hand hygiene and health care-associated infections clint pollack, md, quality director children’s...
TRANSCRIPT
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Hand Hygiene and Health Care-Associated Infections
Clint Pollack, MD, Quality Director
Children’s Hospital Central California
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The impact of HCAI
HCAI can cause:
■ more serious illness
■ prolongation of stay in a health-care facility
■ long-term disability
■ excess deaths
■ high additional financial burden
■ high personal costs on patients and their families
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Most frequent sites of infection and their risk factors
LOWER RESPIRATORY TRACT INFECTIONSMechanical ventilationAspirationNasogastric tubeCentral nervous system depressantsAntibiotics and anti-acidsProlonged health-care facilities stayMalnutritionAdvanced ageSurgeryImmunodeficiency
13%
BLOOD INFECTIONSVascular catheterNeonatal ageCritical care Severe underlying diseaseNeutropeniaImmunodeficiencyNew invasive technologiesLack of training and supervision
14%
SURGICAL SITE INFECTIONSInadequate antibiotic prophylaxis
Incorrect surgical skin preparationInappropriate wound care
Surgical intervention durationType of wound
Poor surgical asepsisDiabetes
Nutritional stateImmunodeficiency
Lack of training and supervision 17%
URINARY TRACT INFECTIONSUrinary catheter
Urinary invasive proceduresAdvanced age
Severe underlying diseaseUrolitiasis
PregnancyDiabetes
34%
Most common sites of health care-associated infection and the risk factors
underlying the occurrence of
infections
LACK OF HAND
HYGIENE
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Prevention of HCAI
■ At least 50% of HCAI could be prevented!
■ Most solutions are simple and not resource-demanding
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Hand transmission
■ Hands are the most common vehicle to transmit health care-associated pathogens
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The 5 Moments for Hand Hygiene
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How to clean your hands
■ Handrubbing with alcohol-based handrub is the preferred routine method of hand hygiene if handsare not visibly soiled
■ Handwashing with soap and water – essential when when hands are visibly dirty or visibly soiled (following visible exposure to body fluids)1
1 If exposure to spore forming organisms e.g. Clostridium difficile is strongly suspected or proven, including during outbreaks – clean hands using soap and water
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To effectively reduce the
growth of germs on hands,
handrubbing must be
performed by following all of
the illustrated steps.
This takes only 20–30
seconds!
How to handrub
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How to handwash
To effectively reduce the
growth of germs on hands,
handwashing
must last 40–60 seconds
and should be performed by
following all of the illustrated
steps.
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Hand hygiene and glove use
■ The use of gloves does not replace the need to clean your hands!
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Adequate handwashing with water and soap requires 40–60 seconds
Average time usually adopted by health-care workers: <10 seconds
Alcohol-based handrubbing: 20–30 seconds
Time constraint = major obstacle for hand hygiene
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Pop-QuizWhat are the 5 moments for hand hygiene?
1. Before touching a patient
2. After touching a patient
3. Before a procedure
4. After a body-fluid exposure risk
5. After touching patient surroundings
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Summary
■ HCAI places a serious disease burden and significant economic impact on patients and health-care systems
■ Appropriate hand hygiene – the simple task of cleaning hands at the right times and in the right way – saves lives
■ There are 5 indications (moments) for hand hygiene in health care
■ Global compliance with the “My 5 Moments for Hand Hygiene” approach is universally sub-optimal
■ CHCC has implemented an action plan to improve hand hygiene and reduce infection
■ Your support and compliance with the initiatives is essential to save lives in our facility