hand hygiene
hand hygiene
By Robert P . Lee
Hand Hygiene and Surfaces : The Case for Big Data , Lean 6-Sigma and Improved Standardized Training and Education
Hand hygiene is not handwashing but rather the execution of cleaning and sanitizing one ’ s hands properly at critical times during patient care . Unfortunately , achieving this goal at a high level of compliance has proven difficult . Sanitizing your hands upon entering a patient ’ s room and then using the keyboard of a workstation , handling a patient chart , or touching anything in the room prior to touching the patient can negate the impact of hand cleansing and potentially acquire a pathogen that can then be transferred to the patient during contact . Entering a room and quickly activating a dispenser but never ensuring that a proper amount of sanitizer is dispensed and that the dispensed solution is properly dispersed and spread over the surface of the hands can also negate the value of hand cleansing .
Part 1 : Sanitizing Your Hands
Guidelines for appropriate hand hygiene are widely available and an important component of infection control training and reinforcement . Recently , the Society for Healthcare Epidemiology of America ( SHEA ) published some newer guidance focused on fingernails , polish , fingertips and maintaining healthy skin ( Infection Control & Hospital Epidemiology 2023 , 1-22 ). Because healthcare personnel average about 200 hand-hygiene opportunities per shift , compliance and proficiency are critical and challenging . Sanitizing hands this many times per shift can cause skin damage which can both impact compliance and increase colonization with potential transferable pathogens .
Part 2 : When Should I Sanitize My Hands ?
The question I would like to ask is , “ If your child , parent , grandparent , or significant other happened to be flying on an airplane today , and you were told that airplane conformed to the minimal standards of safety and airworthiness , would you let your family fly on the aircraft ?”
The point I am trying to make is that the standards established by organizations are minimal standards of performance , not maximum standards .
The traditional minimal standard of timely hand hygiene sanitation is the concept of entry / exit , or sanitizing hands upon entry to or exit from a patient room . The World Health Organization ( WHO ) defined the minimal standard of hand hygiene centered on the 5 Moments ( See illustration ). This approach adds other instances requiring hand hygiene , such as contact with equipment or surfaces in the patients ’ environment . The recognition of potential contamination “ beyond the doorway ” addresses the issue of hand contamination after hand hygiene prior to entering the room and subsequent contamination of previously sanitized hands with potential pathogens when touching surfaces in the patient rooms . Although this expands the need for hand hygiene in new situations , it also offers a more effective method to avoid transfer of potential pathogens in the patient care environment .
Part 3 : Process Improvement
Pathogens don ’ t have legs but we give them legs , as our hands and surfaces provide mobility for pathogens . A critical component to address the issue outlined above is a performance improvement team . Enhancing your infection prevention and control program and potentially moving to the 5 Moments guidelines should precipitate engagement with Lean 6 Sigma to assist your endeavors . You should engage them to provide Lean 6 Sigma for the unit that you hope to implement your hand hygiene compliance strategies . Collect good data on current state and project your future state by applying “ lean principles ” to your unit ( lean process ) and eliminate any opportunities for error ( 6 Sigma ).
Now you can establish the proper hand hygiene protocol for that unit . You can also train staff on what are the scenarios that require hand hygiene and when . An example might be :
24 june 2023 • www . healthcarehygienemagazine . com