- Hand Hygiene Day 2016 is
celebrated to prevent the spread of infections.
- This year,
the focus is on hand hygiene in health care.
- The campaign is aimed at lowering
risk of infections prior to surgery, during
surgery and post surgery.
Hygiene day is celebrated on the 5th
of May every year to highlight the importance of washing hands and keeping them
clean. The accent on hand hygiene is not only to ensure that hands are free
from dirt and grime but also, that they are free from infectious agents. Apart
from posing a risk to the health of the individual, improperly cleaned hands
could lead to the spread of infections to others.
A stay at the hospital or the 'journey' through care for surgery increases the risk for infections. Most hospitals have detailed procedures that health care workers need to perform before touching a patient. However, the rise in the number of infections associated with hospital care has necessitated the need to raise awareness about hand hygiene
among health care workers to protect patients undergoing surgery.
‘Good hand hygiene could limit spread of infections.’
The incidence of nosocomial infections in a medical intensive care unit in a district hospital in India ( August 2012-May 2013) was found to be 17.7%. Out of which
- 34.8 % urinary tract infections
- 21.7% pneumonia
- 17.4% surgical site infection
- 13% meningitis and infections in the blood
- 13% gastroenteritis
Burden of Nosocomial Infections
infections are defined as those infections, which infect patients during stay
at the hospital or soon after, and they were not
present or incubating at the time of admission. These infections lead to
- Longer period of recovery for the patient
- Adds to already existing medical complication in the patient
- Longer periods of stay at the hospital due to the infection
- Increased economic burden for the patient
- Patient's family undergoes further emotional strain due to the
While there are some patients who are at an increased risk of being infected at the hospital
than others, the risk of infection remains large.
Increased Risk for Nosocomial Infections
- Premature babies
- Elderly patients
- Patients in the intensive care unit
- Patients with poor immunity due to an underlying infection
Due to the far reaching effects of these nosocomial infections that are transferred to patients during their stay at hospitals, WHO has focused its attention on hand hygiene among health care workers to prevent infections being transmitted to patients
and among health caregivers.
Focus of World Hand Hygiene Day 2016
"Hand hygiene as part of an infection prevention and control programme
in all settings that support surgery, prevents patient infection and reduces an avoidable burden on health systems"-WHO
Professor Didier Pittet
, Director, Infection Control programme and WHO collaborating Center on Patient Safety and the lead adviser of WHO's 'Clean Care is Safe Care' says that between 5 and 8 million lives can be saved through safe hands. Hand hygiene to support safe surgical care will ensure that patients are effectively protected while in surgical care, operating room and even during outpatient services.
Dr Peter M
, Surgeon, A/C
Kijabe Hospital, Kenya relates how hand washing with soap and water or with
alcohol based hand sanitizers could prevent the spread of a large number of
diseases in Kenya and the rest of the world.
5 Moments of Hand Hygiene in Health Care
WHO describes 5 moments in surgical care before which hand hygiene practices should be followed
to minimize the risk of infection spread.
Before Patient Contact
Hand hygiene is
extremely important before contact with the patient. Contact with the patient
may be for a fleeting period, but even a single touch
could spread disease among immunocompromised patients. Examples of incidences
Before a Procedure
- Helping patients wear their spectacles
- Checking the patient's blood pressure or ECG
- Applying a mask for providing oxygen
should be practiced to prevent entry of germs into the patient while preparing
the patient for the surgery. This could include situations like:
After a Procedure or Body Fluid Exposure Risk
- Drawing blood for tests before the surgery
- Inserting needles for IV medications
- Changing wound dressing
- Inserting catheters
Body fluids from
patients are potentially infectious and health care workers should be careful
while handling these. Improper handling could result in infection to other
patients, environment and pose a risk to health workers too.
After Patient Contact
Washing hands to ensure hand hygiene
- Changing bed pans
- Holding a cup while the patient spits out sputum
- Cleaning up after the patient throws up
is important especially after any form of contact with the patient. This will prevent transfer of infectious agents from the patient to the environment and infection to the healthcare worker.
After Touching Patient Surroundings
The patient is
not the only source of infection, but bedding, linen,
tables, TV remotes and other items that are touched or used by the patient and
then handled by a health care worker also necessitates
Professor Pittet further adds that nearly 31% of patients get surgical site infections in hospitals. 1 in 3 incidences is due to Staphylococcus aureus
, with a large percentage of those Methicillin Resistant Staphylococcus Aureus (MRSA)
. Infections due to such 'super bugs' increase hospital stay and economic burden of the patient. When staff cleaned hands with soap and water or using an alcohol based sanitizer, there is considerably a lowered risk of infection.
Patchen Dellinger, Professor of Surgery, University of Washington Medical
School, says that health care workers could use alcohol based scrubs before
handling a patient and after. This lowers risk for irritation of the surgeon's
hands, hands without irritation harbor fewer germs, according to the professor.
After Surgical Care - Wound Cleaning
says health care workers should 'see' their hands as life saving equipment, and
also see their hands as potential vehicle of harm if not cleaned at the right
times. Germs are not visible to the naked eye and hand hygiene practiced during
the 5 moments of patient care will make sure the patient is protected. A
patient journey happens everyday and every touch is important.
S. Solomkin, Professor at The University of Cincinnati College of Medicine
stresses the risk of infections that could occur even
outside hospitals, during surgery and post operative care.
Tips to Maintaining Hand Hygiene Among Health
- Make hand washing a regular practice that it feels like second
nature to do it immediately before and after touching a patient.
- Ensure availability of hand wash in every room and corridor of
- Head of departments should monitor hand hygiene practices of
others in the department.
- Simple procedures like holding a patient's hand or checking for
the pulse of the patient are risky procedures. Patient to patient
transmission occurs through such simple gestures and so hand sanitization
should be practiced diligently.
- The same gloves should not be used for multiple patients, change gloves between patients.
- WHO's six step hand washing technique should be followed for
effective hand hygiene.
- Infections in hospital - reduce the risk
- Nosocomial Infections in Patients Admitted in Intensive Care Unit of a Tertiary Health Center, India
- The 5 moments for hand hygiene