Healthcare Hygiene magazine January 2024 January 2024 | Page 26

hand hygiene

hand hygiene

By Robert Lee

How Important is Hand Hygiene in the Use of Gloves , Masks , Surgical Drapes and Gowns , and Other Medical Devices ?

I ask the question that if hand hygiene is the No . 1 way to reduce the risk of infection , why do we not get the correct guidance on how and , most importantly , when to perform hand hygiene ?”
Infection prevention is not a singular intervention ; as Septimus , et al . ( 2014 ) note , multiple interventions implemented simultaneously is recommended . And as Wohrley and Bartlett ( 2018 ) observe , “ Horizontal strategies seek to broadly reduce the burden of common healthcare-associated pathogens including S . aureus , Enterococcus , gram-negative bacteria , and Candida through interventions such as hand hygiene and environmental cleaning .”
As a result , it is very difficult to determine the cause and effect of each intervention . We know that hand hygiene is a key component , but high levels of hand hygiene compliance do not always result in infection rate reduction . Why ?
In this article , I consider the relationship between hand hygiene and medical devices such as gloves , masks , surgical drapes / gowns , etc ., as well as explore how this relationship reduces or accelerates the risk of infection transmission .
Gloves Why do you wear gloves and when do you perform hand hygiene ? According to the Food and Drug Administration ( FDA ), “ Use medical gloves when your hands may touch someone else ’ s body fluids ( such as blood , respiratory secretions , vomit , urine , or feces ), certain hazardous drugs or some potentially contaminated items . Hand hygiene should be performed prior to and after removing gloves . Unfortunately , gloving has been used as a substitute for hand hygiene . Gloving protects the wearer , but improper glove use can result in pathogen transmission from patient to patient , patient to surfaces , etc . When reminding staff on how to
use this medical device , many acknowledge and are appreciative , but an alarming number demonstrate that their only concern is their own protection .”
Masks
So , did you know that masking can both help prevent transmission of microorganisms or can accelerate the transmission of such organisms ? You must ask which microorganism / pathogens you are trying to address . Is it viral or bacterial ? Most masks are designed for bacterial not viral protection . Unless you are using a sheet of plastic , viruses will permeate your mask . Bacteria and viruses use vehicles such as liquid , moisture , particulate matter , blood , bodily fluids , even airborne dust , as well as hand contact , etc . So , if you are trying to prevent viral transmission , as in SARS- COV-2 , and you are not sanitizing your hands , touching your face , your cell phone , and your mask , then you may be risking viral contamination . We are told to wear masks , but we are not told how to use this medical device properly . Thus , this can contribute to increased transmission . You must ask yourself , why are we not being told how to properly use masks if they are so effective in reducing the risk of catching and spreading a viral pathogen ?
Evidence-based studies show the average individual touches his or her face 23 times per hour ( Kwok , et al ., 2015 ). Tajouri , et al ., ( 2021 ) showed that 45 percent of cell phones carried SARS-CoV-2 during the pandemic . Do you think that individuals performed proper hand hygiene each time they touched their faces or handled their cell phone ? Of course not . Think of a couple of common scenarios . How about
your children at school who were required to mask , usually with a single mask worn all day . How about members of the public in a grocery store wearing masks and gloves , touching everything in sight and never doing hand hygiene ? Watch television and you ’ ll see public officials or other personalities who are wearing and touching their masks but never doing hand hygiene .
Drapes and Gowns Over the past 30 years , surgery has demonstrated the importance of barrier material and the science of sterile technique . The same principles as articulated above apply , but the difference in the operating room ( OR ) is that OR personnel revisit these principles during each case . They also hold each other accountable for maintaining proper technique . Surgical drapes and gowns are manufactured with the knowledge that fluid , blood , particulate matter , and touch are all vehicles for pathogen transmission . Drape and gown technology is focused on fluid penetration barrier performance while balancing comfort and drapeability . Materials are either permeable or impermeable ; performance is matched to the expected opportunity for them to encounter blood , fluid , or particulate matter , as well as taking into consideration the length of case , risk of foreign bodies , etc . Even with all this technology , hand hygiene and hand hygiene science are important parts of the sterile process . Should hands become contaminated ( usually gloved ), rescrubbing may be required and / or re-gloving . Nevertheless , in the OR , the hands play a pivotal role in the infection prevention chain .
26 • www . healthcarehygienemagazine . com • january 2024