control, cross, hand, infection, washing

المدير العام تاريخ التسجيل : 29/08/2009

control, cross, hand, infection, washing

Cross Infection Control - Hand washing

The main purpose of hand washing is to reduce the number of pathogenic (disease-causing) micro-organisms on the skin surface.

Water
Warm water should be used when washing hands. Why is this better than cold water?

When combined with a detergent, the warmth helps to dissolve the natural oils on the hands that harbour bacteria.

Basins
Each surgery must have at least one dedicated wash-hand basin. The UK NHS recommends that separate dedicated wash-hand basins for use by staff conducting decontamination should be provided. (In addition, two dedicated sinks should be available for decontamination work – including where an automated washer-disinfector is in use. These sinks should not be used for hand-washing.)

Taps
Taps should be hands-free. This means they can be turned on with the wrist or elbow, foot-operated, or have electronic sensors. This will prevent cross contamination from the handle.

How should you turn a tap off after washing your hands if it is not hands-free?

Use the paper towel you have dried your hands with, after they have been dried

Solid soap? No !
Ordinary soap is not antibacterial – in fact, bacteria can grow well on soap. Using ordinary soap will remove obvious dirt, but may actually increase the amount of pathogens on the hands.

Even antibacterial solid soap will be remain contaminated on the surface after it is used.

Liquid or foam detergent hand wash, and dispenser

These are recommended for use in dental practices. The dispenser should ideally be “hands-free” – an infra-red beam detects when a hand is under the dispenser. Most experienced dental staff will have seen how dirty a “push-dispenser” gets after a while.

The detergent should be provided in sealed single-use bags
Why?

To prevent contamination when re-filling, and further growth of bacteria left in the residual detergent after extra is added.

Antiseptic Hand Rub
Antiseptic Gel or Foam dispensers are commonly seen in hospital wards and corridors. They are sometime called Hand Sanitisers, Hand antiseptics, or Alcohol Rubs. They contain mainly alcohol, with a thickening agent like glycerine. Again, dispensers should be hands-free to prevent cross contamination.

They are used for killing bacteria and viruses on clean hands. They will not remove dirt.

Nail Brushes, Orange sticks.
These should be used when hands are initially washed to clean dirt from under the nails. This should be done gently. The nail brush should be used once, then autoclaved or disposed. A better alternative is to clean the nails with "orange" sticks.

Scrubbing brushes? No
The dental team should not use scrubbing brushes to clean the skin. Why?

Repeated use can cause damage to the skin, making it more likely to harbour pathogenic bacteria. There are also reports that scrubbing actually increases the surface bacterial count, perhaps by bringing deep bacteria up to the surface.

Drying
After rinsing, the hands should be dried with disposable towels. This is an essential part of removing dirt and bacteria, which are present in the residual water on the hands. Using a towel can decrease the bacteria on the hands by 75%.

Hot air driers, and jet driers, should not be used. This can actually increase the amount of bacteria on the skin, as well as spreading bacteria into the air.

The procedure

Preparation:
• Remove jewellery.
• Cover any skin abrasions with a waterproof plaster.

Washing (should take about 1 minute)
• Wet hands with warm water.
• Apply antiseptic hand wash.
• Wash hands using an approved technique (picture below).
• Use an orange stick, if necessary, to clean nails.
• Rinse hands under running water.
• Dry with a disposable towel.

Disinfecting (about 20 seconds)
• Use an Antiseptic hand rub until it has evaporated.

Cross Infection Control washing

Sequence for hand washing and/or disinfecting

Types of hand washing

1) Social Hand-wash
Routine for all patient contact. Use liquid or foam detergent from a dispenser.
This will remove 95% of transient micro-organisms from the hands. The skin has a resident flora consisting of bacteria that are a ntaural part of the body. Transient micro-organisms are those that are acquired temporarily by touching things.

2) Disinfection Hand-wash
Prior to undertaking operative procedures. Use liquid/foam detergent as above, then alcohol rub. This combination will remove 99% of transient mico-organisms, and some resident mico-organisms.

3) Surgical Scrub
Prior to undertaking surgical procedures. Use an antiseptic hand wash solution like Hibiscrub, Aquasept, Hydex etc, for two minutes. Include forearms. Effective against both transient and resident mico-organisms.

The Hand Hygiene Policy

A practice should have a written policy for hand hygiene. For a printable version you can use in your practice,