8 Hand hygiene

Question 1

What is the advice regarding using soap bar for disinfection?

Answer 1

soap has minimal antimicrobial properties

as long as soap put in a rack, and allowed the dry, then minimal risk of transferring bacteria from person-person via the soap

Question 2

Alcohol hand gel is more effective than soap at disinfection

What concentration of alcohol should be used?

Answer 2

60-80% alcohol

Question 3

What are the draw backs of alcohol gel?

Answer 3

Does not kill bacterial spores (C.diff) or protozoan oocysts

Question 4

What are the WHO 5 moments of hand hygiene

Answer 4

Before touching patient
After touching patient
After touch patients surroundings

Before clean procedure
After body fluid exposure

Recommended hand washing steps have no evidence, but likely to be beneficial as covers all aspects of the hand when cleaning

Question 5

IPC recommends monitoring alcohol gel consumption, as a means to determine handwashing rates in wards.

What are pros/cons of this

Answer 5

very inaccurate - different people use different amounts of gel

alcohol gel often used by visitors and patients - so does not reflect how much used by clinical team

Question 6

What factors make staff reluctant to wash their hands?

Answer 6

Lack of education

Overworked/ not enough time

Lack of facilities to wash hands

Skin reactions to products

Falsely thinking gloves will protect from infection - not washing hands afterwards

Question 7

What skin reactions can occur when using skin washing products?

Answer 7

irritant contact dermatitis - denaturation of stratum corneum proteins, change in intercellular lipids, which allows skin to dry out. Use moisturising products or change product

allergic contact dermatitis - delayed reaction usually perfumes. Alcohol rubs do not usually cause this