Maintaining hygiene and cleanliness is the key to health in all areas of life. If we're talking about about medicine, then cleanliness of hands should be an integral rule, because the life of both the entire medical staff and the patient depends on such a seemingly trifle. The nurse is responsible for ensuring that the condition of her hands is satisfactory and meets medical health standards. It is important to get rid of micro cracks, hangnails, clean your nails and remove any nails, if any. Why is this so important and what are the requirements?
In order for all personnel to comply with the European medical standard, it is important for each employee to be told about the existing requirements for disinfection of hands, instruments and other medical supplies. Available for nurses separate rules hand care, this includes the following requirements:
It was found that it is the lack of respect for hands among doctors and nurses that contributes to the development and rapid spread throughout the clinic of hospital-acquired infectious agents. Touching manipulation devices, devices, patient care items, test equipment with unclean hands, technical equipment, clothing and even medicinal waste can negatively affect the health of the patient and everyone in the hospital for a long period of time.
To prevent the spread of microorganisms and reduce the risk of infection through hands, there are rules and means of disinfection. Any hospital employee must follow these recommendations, especially those who work closely with sources of infection and infected patients.
In medicine, several methods have been developed for disinfecting the hands of all medical staff:
Cosmetology and folk remedies for hair care
However, there are rules for washing hands this way. It has been noticed that in frequent cases, after treating the skin of the hands, many bacteria remain on the inner surface and fingertips. To avoid this, you must follow the following recommendations:
When the washing procedure is performed for the first time, dirt and bacteria located on the surface of the skin are removed from the hands. When repeated treatment with warm water, the skin pores open and the cleansing goes deeper. It is useful to do light self-massage when soaping.
Cold water is less beneficial in in this case, because it is the elevated temperature that allows soap or other hygiene products to penetrate deeply into the skin and remove the thick layer of fat from both hands. Hot water is also not suitable; it can only lead to negative results.
Surgery is an area where neglect of hand hygiene rules can cost the patient’s life. Hand treatment is carried out in the following situations:
Of course, the doctor and everyone assisting during the operation put on disposable sterile gloves on their hands, but this does not give the right to forget about hygienic means of protection and hand treatment.
Next, the usual hand cleaning is carried out again and three milligrams of antiseptic are applied, and in a circular motion it is rubbed into the fabric and skin. It is advisable to carry out this entire process several times. A maximum of ten milligrams of antiseptic is used. The processing time takes no more than five minutes.
After the procedure or operation has been completed, the sterile gloves are thrown away, and the skin of the hands is washed with soap and treated with lotion or cream, preferably made from natural substances.
Medicine is moving forward and disinfection techniques are improving every day. At the moment, a mixture is widely used, which includes the following components: distilled water and formic acid. The solution is prepared daily and stored in enamel containers. Wash your hands immediately regular soap, and then washed with this solution for a couple of minutes (the part from the hand to the elbow is treated for 30 seconds, the rest of the time the hand itself is washed). Hands are wiped with a napkin and dried.
Another method is disinfection with chlorhexidine, which is initially diluted with 70% medical alcohol (dosage one to forty). The processing procedure lasts about three minutes.
Iodopirone is also used for hygienic treatment of the hands of medical staff. The whole process follows a similar pattern: hands are washed with soapy water, then nails, fingers and other areas are disinfected with cotton swabs.
Ultrasound treatment. The hands are lowered into a special one through which ultrasonic waves pass. Processing lasts no more than a minute.
All methods are good, it’s just important not to neglect the general recommendations.
So, hand disinfection plays an important role in medicine. It is not enough to simply wash your hands with water. Hand treatment is carried out in different ways, various hygiene products are used, depending on the situation. Neglecting basic rules can lead to negative consequences, from which not only patients, but also medical personnel will suffer.
Jun 22, 2017 Violetta Doctor
Target household level hand treatment - mechanical removal of most of the transient microflora from the skin (antiseptics are not used).
A similar hand treatment is carried out:
Required equipment:
Hand treatment rules:
All jewelry and watches are removed from hands, as they make it difficult to remove microorganisms. Hands are soaped, then rinsed with warm running water and everything repeats all over again. It is believed that the first time you soap and rinse with warm water, germs are washed off from the skin of your hands. Under the influence of warm water and self-massage, the pores of the skin open, so when repeated soaping and rinsing, germs are washed away from the opened pores.
Warm water makes the antiseptic or soap work more effectively, while hot water removes the protective fat layer from the surface of the hands. In this regard, you should avoid consuming too much hot water for washing hands.
Hand treatment - the necessary sequence of movements
1. Rub one palm against the other palm in a back-and-forth motion.
Each movement is repeated at least 5 times. Hand treatment is carried out for 30 seconds - 1 minute.
It is very important to follow the described hand washing technique, since special studies have shown that during routine hand washing, certain areas of the skin (fingertips and their inner surfaces) remain contaminated.
After the last rinse, wipe your hands dry with a napkin (15x15 cm). The same napkin is used to close the water taps. The napkin is dumped into a container with a disinfectant solution for disposal.
In the absence of disposable napkins, it is possible to use pieces of clean cloth, which after each use are thrown into special containers and, after disinfection, sent to the laundry. Replacing disposable napkins with electric dryers is impractical, because... with them there is no rubbing of the skin, which means there is no removal of detergent residues and desquamation of the epithelium.
The purpose of hygienic treatment is to destroy skin microflora using antiseptics (disinfection).
before putting on gloves and after taking them off;
before caring for an immunocompromised patient or during ward rounds (when it is not possible to wash hands after examining each patient);
before and after performing invasive procedures, minor surgical procedures, wound care or catheter care;
After contact with body fluids (e.g. emergency situations with blood).
Required equipment:
Napkins measuring 15x15 cm are disposable, clean.
Skin antiseptic. It is advisable to use alcohol-containing skin antiseptics (70% ethyl alcohol solution; 0.5% solution of chlorhexidine bigluconate in 70% ethyl alcohol, AHD-2000 special, Sterillium, etc.)
Hand treatment rules:
Hand hygiene consists of two stages: mechanical hand cleaning (see above) and hand disinfection with a skin antiseptic.
After completing the mechanical cleaning stage (twice soaping and rinsing), the antiseptic is applied to the hands in an amount of at least 3 ml and thoroughly rubbed into the skin until completely dry (do not wipe your hands). If the hands were not contaminated (for example, there was no contact with the patient), then the first stage is skipped and the antiseptic can be immediately applied. The sequence of movements when processing hands corresponds to the EN-1500 scheme. Each movement is repeated at least 5 times. Hand treatment is carried out for 30 seconds - 1 minute.
Surgical treatment of hands
The purpose of the surgical level of hand cleaning is to minimize the risk of disruption of surgical sterility in the event of glove damage.
A similar hand treatment is carried out:
before surgical interventions;
Before serious invasive procedures (for example, puncture of large vessels).
Required equipment:
Liquid dosed pH-neutral soap or individual disposable soap in pieces.
Wipes measuring 15x15 cm are disposable, sterile.
Skin antiseptic.
Disposable sterile surgical gloves.
Hand treatment rules:
Surgical treatment of hands consists of three stages: mechanical cleaning of hands, disinfection of hands with skin antiseptic, covering hands with sterile disposable gloves.
Unlike the method of mechanical cleaning described above at the surgical level, the forearms are included in the treatment, sterile napkins are used for blotting, and hand washing itself lasts at least 2 minutes. After drying, the nail beds and periungual folds are additionally treated with disposable sterile wooden chopsticks, soaked in an antiseptic solution.
It is not necessary to use brushes. If brushes are used, sterile, soft, single-use or autoclave-resistant brushes should be used only for periungual areas and only for the first brush of a work shift.
After completing the mechanical cleaning stage, an antiseptic is applied to the hands in 3 ml portions and, without allowing drying, rubbed into the skin, strictly following the sequence of movements of the EN-1500 scheme. The procedure for applying skin antiseptic is repeated at least twice, the total consumption of antiseptic is 10 ml, total time procedures - 5 minutes.
Sterile gloves are worn only on dry hands. When working with gloves for more than 3 hours, the treatment is repeated with a change of gloves.
After removing the gloves, hands are wiped again with a cloth moistened with a skin antiseptic, then washed with soap and moisturized with an emollient cream.
It does not matter who has the priority of opening the need for hand sanitizing. Many authors, by the way, assign the role of the founder to the Hungarian obstetrician Ignaz Philipp Semmelweis (1818-1865), who empirically established the cause of postpartum sepsis in 1846 and proposed a method of treating obstetricians’ hands with chlorine water.
It is important that hand treatment is one of the most effective and at the same time in a simple way prevention of infections in medical institutions. But precisely because of its simplicity, this method is often underestimated.
For example, in the article “Out of touch in the NICU: nurses and doctors practice bad hand hygiene”, published in 2003 on the Antibiotic.ru website, it is reported that only 22.8% of staff in neonatal intensive care units comply with all established hygiene standards. On average, according to studies, health care workers wash their hands about half of the time hand sanitization is required, and they tend to exaggerate the frequency and quality of hand sanitization. It is noted that doctors wash their hands less often, but more thoroughly, than nurses do. In many health care settings, the problem is not that the facility's health care staff do not know how to wash their hands or do not know in which situations appropriate hand sanitization is required, but that the health care staff simply do not do what they are supposed to do. In other words, the problem is compliance with service instructions.
In addition, danger for one’s health is also considered a refusal. Thus, according to a survey conducted by the Society for the Control of Hospital Infections in St. Petersburg hospitals, 10% of surveyed doctors, 18.7% of orderlies and 43.6% of nurses believe that hand sanitizing has an extremely adverse effect on their own health. That is, we are talking about professional incompetence.
Staff hand washing or decontamination.
Decontamination is the process of removing or destroying microorganisms for the purpose of neutralization and protection - cleaning, disinfection, sterilization.
Hand washing– the most important procedure to prevent nosocomial infections. There are 3 levels of hand decontamination: social level, hygienic (disinfection), surgical level.
Social level– washing lightly soiled hands with soap and water, which removes most transient microorganisms from the skin.
Social processing hands is carried out:
1. Before eating
2. After going to the toilet
3. Before and after patient care
4. When your hands are dirty.
Equipment: liquid soap (soap dish with wire rack and a bar of soap), napkins, paper towel.
Preparation for the procedure:
Performing the procedure:
4. Lather your palms (if using bar soap, rinse and place in a soap dish with a wire rack).
5. Wash your hands by vigorously and mechanically rubbing your soaped palms together for 10 seconds.
6. Rinse off the soap under running water: hold your arms so that your wrists and hands are below elbow level (in this position, the water flows from the clean area to the dirty area).
Completing the procedure:
7. Close the water tap using paper napkin.
8. Dry your hands with a paper towel (a cloth towel quickly becomes damp and is an ingenious breeding ground for organisms).
Note: If running water is not available, a basin of clean water can be used.
Hygienic level of hand washing.
Equipment: liquid soap (soap dish with wire rack and a bar of soap), skin antiseptic, napkins, paper towel.
Hygienic level of hand treatment- this is washing using antiseptics. It's more effective method removal and destruction of microorganisms.
Hand hygiene is carried out:
1. Before performing invasive procedures
2. Before caring for an immunocompromised patient.
3. Before and after care of the wound and urinary catheter.
4. Before putting on and after taking off gloves.
5. After contact with body fluids or after possible microbial contamination.
Preparation for the procedure:
1. Remove all rings from your hands, with the exception of the wedding ring (the depressions on the surface of jewelry are breeding grounds for microorganisms).
2. Move the watch above your wrist or remove it. Place in your pocket or pin to your robe.
3. Open the water tap, using a paper napkin to avoid contact with microorganisms present on the tap, adjust the water temperature.
Performing the procedure:
4. Wet your hands under running water or in a bowl of water.
5. Apply 4-5 ml of antiseptic to your hands or thoroughly wash your hands with soap.
6. Wash your hands using the following technique:
a) Vigorous mechanical friction of the palms - 10 seconds (repeat 5 times).
b) The right palm washes (disinfects) the back of the left hand with rubbing movements, then the left palm also washes the right one, repeat 5 times.
V) Left palm located on the right hand, fingers intertwined, repeat 5 times.
d) The fingers of one hand are bent and are on the other palm (fingers intertwined) - repeat 5 times.
e) Alternately rubbing the thumbs of one hand with the palms of the other, palms clenched, repeat 5 times.
f) Alternating friction of the palm of one hand with the closed fingers of the other hand, repeat 5 times.
7. Rinse your hands under running water, holding them so that your wrist and hands are below the level.
Completion of the procedure.
8. Close the tap with a paper towel.
9. Dry your hands with a paper towel.
Note: if hygienic hand washing with water is not possible, you can treat them with 3-5 ml of antiseptic (based on 70% alcohol for 2 minutes).
Gloves.
Clean or sterile, also part of protective clothing. They are worn when:
1. Contact with blood
2. In contact with seminal fluid or vaginal secretions
Any involves preparation and direct decontamination (removal of contaminants). The nurse's hands should be well-groomed, free of inflammation, hangnails and microcracks.
Nails must be neatly trimmed and not varnished. The skin edge of the nail bed should not be cut off due to the risk of microtrauma and inflammation. Artificial nails on a nurse's hands are not acceptable. Before it startsfor carrying out manipulations, wrist watch and jewelry must be removed.
Routine hand washing is carried out liquid soap from the dispenser, and in case of its absence - in simple lump form. Manipulation rooms must be equipped with elbow-controlled mixers.
After preparing your hands, moisten them with warm water, soap your palms, the backs of your hands, the spaces between your fingers and nail beds.
Vigorously three hands touching each other:
Each action must last at least 30 seconds. After washing, we dry our hands with a disposable towel or a cloth one, which is immediately removed from circulation.
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