HAND WASHING IN CLINICAL SETTING

Importance of Hand Washing In Clinical Setting



Importance of Hand Washing In Clinical Setting

Introduction

In the healthcare setting, handwashing is often cited as the primary weapon in the infection control arsenal. The purpose of handwashing in the healthcare setting is microbial reduction in an effort to decrease the risk of nosocomial infections.

Hand hygiene can also be a problem in busy health centers and clinics where patients are seen both in increasing numbers and treated in rapid succession (Larson, 2010, Pp 371-375). Prevention and control of infectious activities are designed to limit the spread of infection and provide a safe environment for all patients, regardless of the setting. In light of the emergence of antibiotic resistant organisms, effective infection control measures, such as handwashing, are essential to prevention (Huber, 2006, pp 37-45).

Discussion

Handwashing is a simple and effective infection control intervention.

When To Wash Hands

Hands should be washed:

- When they are visibly soiled;

- Before an aseptic or sterile procedure;

- When they feel dirty or sticky;

- Following frequent applications of a decontaminant gel. (Boyce , 2001, pp 231-233)

Hands may also be washed before and after patient contact or putting on gloves. If hands are not soiled or sticky, a decontaminant rub or gel may be used. Where handrubs are not available, the hands should be washed.

Anatomy and Physiology

All humans have bacterial flora on their skin, although the quantities present vary. The bacterial flora on the hands can be divided into two groups:

- Transient;

- Resident. (Boyce , 2001, pp 231-233)

Resident flora are found on the surface of the skin and under the superficial layers (stratum corneum). They live and multiply on the hands. A common example is Staphylococcus epidermidis. Resident bacterial hand flora are unlikely to cause infections on the skin surface but may be problematic if they enter wounds or body cavities. Transient bacterial flora are frequently acquired from contact with surfaces, substances or people. An example is Staphylococcus aureus(Ansari, 1989,Pp 3113). They may or may not colonise the hands and are more easily removed by handwashing than resident flora. Transient flora may be pathogenic and cause health care-associated infections.

The aim of handwashing is to remove transient and some resident flora to prevent transmission of pathogenic micro-organisms to patients. The action of friction (rubbing hands together and drying with a towel) and the effect of soap and water remove debris and micro-organisms. Scrubbing should be avoided as this may damage the skin.

Preparation

Taylor (1978) found that the handwashing techniques of health professionals were often inadequate, and training is therefore useful. Posters are a good reminder of the correct technique and the importance of handwashing.

In clinical settings, sinks should be at the correct height for professionals to stand while handwashing. Elbow or wrist action taps should be adjusted for easy operation.

A foot-operated lidded bin is preferable. Liquid soap and disposable towels should be wall-mounted near the sink(Ansari, 1989,Pp 3113).

In the community, health professionals may have to adapt to the available facilities, possibly carrying a supply of disposable towels and liquid ...