This document from BestCare Laboratory Services discusses the importance of hand hygiene in healthcare settings. It notes that healthcare acquired infections occur in 5-10% of hospital patients and cause over $10 billion in excess costs annually. About 1/3 of healthcare acquired infections are preventable through measures like hand hygiene using alcohol-based sanitizers or soap and water. Proper hand hygiene can significantly decrease infection rates and is the most effective way to prevent transmission between patients and staff. The document provides guidelines from the CDC on appropriate hand hygiene techniques and recommends a culture change is needed for sustained improvement in hand hygiene compliance.

1. BestCare Laboratory Services
HAND HYGIENE
SAVES LIVES

2. Impact of Health-care
Acquired Infections
 Healthcare acquired infections occur in
5 to 10% of patients admitted to acute
care hospitals in the US
 Direct costs of excess hospital stay
exceed $10 billion annually
 Caused over 88,000 deaths in 1995-
one death every 6 minutes
UPMC Institute for Performance Improvement

3. Prevention of Health-care
Acquired Infections
 About 1/3 of all Health-care Acquired
infections are Preventable
 Infection Control measures are
VERY Cost Effective
* Hand Hygiene (HH)
* Alcohol Sanitation
* Antimicrobial Soaps *
Personal Protective Equipment (PPE)

4. Benefits of Hand Hygiene
 can decrease infection rates
 is the most important procedure for
preventing health-care acquired
infections
 can prevent transmission of bacteria to
other Health Care Workers and their
families
Bryan, Infection Control in Critical Care, 1996:7:617
MMWR, 1987:37:24 – Copyright UPMC Institute for
Performance Improvement

5. CDC Recommendations for
Alcohol Based Hand Rub
 If hands are not visibly soiled, use an
alcohol based hand rub
* apply golf ball size portion to
palm of one hand and rub hands
together, covering all surfaces of hands
and fingers until hands are dry.

6. CDC Recommendations for
Hand Washing (Soap &
Water)
 If hands are visibly soiled or
contaminated with proteinaceous
material, blood or other body fluids:
wash hands with either a non-microbial
soap and water or an antimicrobial soap
and water for at least 15 seconds.
 Soap and Water must if patient is
diagnosed with C. difficile.

7. Hand Washing Technique
 Avoid hot water – hot water may increase the
risk of dermatitis
 Wet hands with water
 Apply soap
 Rub hands together for at least 15 seconds
 Rinse hands
 Dry thoroughly with a disposable towel
 Use towel to turn off the faucet

8. When To Perform Hand
Hygiene - THE BEFORES
 Before having direct patient contact.
 Before donning gloves when performing
phlebotomy.
NOTE: Always dispose of gloves
before leaving the patient’s room.

9. When To Perform Hand
Hygiene – THE AFTERS
 After contact with patient’s intact skin.
 After contact with bodily fluids or
excretions, mucous membranes, non-
intact skin or wound dressings.
 After contact with inanimate objects
(i.e., medical equipment) in the
immediate vicinity of the patient.
 After removing gloves.

10. Making a Difference
 It is estimated that in US hospitals, appropriate
hand hygiene only occurs about 50% of the time.
 Some ICU’s rates have been reported as low as 17%
 Most attempts to improve hand hygiene are only
associated with a short lived improvement.
 CHANGING THE CULTURE IS THE ONLY
WAY TO MAKE A DIFFERENCE.
 CHANGING THE CULTURE REQUIRES
ACTIVE INVOLVEMENT FROM ALL WITH A
COMMITMENT TO PERFORM
APPROPRIATE HAND HYGIENE 100% OF
THE TIME.

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