Clean Care is Safer Care
Hand hygiene
Any action of hygienic hand antisepsis in order to reduce transient microbial flora (generally performed either by handrubbing with an alcohol-based formulation or handwashing with plain or antimicrobial soap and water).
WHY?
• Thousands of people die every day around the world from infections acquired while receiving health care.
• Hands are the main pathways of germ transmission during health care.
• Hand hygiene is therefore the most important measure to avoid the transmission of harmful germs and prevent health care-associated infections.
• This brochure explains how and when to practice hand hygiene.
• Any health-care worker, caregiver or person involved in direct or indirect patient care needs to be concerned about hand hygiene and should be able to perform it correctly and at the right time.
HOW?
• Clean your hands by rubbing them with an alcohol-based formulation, as the preferred mean for routine
hygienic hand antisepsis if hands are not visibly soiled. It is faster, more effective, and better tolerated
by your hands than washing with soap and water.
• Wash your hands with soap and water when hands are visibly dirty or visibly soiled with blood or other body fluids or after using the toilet.
• If exposure to potential spore-forming pathogens is strongly suspected or proven, including outbreaks of
Clostridium difficile, hand washing with soap and water is the preferred means.
WHEN?
YOUR 5 MOMENTS FOR HAND HYGIENE
1. Before touching a patient
WHY? To protect the patient against colonization and, in some cases,
against exogenous infection, by harmful germs carried on your hands
WHEN? Clean your hands before touching a patient when
approaching him/her*
Situations when Moment 1 applies:
a) Before shaking hands, before stroking a child’s forehead
b) Before assisting a patient in personal care activities:
to move, to take a bath, to eat, to get dressed, etc
c) Before delivering care and other non-invasive treatment:
applying oxygen mask, giving a massage
c) Before performing a physical non-invasive examination:
taking pulse, blood pressure, chest auscultation, recording ECG
2. Before clean / aseptic procedure
WHY? To protect the patient against infection with harmful germs,
including his/her own germs, entering his/her body
WHEN? Clean your hands immediately before accessing a critical
site with infectious risk for the patient (e.g. a mucous membrane,
non-intact skin, an invasive medical device)
Situations when Moment 2 applies:
a) Before brushing the patient’s teeth, instilling eye drops, performing a digital
vaginal or rectal examination, examining mouth, nose, ear with or without
an instrument, inserting a suppository / pessary, suctioning mucous
b) Before dressing a wound with or without instrument, applying ointment
on vesicle, making a percutaneous injection / puncture
c) Before inserting an invasive medical device (nasal cannula, nasogastric
tube, endotracheal tube, urinary probe, percutaneous catheter, drainage),
disrupting / opening any circuit of an invasive medical device (for food,
medication, draining, suctioning, monitoring purposes)
d) Before preparing food, medications, pharmaceutical products,
sterile material
3.After body fluid exposure risk
WHY? To protect you from colonization or infection with
patient’s harmful germs and to protect the health-care
environment from germ spread
WHEN? Clean your hands as soon as the task involving an
exposure risk to body fluids has ended (and after glove removal)
Situations when Moment 3 applies:
a) When the contact with a mucous membrane and with non-intact skin ends
b) After a percutaneous injection or puncture; after inserting an invasive
medical device (vascular access, catheter, tube, drain, etc); after
disrupting and opening an invasive circuit
c) After removing an invasive medical device
d) After removing any form of material offering protection
(napkin, dressing, gauze, sanitary towel, etc)
e) After handling a sample containing organic matter, after clearing
excreta and any other body fluid, after cleaning any contaminated
surface and soiled material (soiled bed linen, dentures, instruments,
urinal, bedpan, lavatories, etc)
4. After touching a patient
WHY? To protect you from colonization with patient germs
and to protect the health-care environment from germ spread
WHEN? Clean your hands when leaving the patient’s side,
after having touched the patient
Situations when Moment 4 applies, if they correspond to the
last contact with the patient before leaving him / her:
a) After shaking hands, stroking a child’s forehead
b) After you have assisted the patient in personal care activities:
to move, to bath, to eat, to dress, etc
c) After delivering care and other non-invasive treatment: changing bed
linen as the patient is in, applying oxygen mask, giving a massage
d) After performing a physical non-invasive examination:
taking pulse, blood pressure, chest auscultation, recording ECG
5. After touching patient surroundings
WHY? To protect you from colonization with patient germs that may
be present on surfaces / objects in patient surroundings and to protect
the health-care environment against germ spread
WHEN? Clean your hands after touching any object or furniture when
living the patient surroundings, without having touched the patient
This Moment 5 applies in the following situations if they correspond
to the last contact with the patient surroundings, without having
touched the patient:
a) After an activity involving physical contact with the patients immediate
environment: changing bed linen with the patient out of the bed,
holding a bed trail, clearing a bedside table
b) After a care activity: adjusting perfusion speed, clearing a monitoring alarm
c) After other contacts with surfaces or inanimate objects (note – ideally
try to avoid these unnecessary activities): leaning against a bed,
leaning against a night table / bedside table
http://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf
http://www.who.int/gpsc/en/
