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Hand Hygiene at the Point of Care : Never More Important Than During a Pandemic
By Kelly M . Pyrek
Effective hand hygiene not only reduces the burden of healthcareassociated infections ( HAIs ) and the spread of antimicrobial resistance but is also a key IP & C measure for safe COVID-19 vaccination .”
This year ’ s World Health Organization
( WHO ) SAVE LIVES : Clean Your Hands campaign focuses on achieving appropriate hand hygiene action at the point of care ( POC ), an element of WHO ’ s patient safety strategies during healthcare delivery for many years but is now more critical than ever in the face of the lingering COVID-19 pandemic . The WHO campaign calls to action key stakeholders who can play critical roles in achieving optimal hand hygiene at the point of care , in both the current situation and a broader sense , helping to strengthen society involvement as promoted by the Hand Hygiene for All initiative .
As Allegranzi , et al . ( 2021 ) explain , “ The first prerequisite for effective implementation of hand hygiene action at the point of care is ‘ system change ,’ meaning that the appropriate infrastructure and supplies should be available at the point of care so that health workers can clean their hands promptly when needed . This requires reliable and uninterrupted provision of good-quality alcohol-based handrub ( ABHR ), supplies of clean water , soap , single-use towels and an adequate number of functioning sinks . ( WHO , 2019 ) Although effective infection prevention and control ( IP & C ) programs in healthcare facilities should meet WHO minimum requirements , the 2020 global WASH report ( 2020 ) revealed that 1 in 3 facilities do not have adequate hand hygiene stations at the point of care .”
They continue , “ Effective hand hygiene not only reduces the burden of healthcare-associated infections ( HAIs ) and the spread of antimicrobial resistance but is also a key IP & C measure for safe COVID-19 vaccination . ABHR is the preferred method for hand hygiene in healthcare as it can be easily accessible at the point of care , kills microorganisms quickly ( within 20 to 30 seconds ) and is well tolerated by the skin . These advantages can help to overcome behavioral barriers to compliance .”
Kendall , et al . ( 2012 ) remind us that , “ Key aspects of POC hand hygiene include the provision of alcohol-based handrub products , integration of dispensing solutions within the patient zone , consideration of patient care workflow , and dispenser designs that optimize acceptance and usage .”
As Kirk , et al . ( 2016 ) explain , “ The POC is defined as the place where the following three elements come together : the patient , the healthcare worker , and the provision of care or treatment . According to current best practice , hand hygiene products must be available at the POC . This requires that a hand hygiene product be easily accessible and as close as possible — ideally within arm ’ s reach of where patient care or treatment is taking place .”
As we know , the WHO identified two specific geographic zones within the healthcare setting -- the patient zone and the healthcare area . The patient zone is considered to be a patient ’ s intact skin and his / her immediate surroundings colonized by the patient flora , and the healthcare area is considered to encompass all other surfaces . Experts say that POC hand hygiene products should be accessible without leaving the patient zone . Most healthcare workers are familiar with the five opportunities that have been identified by the WHO when hand hygiene is most to prevent infection and improve patient outcomes : before patient contact , as you enter the patient zone ; before performance of an aseptic task ; after body fluid exposure risk ; after patient contact ; and after contact with patient surroundings , and when leaving the patient zone .
But , as Kirk , et al . ( 2016 ) point out , “ In accordance with hand hygiene recommendations during these moments , providing POC hand hygiene products facilitates integration of hand hygiene in to the natural workflow patterns of healthcare providers and can contribute to higher hand hygiene compliance . In contrast ,