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Infection control 101: Hand hygiene

Infection risks are everywhere but are especially prevalent in health care settings, where patients are vulnerable, at risk and exposed to others in similar circumstances. In hospitals, among the most intractable infections are those caused by three types of bacteria – Clostridium difficile (C. diff ), methicillin-resistant Staphylococcus aureus (MRSA) and streptococcal (strep) infections – plus the viruses that cause flu and norovirus.

Among the most effective remedies is hand hygiene. “Since anything you touch carries a risk forMWH Handwashing T infection, cleaning your hands can cut risks considerably,” said Elaine Boerger, RN, Hallmark Health System (HHS) infection control nurse. Since 2006, HHS has improved hand hygiene compliance significantly (see chart).

Soap-and-water and alcohol-based rubs are the most common hand hygiene practices. “Most often, staff use the foam rubs,” said Boerger. “They are fast, efficient, effective and convenient, with dispensers outside and inside patient rooms.” Soap and water is recommended in some circumstances, such as with certain infections or when staff have come in contact with blood or bodily fluids.

In home care, Paula McCartney, RN, Hallmark Health VNA and Hospice education coordinator, said “we have specific protocols on every aspect of hand hygiene, including when and how to wash and specific products to use.” Staff are supplied with everything they need (liquid soap, paper towels, hand gel and towelettes), carried in their clinical bags.

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Patient education is an important aspect of infection control. “We encourage patients and visitors to wash their hands frequently,” said Boerger, “and to remind their caregivers to do so, too.”
McCartney added that home care education includes “suggesting that families use liquid rather than bar soap and paper rather than cloth towels.”

Also important is surveillance. Timely, unit-specific tracking helps identify hospital infection control spikes. Checks and balances in home care also include annual competency reviews and periodic supervisory visits where hand hygiene is assessed to ensure compliance. 

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