HAND HYGIENE AND HAND WASHING AMONG HEALTH WORKERS

Maintenance of proper hand hygiene among treating doctors and nurses is one of the most important measures to curb healthcare-associated infections. Hand hygiene is one of the most critical healthcare concerns globally. It is a single most cost-effective and practical measure to cut down infections and spread of antimicrobial resistance across all settings—from advanced healthcare systems to primary healthcare centers. WHO introduced the “My five moments with hand hygiene” approach for healthcare workers and these are before and after touching a patient, before performing aseptic procedures, after exposure to body fluids, and after touching the patient surroundings. The knowledge and practice of the medical and nursing students reflect the future healthcare community.

Hand Hygiene is a general term that applies to handwashing, antiseptic hand wash, antiseptic hand rub, or surgical hand antisepsis.

Hand hygiene is a way of cleaning one’s hands that substantially reduces potential pathogens (harmful microorganisms) on the hands. Hand hygiene is considered a primary measure for reducing the risk of transmitting infection among patients and healthcare personnel.

Hand washing is the process of mechanically removing soil and debris from the hands using plain water and soap.According to world health organization guidelines, hand washing remains the most effective measure to prevent the mode of transmission of micro-organisms.

However, hand washing with soap and water is the single most weapon against infectious agents.

Adequate infection control practice is one of the key elements for restricting the spread of healthcare-associated infectious disease. Numerous guidelines state that handwashing is the most essential procedure to prevent nosocomial infection but on the parallel hand many studies continue to report unacceptable healthcare worker hand-hygiene compliance rates. Minimal sustained success has been outlined even after countless efforts to improve hand-hygiene behaviour that focused on broad-based educational and motivational programs. Poor hand-hygiene adherence transpires due to the unavailability of hand-washing sinks, lack of time to perform hand hygiene, patient’s underlying condition, outcomes of hand-hygiene products on the skin, and unawareness of the guidelines. HealthCare syndicated infections are voluminously listed as a consequence of person-to-person transmission of nosocomial pathogens via the hands of healthcare personnel. It is also evident that the rise in levels of micro-organisms contamination has been identified due to flawed nursing practices, such as direct touching, contact with bodily fluids, and wound care. Even during relatively clean procedures, such as taking the pulse, measuring arterial blood pressure and checking temperature, nurses’ hands can become open to bacteria. The hand-washing habits of nurses are debatable for many reasons, which include the cumbersome structure of intensive care units, the characteristics of the patients in intensive care, the heavy workload in such units, and the insufficiency of nurses. Undeniably, with varied environmental factors and host factors, human skin is known to be immutably covered with microorganisms, both commensals and pathogens depending on topography. Either hospital surroundings or poor hygiene is one of the key factors of transient micro-flora on the hand which is dynamically responsible for cross-infections.

Principles of hand Hygiene

• One must use running water in a sink that drains out instead of using a basin.
• One may use soap – antibacterial soap if necessary.
• One must rub your hands against each other for at least 30 seconds to facilitate removal of microorganisms.
• Long nails and jewelry trap germs. It is best to keep fingernails short. If you wear a ring, it is better not to remove the ring before hand washing so that it can be washed too.
• It is always better to use disposable paper towels than to use cloth towel when drying hands to ensure that you can only use those once.
• The faucet is always considered dirty and it is recommended to turn it off using a paper towel in the absence of the ideal sensor or foot pedal.
• Dispensers of soap should be used until completely empty. Once emptied, It should be washed before refilled

Types of Hand Hygiene

• Routine hand wash. Use of water and non-antimicrobial soap for the purpose of removing soil and transient microorganisms.
• Antiseptic hand wash. Use of water and antimicrobial soap to remove or destroy transient microorganisms and reducing resident flora.

Antiseptic hand rub. Use of alcohol-based hand rub.

Surgical antisepsis. Use of water and antimicrobial soap for the purpose of removing or destroying transient microorganisms and reduce resident flora. Recommended duration is 2-6 minutes.

Indicators of Hand Hygiene

According to the World Health Organization (WHO), there are Five Moments for Hand Hygiene:

• Before Patient Contact.
• Before and Antiseptic Task.
• After Body Fluid Exposure Risk.
• After Patient Contact.
• After Contact with Patient Surroundings.

CONCLUSION

Hand hygiene being one of the simplest and effective practice to prevent infections, compliance and knowledge are still poor and the most important and basic practice to minimize the health care associated infections in primary care is maintaining the proper Hand hygiene by the primary care physicians. Hand hygiene procedures include the use of alcohol-based hand rubs (containing 60%–95% alcohol) and hand washing with soap and water. Implementation of hand washing technique on the regular basis in primary care physicians is contributing in lowering the morbidity and mortality. Frequent training programs and reminders should be implemented to boost up the knowledge and increase the compliance of this practice.

It cannot be said too often that hand washing Is the most important and most basic technique in preventing and controlling infections. It is the single most effective infection control measure.