubs may have on the effectiveness of antimicrobial soaps��0U2� ��[�� Fingernails and Artificial Nails�!P!���Natural nail tips should be kept to � inch in length
Artificial nails should not be worn when having direct contact with high-risk patients (e.g., ICU, OR)��0U2� ��m��Unresolved Issues�P��MRoutine use of nonalcohol-based handrubs
Wearing rings in healthcare settings�<�)0U2%0P2 <� ��Z��Gloving�P���Wear gloves when contact with blood or other potentially infectious materials is possible
Remove gloves after caring for a patient
Do not wear the same pair of gloves for the care of more than one patient
Do not wash gloves��0U2� ��i��Education/Motivation Programs�P�� Monitor healthcare workers (HCWs) adherence with recommended hand hygiene practices and give feedback
Implement a multidisciplinary program to improve adherence to recommended practices
Encourage patients and their families to remind HCWs to practice hand hygiene�
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Place alcohol-based handrubs at entrance to patient room, or at bedside
Provide HCWs with pocket-sized containers��0U2� ��o��Alcohol and Flammability�P���Alcohols are flammable
Alcohol-based handrubs should be stored away from high temperatures or flames
Europe: fire incidence low
U.S.: one report of flash fire
Application is key: Let It Dry!��0U2� ��j��Performance Indicators�P��Monitor and record adherence to hand hygiene by ward or service
Provide feedback to healthcare workers about their performance
Monitor the volume of alcohol-based handrub used per 1,000 patient days
Monitor adherence to policies on wearing artificial nails�0U2 ���>SummaryAlcohol-Based Handrubs: What benefits do they provide?� ?P $���Require less time
More effective for standard handwashing than soap
More accessible than sinks
Reduce bacterial counts on hands
Improve skin condition��0U2� ��u/������������
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Historical study: Semmelweis
More recent studies: rates lower when antiseptic handwashing was performed� ��0�dU2��^
M��Q��p��:Self-Reported Factors for Poor Adherence with Hand Hygiene�;P;(���Handwashing agents cause irritation and dryness
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Lack of soap and paper towels
Too busy/insufficient time
Understaffing/overcrowding
Patient needs take priority
Low risk of acquiring infection from patients���0�dU2���H��Definitions����Hand hygiene
Performing handwashing, antiseptic handwash, alcohol-based handrub, surgical hand hygiene/antisepsis
Handwashing
Washing hands with plain soap and water
Antiseptic handwash
Washing hands with water and soap or other detergents containing an antiseptic agent
Alcohol-based handrub
Rubbing hands with an alcohol-containing preparation
Surgical hand hygiene/antisepsis
Handwashing or using an alcohol-based handrub before operations by surgical personnel�
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Patient contact
Donning gloves when inserting a CVC
Inserting urinary catheters, peripheral vascular catheters, or other invasive devices that don t require surgery
After:
Contact with a patient s skin
Contact with body fluids or excretions, non-intact skin, wound dressings
Removing gloves�`0U�0U0Ux0U � x��b��5Selection of Hand Hygiene Agents: Factors to Consider�6P6���Efficacy of antiseptic agent
Acceptance of product by healthcare personnel
Characteristics of product
Skin irritation and dryness
Accessibility of product
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Based on seven (60 second) handwashing episodes per hour
Alcohol-based handrub: 18 minutes
Based on seven (20 second) handrub episodes per hour��.�0�dU29�0 A��㑳2"�0�dU25�0 A��㑳2. 9" 5��`��"Recommended Hand Hygiene Technique�#P#��Handrubs
Apply to palm of one hand, rub hands together covering all surfaces until dry
Volume: based on manufacturer
Handwashing
Wet hands with water, apply soap, rub hands together for at least 15 seconds
Rinse and dry with disposable towel
Use towel to turn off faucet�n 0U2m0U20U2�0U2 m ���k�� Surgical Hand Hygiene/Antisepsis�!P!��>Use either an antimicrobial soap or alcohol-based handrub
Antimicrobial soap: scrub hands and forearms for length of time recommended by manufacturer
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Artificial nails should not be worn when having direct contact with high-risk patients (e.g., ICU, OR)��0U2� ��m��Unresolved Issues�P��MRoutine use of nonalcohol-based handrubs
Wearing rings in healthcare settings�<�)0U2%0P2 <� ��Z��Gloving�P���Wear gloves when contact with blood or other potentially infectious materials is possible
Remove gloves after caring for a patient
Do not wear the same pair of gloves for the care of more than one patient
Do not wash gloves��0U2� ��i��Education/Motivation Programs�P�� Monitor healthcare workers (HCWs) adherence with recommended hand hygiene practices and give feedback
Implement a multidisciplinary program to improve adherence to recommended practices
Encourage patients and their families to remind HCWs to practice hand hygiene�
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Place alcohol-based handrubs at entrance to patient room, or at bedside
Provide HCWs with pocket-sized containers��0U2� ��o��Alcohol and Flammability�P���Alcohols are flammable
Alcohol-based handrubs should be stored away from high temperatures or flames
Europe: fire incidence low
U.S.: one report of flash fire
Application is key: Let It Dry!��0U2� ��j��Performance Indicators�P��Monitor and record adherence to hand hygiene by ward or service
Provide feedback to healthcare workers about their performance
Monitor the volume of alcohol-based handrub used per 1,000 patient days
Monitor adherence to policies on wearing artificial nails�0U2 ���>SummaryAlcohol-Based Handrubs: What benefits do they provide?� ?P $���Require less time
More effective for standard handwashing than soap
More accessible than sinks
Reduce bacterial counts on hands
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The chi-square test for equivalence shows that SSI rates were comparable for the two forms of hand antisepsis. That is the handrubs were not associated with an increased risk of SSIs compared with traditional handscrubs. Moreover, the alcohol-based handrub was better tolerated by the surgical teams, and improved compliance with hand hygiene guidelines.�.>y��f餒
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Historical study: Semmelweis
More recent studies: rates lower when antiseptic handwashing was performed� ��0�dU2��^
M��Q��p��:Self-Reported Factors for Poor Adherence with Hand Hygiene�;P;(���Handwashing agents cause irritation and dryness
Sinks are inconveniently located/lack of sinks
Lack of soap and paper towels
Too busy/insufficient time
Understaffing/overcrowding
Patient needs take priority
Low risk of acquiring infection from patients���0�dU2���H��Definitions����Hand hygiene
Performing handwashing, antiseptic handwash, alcohol-based handrub, surgical hand hygiene/antisepsis
Handwashing
Washing hands with plain soap and water
Antiseptic handwash
Washing hands with water and soap or other detergents containing an antiseptic agent
Alcohol-based handrub
Rubbing hands with an alcohol-containing preparation
Surgical hand hygiene/antisepsis
Handwashing or using an alcohol-based handrub before operations by surgical personnel�
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e(U5!V��L��Indications for Hand Hygiene�P���When hands are visibly dirty, contaminated, or soiled, wash with non-antimicrobial or antimicrobial soap and water.
If hands are not visibly soiled, use an alcohol-based handrub for routinely decontaminating hands.� ��0�dU2� ��M��%Specific Indications for Hand Hygiene�&P&��XBefore:
Patient contact
Donning gloves when inserting a CVC
Inserting urinary catheters, peripheral vascular catheters, or other invasive devices that don t require surgery
After:
Contact with a patient s skin
Contact with body fluids or excretions, non-intact skin, wound dressings
Removing gloves�`0U�0U0Ux0U � x��b��5Selection of Hand Hygiene Agents: Factors to Consider�6P6���Efficacy of antiseptic agent
Acceptance of product by healthcare personnel
Characteristics of product
Skin irritation and dryness
Accessibility of product
Dispenser systems�FL0U270U2+0U2L 7+ ��d��9Efficacy of Hand Hygiene Preparations in Killing Bacteria�:P:��R��S�k7��6Time Spent Cleansing Hands:one nurse per 8 hour shift�"7P$���Hand washing with soap and water: 56 minutes
Based on seven (60 second) handwashing episodes per hour
Alcohol-based handrub: 18 minutes
Based on seven (20 second) handrub episodes per hour��.�0�dU29�0 A��㑳2"�0�dU25�0 A��㑳2. 9" 5��`��"Recommended Hand Hygiene Technique�#P#��Handrubs
Apply to palm of one hand, rub hands together covering all surfaces until dry
Volume: based on manufacturer
Handwashing
Wet hands with water, apply soap, rub hands together for at least 15 seconds
Rinse and dry with disposable towel
Use towel to turn off faucet�n 0U2m0U20U2�0U2 m ���k�� Surgical Hand Hygiene/Antisepsis�!P!��>Use either an antimicrobial soap or alcohol-based handrub
Antimicrobial soap: scrub hands and forearms for length of time recommended by manufacturer
Alcohol-based handrub: follow manufacturer s recommendations. Before applying, pre-wash hands and forearms with non-antimicrobial soap� 0U2 ��l��/Infection Rates: Surgical Handscrub vs. Handrub�0P0��f�� Skin Care�
P
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Get information from manufacturers regarding effects that hand lotions, creams, or alcohol-based handrubs may have on the effectiveness of antimicrobial soaps��0U2� ��[�� Fingernails and Artificial Nails�!P!���Natural nail tips should be kept to � inch in length
Artificial nails should not be worn when having direct contact with high-risk patients (e.g., ICU, OR)��0U2� ��m��Unresolved Issues�P��MRoutine use of nonalcohol-based handrubs
Wearing rings in healthcare settings�<�)0U2%0P2 <� ��Z��Gloving�P���Wear gloves when contact with blood or other potentially infectious materials is possible
Remove gloves after caring for a patient
Do not wear the same pair of gloves for the care of more than one patient
Do not wash gloves��0U2� ��i��Education/Motivation Programs�P�� Monitor healthcare workers (HCWs) adherence with recommended hand hygiene practices and give feedback
Implement a multidisciplinary program to improve adherence to recommended practices
Encourage patients and their families to remind HCWs to practice hand hygiene�
0U2
��h��/Administrative Measures to Improve Hand Hygiene�0P0���Make improved hand hygiene an institutional priority
Place alcohol-based handrubs at entrance to patient room, or at bedside
Provide HCWs with pocket-sized containers��0U2� ��o��Alcohol and Flammability�P���Alcohols are flammable
Alcohol-based handrubs should be stored away from high temperatures or flames
Europe: fire incidence low
U.S.: one report of flash fire
Application is key: Let It Dry!��0U2� ��j��Performance Indicators�P��Monitor and record adherence to hand hygiene by ward or service
Provide feedback to healthcare workers about their performance
Monitor the volume of alcohol-based handrub used per 1,000 patient days
Monitor adherence to policies on wearing artificial nails�0U2 ���>SummaryAlcohol-Based Handrubs: What benefits do they provide?� ?P $���Require less time
More effective for standard handwashing than soap
More accessible than sinks
Reduce bacterial counts on hands
Improve skin condition��0U2� ��u/������������
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