2. Hand Hygiene in Healthcare Settings
An Overview:-
Background
Bacterial flora in our hand
Aim for hand washing
Selection of Agents
Techniques
Surgical
Other
3. Background
Ignaz Semmelweis discovered the importance of hand
hygiene in 1858
Semmelweis introduced hand washing with chlorinated
lime solutions for interns who had performed autopsies.
He immediately reduced the incidence of fatal puerperal
fever from about 10 percent to about 1–2 percent.
4. • At the time, diseases were
attributed to many different
and unrelated causes.
• Semmelweis’s hypothesis,
that there was only one
cause, that all that mattered
was cleanliness, was largely
ignored, rejected or ridiculed.
5. • Semmelweis’s practice earned
widespread acceptance only years
after his death,
• 1868–1881-Louis Pasteur
developed the germ theory of
disease , offering a theoretical
explanation for Semmelweis’s
findings.
• He is considered a pioneer of
antiseptic procedures.
7. Normal Resident Flora:-
• Microorganisms that are always present on/in a
person and usually do not cause any disease.
• These are like the permanent residents of a city.
e.g.
Mutualistic bacteria (symbiotic relationship)
8. • Depending on what part of the body we're
talking about, the normal flora can vary.
• On the skin, normal flora is made up of
bacteria such as staphylococci.
• In the mouth, bacteria that are present are
called streptococci.
9. In general
• Resident flora is less likely to be
associated with infections, but may
cause infections in sterile body cavities,
the eyes, or on non-intact skin.
10. Transient flora
• It’s a visitor of the city
• Transient or temporary skin flora refers to the
microorganisms that transiently colonize the
skin.
11. Transient flora
Transient microorganisms do not usually multiply on the skin,
but they can survive and sporadically multiply on/inside the skin
surface.
Healthcare workers often acquire transient floras during direct
contact with patients or contact with contaminated
environmental surfaces within close proximity of a patient.
• e.g. routine neonatal care, respiratory secretions
12. • According to the CDC, the single most important
thing we can do to keep from getting sick and
spreading illness to others is to wash our hands with
soap and water.
13. Aim of hand washing
• Remove microorganisms from the hands,
preventing their potential transfer.
• Hand washing reduces the number of transient
organisms on the skin surface to enter in the
body.
15. Soap
• Washing your hands with plain soap and
water removes germs, including antibiotic-
resistant germs. Keeping your hands clean can
prevent the spread of germs, reducing the risk
for antibiotic-resistant infections.
• Soap and water don't kill germs; they work by
mechanically removing them from your hands.
16. Alcohol
• Alcohol is a very effective antimicrobial agent
when used in concentrations greater than 61
percent
• Alcohol does not harm skin cells, as the body
rapidly re-supplies intra-cellular water that is
lost in denaturing
• Alcohol-based hand sanitizers can’t kill all types
of germs, such as a stomach bug called
Norovirus.
17. • Alcohols act by rapidly denaturing DNA, RNA
and lipid biomolecules that are essential for
microbial growth and development.
18. Chlorhexidine Gluconate (CHG)
• It has both bacteriostatic (inhibits bacterial growth) and
bactericidal (kills bacteria) mechanisms of action, depending on
its concentration.
• Chlorhexidine kills by disrupting the cell membrane. Upon
application.
19. • That is why it is very important to rinse hands
thoroughly after use of CHG.
• Chlorhexidine can kill nearly 100% of Gram-positive
and Gram-negative bacteria within 30 seconds.
23. Donning PPE’s:
• Perform Hand Hygiene (15 seconds
minimum) With alcohol based hand rub, or
if hands are visibly
• Put on Gown
• Put on Mask/N95 Respirator
• Put on Protective Eyewear (if not already
attached to
• Put on Gloves
24. Doffing PPE’s:
1.Remove gloves
2.Remove gown
3.Healthcare personnel may now exit patient
room
4.Perform hand hygiene
5.Remove face shield or goggles
6.Remove and discard respirator (or
facemask if used instead of respirator).
26. Surgical Asepsis:
• Aseptic technique means using practices
and procedures to prevent contamination
from pathogens. It involves applying the
strictest rules to minimize the risk of
infection.
I. Sterile gloves
II. Sterile gowns
III. Masks for the patient and healthcare
provider
IV. Sterile drapes
27. Surgical Techniques:
• Barriers. A barrier is a physical, sterile object that
prevents any germs on the healthcare
professionals from getting on the patient
• Contact guidelines. Aseptic technique relies on
keeping sterile objects guaranteed sterile
• Tool and patient preparation
• Environmental controls
29. Isolation:
• According to the CDC, isolation is the act
of separating a sick individual with a
contagious disease from healthy
individuals without that contagious disease
in order to protect the general public from
exposure of a contagious disease.
Editor's Notes
In any given city there are those who live there permanently and those that are just passing through. It's interesting to note that on the human body, the same basic concept occurs with respect to flora, the collection of microorganisms inhabiting a person. There are two types of flora, normal flora and transient flora. Let's distinguish between the two and showcase some examples of each.
