5.10: Hand hygiene
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing consists of a fast, vigorous rubbing motion across all parts of the hands, with lathered surfaces, followed by 15 seconds of washing under water. Handwashing works by mechanically removing microorganisms from the hands and rinsing them with water. Microorganisms are not killed by handwashing. There are three techniques of hand washing.
Hand washing
By performing hand hygiene at the right moments and using appropriate techniques, hands become clean and safe as infectious organisms are not transmitted to yourself or others. Using handwashing products that contain an antimicrobial or antibacterial ingredient is recommended in any setting where the risk for infection is high, such as:
- • When hands are visibly soiled with blood and body fluids
- • Before eating and after toileting
- • When exposed to spore-forming microorganisms.
Antiseptic hand wash
An antiseptic hand rub is used to decrease the number of microorganisms present on hand surfaces by applying an antiseptic hand rub. Ethanol-based hand antiseptics containing 70% to 90% alcohol appear to be the most effective against common pathogens found on the hands.
All healthcare workers must practice proper hand hygiene at all times, including:
- • Just before touching a patient
- • Before performing an aseptic task or working with invasive devices
- • Before switching from a soiled to a clean body site on a patient
- • After contacting a patient or their immediate surroundings
- • Following exposure to blood, bodily fluids, or contaminated surfaces (with or without glove use)
- • Immediately following glove removal
Antiseptic hand rub or surgical hand antisepsis
Surgical hand antisepsis is an antiseptic hand wash or hand-rub technique that is an integral part of the preparation for surgery by surgical personnel. Its purpose is to eliminate transient microorganisms and reduce resident hand flora. The most currently used antiseptics are chlorhexidine (CHG) and povidone-iodine (PVI). These agents are applied with a sponge and brush. This technique involves coating the elbow to the fingers and can take up to three minutes, depending on hospital protocol.
