Hand Hygiene &
Hand Hygiene &
Hand Hygiene &
CONCEPTS IN
INFECTION PREVENTION
AND CONTROL
AISA JENSEN LEE, RN
Objectives
At the end of the lecture, the participants
will be able to:
Define the burden of disease of healthcare
associated infection
Identify the strategies to combat healthcare
associated infection
Hand hygiene
Cleaning and Disinfection
Question?
Can omission of hand hygiene cause an
adverse event?
Yes
Hospitals
Can
Make YOU
Sick!
Question?
What is a healthcare associated infection?
What are its implications in a healthcare
institution?
Burden of Healthcare-associated
Infections (HCAIs)
HCAIs are most frequent adverse events in
healthcare delivery
7-10/100 hospitalized patients will acquire at
least one HCAI
Burden of HCAI is higher in middle and low
income countries
1/3 of operated patients in low income
countries will develop SSI
WHO Fact Sheet
Burden of Healthcare-associated
Infections (HCAIs)
30% of ICU patients in high income countries will
develop at least one HCAI
ICU infections are 2-3 times higher in low to
middle income countries, with device-related
infections 13 times higher
Newborns in developing countries have 3-20 times
higher HCAI rate than high income countries
WHO Fact Sheet
Impact of HCAIs
Critical site
with body fluid
exposure risk
Strengths:
Count both opportunities for hand hygiene and
the action of hand hygiene
Determine who performed hand hygiene and the
quality of the act
It can provide quantitative and qualitative
information about why and when hand hygiene
failures occur.
Able to differentiate the types of hcws and
patients or family members.
Limitations:
Laborious and costly
Requires uniformity in the selection and training
of observers and in the recording of data.
Possibility of inaccuracy in getting the "true
picture" due to Hawthrone effect.
Captures only a small sample of all opportunities
for performing hand hygiene.
May compromise the patients privacy.
Selection of Opportunities
5 Moments of
Hand Hygiene
Selection of Respondents
Physicians
Nurses
Pastoral Care Personnel
Technicians
Physical Therapists
Environmental Services Workers
Dietitians
Phlebotomists
Radiology Technicians
Conducting Observations
Dealing with Double Counting
It is essential that observers be able to
determine what qualifies (what should be
counted) as an opportunity or an action.
Opportunities and actions must be
operationally defined to ensure an accurate
tally.
Determining Frequency of
Observation
Dependent on the reasons for monitoring and resources.
Daily
Weekly
Monthly
Quarterly
Cleaning
Cleaning is the removal of visible soil
(e.g., organic and inorganic material) from
objects and surfaces and normally is
accomplished manually or mechanically
using water with detergents or enzymatic
products.
Question?
Is thorough cleaning is essential before
high-level disinfection and sterilization?
Answer
Yes, because inorganic and organic
materials that remain on the surfaces of
instruments interfere with the
effectiveness of these processes.
Decontamination
Decontamination removes pathogenic
microorganisms from objects so they are
safe to handle, use, or discard.
Terminologies
Terms with the suffix cide or cidal for killing action also are
commonly used.
For example, a germicide is an agent that can kill
microorganisms, particularly pathogenic organisms (germs).
The term germicide includes both antiseptics and
disinfectants.
Antiseptics are germicides applied to living tissue and skin;
disinfectants are antimicrobials applied only to inanimate
objects.
Virucide, fungicide, bactericide, sporicide, and tuberculocide
can kill the type of microorganism identified by the prefix.
Spauldings Classification
Cleaning of Medical
Equipment
Manufacturers of medical equipment should provide
care and maintenance instructions specific to their
equipment. These instructions should include
information about:
the equipment compatibility with chemical
germicides
whether the equipment is water-resistant or can be
safely immersed for cleaning
how the equipment should be decontaminated if
servicing is required
Ideal Disinfectant
Broad spectrum:
Fast acting:
Not affected by
environmental factors:
Nontoxic:
Surface compatibility:
Cleaner:
Environmentally friendly:
Disinfectants
Sterilants and high-level
disinfectants
1 Formaldehyde
2 Glutaraldehyde
3 Ortho-phthalaldehyde
4 Hydrogen peroxide
5 Peracetic acid
6 Hydrogen peroxide /peracetic
acid combination
Intermediate-level disinfectants
7 Sodium hypochlorite
8 Iodophors
Low-level disinfectants
9 Phenols
10 Quaternary ammonium
compounds
http://www.hospitalmanagem
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