​Clinical Procedures – Hand Hygiene

​Clinical Procedures –  Hand Hygiene
When?
The WHO World Alliance for Patient Safety, in 2006, identified '5 moments' for hand hygiene. These are:
• Before patient contact:
• Before touching a patient, when approaching him/her
• Before an aseptic task
• After body fluid exposure risk:
• Immediately after exposure or potential exposure to body fluid (and after removing your gloves)
• After patient contact:
• After touching a patient and his/her immediate surroundings, when you leave the patient's side
• After contact with a patient's surroundings:
• After touching any object or furniture in the patient's immediate surrounding when leaving even if you haven't touched the patient.
Soap or Alcohol Gel?
Repeated washing with soap and water can cause skin dryness and can be time consuming. For these reasons, alcohol gel has become commonplace in clinical settings.
There are no hard and fast rules but:
• Alcohol gel should not be a substitute for soap and water your hands are visibly soiled or if you are undertaking an aseptic procedure
• Remember that alcohol gel is not effective against
Clostridium difficile.
Should visitors also be cleaning their hands?
There is little solid evidence that this is effective in reducing hospital infections. However, visitors are encouraged to clean their hands in most clinical areas, partly because it raises the public profile of the importance of hand hygiene.

Soap and Water Technique
• Adhere to 'bare below elbow' rule
• Wet hands with water
• Apply soap (from a dispenser) to cover all hand surfaces
• Ensure all 7 parts of the hands are thoroughly cleaned:
• Rub hands palm-to-palm
• Rub back of each hand with the palm of the other, fingers interlaced
• Rub hands palm-to-palm with fingers interlaced
• Lock hands together and rub backs of fingers against opposite palm
• Rub thumbs in rotational movement with opposite hand
• Rub tips of fingers into opposite palms
• Rub each wrist with opposite hand
• Hold hands under running water, rub vigorously to remove all suds
. Turn off taps using elbow
• Dry thoroughly with paper towel
• Dispose of paper towels in appropriate clinical bin (using foot pedal to open)
• DO NOT TOUCH any other objects until task is undertaken and completed.
Alcohol Gel Technique
Essentially the same technique as above but no need to rinse or dry with paper towel.
• Squirt small amount of gel onto centre of palm
• Ensure all 7 parts of the hands are thoroughly cleaned as above
• Allow 20-30 seconds for hands to dry, holding hands up
• Following disinfection, DO NOT TOUCH any other objects prior to commencing procedure.