Adaptation to a rural and remote context of the WHO "Guidelines on Hand Hygiene in Health Care. First Global Patient Safety Challenge - Clean Care is Safer Care. 2009". Used at GMLF Hospital as teaching tool during the improvement proposal for reduction of Hospital Associated Infections as part of the Master's Internship in Global Health and Cooperation, Autonomous University of Barcelona.

1. HAND HYGIENE
AND
GLOVES USE AT GMLF HOSPITAL,
CHILAKALAPALLI, INDIA
Maria Noemi Croci
BSc (Hons) Nursing – Adult
Internship in M.S. Global Health and Cooperation

2. 40%
OF ALL HEALTHCARE ASSOCIATED
INFECTIONS
HAND HYGIENE ALONE IS RESPONSIBLE
FOR THE REDUCTION OF UP TO
Source: Günter Kampf at al , Hand Hygiene for the Prevention of Nosocomial Infections, Dtsch Arztebl Int. 2009 Oct; 106(40): 649–655
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770229/

3. THINK ABOUT THIS…
● INDIVIDUAL
PERCEPTION OF HAND
CLEANNESS
● INDIVIDUAL
PERCEPTION/BELIEF
on THE NEED TO wash
your hands
Cost effective on:
● Quality of care
● Infection control
● Burden of
infections and cost
of care

4. How germs are
transmitted from one
person to another?

5. HANDS ARE THE MOST COMMON AND
IMPORTANT CARRIERS OF GERMS
GERMS ARE CARRIED FROM PATIENT “A”
TO PATIENT “B” BECAUSE HAND HYGIENE
IS NOT DONE
GLOVES USE* AND HAND HYGIENE**
WILL PROTECT YOU AND THE PATIENTS
FROM INFECTIONS
*CHANGE GLOVES AND ** WASH YOUR
HANDS BETWEEN DIFFERENT PATIENTS

6. THE WHO MY 5
MOMENTS OF HAND
HYGIENE

7. 1. BEFORE STARTING THE DRESSING ROUND
3. AFTER CONTACT WITH BLOOD, WOUNDS, ULCERS, DISINFECTANT,
BETADINE, INSTRUMENTS (AND OTHER PATIENT CARE ITEMS) EVEN
IF YOU ARE USING GLOVES
2. BEFORE PUTTING ON GLOVES (USE NEW GLOVES FOR EVERY
DIFFERENT PATIENT)
4. WHEN TAKING OFF THE GLOVES (A PAIR FOR EVERY PATIENT)
5. AT THE END OF DRESSING ROUND AND AFTER TIDYING UP THE
DRESSING ROOM
GLOVES ARE NOT A SUBSTITUTE FOR HAND WASH
MY 5 MOMENTS OF HAND HYGIENE DURING DRESSING ROUND
AT CHILAKALAPALLI HOSPITAL

8. IF YOU DO NOT CHANGE GLOVES AND WASH YOUR HANDS FROM ONE PATIENT TO ANOTHER
YOUR HANDS WILL BECOME A VEHICLE FOR GERMS, INCREASING THE RISK FOR PATIENT TO
CONTRACT INFECTIONS.
gLOVES ARE MEANT FOR:
● YOUR PROTECTION
● PATIENT PROTECTION
YOU COULD BE THE REASON WHY PATIENTS ACQUIRE INFECTIONS
WITH GLOVES YOU MIGHT THINK YOU HAVE 100% PROTECTION, BUT THIS IS NOT TRUE!
GLOVES HAVE MICRO ABRASION/HOLES THAT ARE INVISIBLE AT NAKED EYE. THIS IS
WHY IT IS ALWAYS RECOMMENDED TO WASH YOUR HANDS BEFORE AND AFTER
REMOVING YOUR GLOVES. THEY WILL PROTECT FROM THE MAJORITY OF GERMS BUT HAND
WASH IS WHAT MAKES THE DIFFERENCE!
SAVING LIVES IS EASY: USE GLOVES AND WASH YOUR HANDS

9. CHEAP - EASY - COST EFFECTIVE - QUALITY OF CARE -
DURATION: ONLY 40 - 60’’ - REDUCTION 40% HAI

10. BUT HE IS NOT GOING TO
REMOVE THE GLOVES AND WASH
HIS HANDS…
THIS HEALTH CARE PROFESSIONAL
IS TAKING CARE OF PATIENT
“A”...
HE IS WEARING GLOVES...
WHAT WILL HAPPEN NEXT?
REFLECTION: TAKE TIME TO THINK
ABOUT THE DRESSING ROUND
AND COMPARE IT TO THIS
DRAWING:

11. THE HEALTHCARE PROFESSIONAL
IS TRANSMITTING GERMS FROM
PATIENT “a” TO PATIENT “B”
WHAT COULD HAVE HE DONE TO
AVOID GERMS TRANSMISSION?
A) REMOVE THE GLOVES
B) WASH HIS HANDS
c) PUT ON NEW
GLOVESD) ALL THE
PREVIOUSREMEMBER: OPEN
WOUNDS/ULCERS ARE MORE
EXPOSED TO GERMS

12. HOW TO PUT ON
GLOVES

13. 1
2
3
4
6
5
7
8
9
9
HOW TO REMOVE
GLOVES

15. WHAT ARE YOU
DOING?!?!

16. REMEMBER THAT GLOVES ARE NOT
100% SAFE IN THERMS OF
PROTECTION: CHANGE YOUR
GLOVES AND WASH YOUR HANDS
BETWEEN DIFFERENT PATIENTS
DURATION OF CARE UNGLOVED HANDS
INCREASED NUMBER OF GERMS ON HANDS

17. this is why you need to wash your hand after you
remove gloves!
Remember that there are always invisible holes
or damaged areas…
Gloves are never 100% safe...
This is just a visible example...

18. WHEN IS APPROPRIATE TO
USE EXAMINATION
GLOVES:
● IV INSERTION AND
REMOVAL
● IV INJECTION
● CONTACT OR RISK OF
CONTACT WITH BLOOD
● CONTACT OR RISK OF
CONTACT WITH NON
INTACT SKIN (WOUNDS
AND ULCERS)

19. IN CONCLUSION...
● HAND HYGIENE QUALITY OF CARE REDUCTION OF INFECTIONS
● GLOVES USE QUALITY OF CARE REDUCTION OF INFECTIONS
● REMOVE GLOVES WASH YOUR HANDS PUT ON NEW GLOVES
● AVOID TOUCHING EVERYWHERE WHEN YOU HAVE GLOVES ON
● LEARN AND PRACTICE HOW TO CORRECTLY REMOVE GLOVES
● GERMS ARE INVISIBLE TO OUR EYES...THIS IS WHY WE HAVE TO
IMAGINE THEM AS… BIG, ENORMOUS, TERRIFING...
● VERY COST-EFFECTIVE MEASURE
● DISCUSS AND ALLOCATE SPECIFIC BUDGET

20. THE WHO ALSO RECOMMEND TO AFFIX HARD COPIES OF THE HAND
WASH GUIDELINES NEAR TO WASHING BASINS and clinical areas

21. The contents of this presentation were taken and adapted
from “WHO Guidelines on Hand Hygiene in Health Care.
First Global Patient Safety Challenge Clean Care is Safer
Care. 2009” . Free download at:
http://www.who.int/gpsc/5may/tools/9789241597906/en/