Definition Of Hand Washing – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Definition Of Hand Washing
Hand washing or hand hygiene is the act of cleaning one’s hands with or without the use of water c another liquid, or with the use of soap for the purpose of removing soil, dirt, and/or microorganisms.
Or
Hand washing is a vigorous, brief rubbing together of all surfaces of hands lathered in soap followed by rinsing under stream water.
Hand washing may be defined as “the act of cleansing the hands with water or other liquid, with or without the inclusion of soap or other detergent, for the purpose of removing soil or microorganisms”.
Classification of Hand Washing:
A. Social hand wash
a) Social hand wash is performed to render the hands physically clean and to remove transient micro-organisms,
b) It is an infection control practice with a clearly demonstrated efficacy and remains the cornerstone of efforts to reduce the spread of infection
B. Hygienic hand wash
a) Why should a hygienic hand wash be performed?
- To remove or destroy transient micro-organisms and to substantially reduce resident micro-organisms during times when surgical procedures are performed.
b) When should a hygienic hand wash be performed?
- Before all aseptic procedures on the ward.
c) What should be used for performing a hygienic hand wash?
- An approved antiseptic detergent (eg 4% Chlorhexidine gluconate or 7.5% Povidone iodine).
C. Surgical hand wash
a) Why should a surgical hand wash be performed?
- To remove or destroy transient micro-organisms and to substantially reduce resident micro-organisms during times when surgical procedures are performed. It is intended to decrease the risk of wound infections should surgical gloves become damaged.
b) When should a surgical hand wash be performed?
- Before all surgical/invasive procedures
c) What should be used for performing a surgical hand wash?
- An approved antiseptic detergent (eg 4% Chlorhexidine gluconate or 7.5% Povidone iodine).
Importance/Purpose of Hand Washing:
1. To clean dirt and transient micro-organisms from the hands.
2. To reduce total microbial counts over time.
3. To prevent cross infection.
4. It reduces the risk of self-infected disease.
5. It helps to improve patient care.
6. Helps to create safe working environment
7. To prevent transfer of micro-organisms from the environment to the client and from the client to the health care worker.
8. Helps to prevent nosocomial infection/hospital-acquired infection
9. Hand washing is a basic technique for infection control.
Indication of Hand Washing:
A. Before:
a) Feeding the patient
b) Performing invasive procedures.
c) Starting any work.
d) Applying gloves.
e) Any direct client care or contact e.g. dressings, toileting, showering.
f) Between different procedures on the same client
g) Preparing food, eating or feeding others
h) Before eating.
i) Caring for susceptible patient
B. After:
a) Finishing any work.
b) Direct contact with blood or body substances.
c) Removing gloves
d) All patient contact
e) In contact with broken skin or abdominal skin conditions such as rashes or abrasions.
f) Going to the toilet.
g) Handling soiled equipment, clothing or bed linen
h) Toileting patients and touching associated objects
i) Contact with microbial contamination is likely to occur
C. Before and after (both):
a) Some activities such as going to the toilet, eating, handling food or coughing or sneezing.
b) Any patient care procedure
c) Contact with invasive devices such as catheters or respiratory equipment
d) Delivering an infection, finger sticks and heel- sticks
e) Whenever hands are visibly soiled
f) Wearing gloves.
g) In contact with mucous membrane.
Five Moments for Hand Hygiene:
Procedure of (Routine/Social/Clinical) Hand Washing:
1. Remove jewelry such as- ring, bracelet, watches, etc.
2. Wet hands thoroughly and lather vigorously using a neutral pH liquid soap for 15-30 seconds
Figure: Procedure of Hand Washing
3. Rub hands palm to palm
4. Right palm over left dorsum with interlaced fingers and vice versa
5. Palm to palm with fingers interlaced
6. Backs of fingers to opposing palms with fingers interlocked
7. Rotational rubbing of left thumb clasped in right palm and vice versa
8. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa
9. Rinse under running water
10. Do not touch taps with clean hands – if elbow or foot controls are not available, use paper towel to turn off taps
11. Pat hands dry using paper towel
Procedures of Surgical Hand Washing:
A traditional, standardized, surgical hand scrub procedure includes:
- Remove jewelry including rings, watches, and bracelets.
- Don a surgical mask during hand scrub. ✓ Anyone standing at the scrub sink (regardless of whether they are scrubbing), must wear a surgical mask while in the presence of anyone else performing hand scrub activity.
- Wash hands and forearms if visibly soiled with soap and running water immediately before beginning the surgical scrub.
- Clean the subungual areas of both hands under running water using a disposable nail cleaner.
- Rinse hands and forearms under running water.
- Dispense the approved antimicrobial scrub agent according to the manufacturer’s written directions.
- Apply the antimicrobial agent to wet hands and forearms using a soft, nonabrasive sponge.
- A three- or five-minute scrub should be timed to allow adequate product contact with skin, according to the manufacturer’s written directions.
- Visualize each finger, hand, and arm as having four sides. Wash all four sides effectively, keeping the hand elevated. Repeat this process for opposite fingers, hand, and arm.
- For water conservation, turn water off when it is not directly in use, if possible.
- Avoid splashing surgical attire.
- Discard sponges, if used, in appropriate containers.
- Hands and arms should be rinsed under running water in one direction from fingertips to elbows as often as needed.
- Hold hands higher than elbows and away from surgical attire.
- In the OR, dry hands and arms with a sterile towel before donning a sterile surgical gown and gloves.
Read More…