Last Updated 13 May 2021

Cleanliness Champions

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Hand Decontamination

With the outbreak of antibiotic resilient infections, infection control is becoming a major concern for health groups all over the world (WHO, 2011). The risk of infection can be reduced by using three types of hand washing known as social, hygienic and surgical methods (HAI, 2011). Social hand washing is a useful method for removing dirt and transient micro-organisms. Using soap or an alcohol-based gel if hands are not soiled, vigorously clean your hands using the eight stages of hand-washing.

This can stop transmission of the transient micro-organisms when in direct contact with patients (NHS, 2009). Alcohol-based hand rubs or gels should not be used alone when infection is present as this alone will not kill the spores for infection such as clostridium difficile. After washing hands must be dried properly as failure to do this can increase the transfer of bacteria (Nottingham University Hospitals, 2011). Hygienic hygiene not only removes transient microorganisms but also reduces resident microorganisms.

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This is used when preparing to work in a sterile environment, during an outbreak situation or following contact with bodily fluids. Use an antiseptic hand cleanser when washing and vigorously follow the eight steps of hand-washing. After drying properly then apply an alcohol-based hand rub and repeat the eight stages (NHS, 2011). Surgical scrubbing is a longer and more thorough antiseptic wash of both the hands and forearms. Before a surgical procedure this method is designed to remove as many of the micro-organisms as possible.

It involves systematic washing and scrubbing of the hands and forearms using the most effective antibacterial cleansing agent available. Sterile gown and glove procedures are performed following the surgical scrub (NHS, 2010). Effective hand washing can break the chain of infection which is known as: the infectious agent, reservoir, portal of exit, mode of transmission, portal of entry and host. If the chain remains intact then infection will develop, therefore, nurses must wash their hands before, during and after ontact with a patient and their environment. This will consequently stop the infection progressing while ensuring micro-organisms do not build up in the environment. Direct and indirect contact transmission involves contact with a contaminated object which may be unwashed hands or gloves that are not changed between patients (HAI, 2011). One of the main principles of good hygiene is the use of personal protective equipment as this forms a skin barrier. It is important to ensure the equipment is intact and decontaminated.

The decision to use or wear personal protective equipment must be based on risk assessment associated with the patient care activity or intervention. Personal protective equipment includes: gloves, masks, eyewear, caps, gowns, aprons and other items (HAI, 2011). The Healthcare Associated Infection (HAI) advises that gloves be worn whenever there is a reasonable likelihood that hands will be in contact with blood or other potentially infectious material, mucous, non-intact skin or when handling contaminated items or surfaces.

The safe use and disposal of sharps is essential in protecting each and every individual from contamination and injury. The sharps bin can be used to dispose of medical supplies such as needles and syringes. After the use of needles they must be immediately disposed of in the sharps bin (NHS, 2011). All healthcare workers must be aware of their responsibility in avoiding needle stick injuries (NHS, 2007).

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