2. Impact of Health-care
Acquired Infections
Healthcare acquired infections occur in
5 to 10% of patients admitted to acute
care hospitals in the US
Direct costs of excess hospital stay
exceed $10 billion annually
Caused over 88,000 deaths in 1995-
one death every 6 minutes
UPMC Institute for Performance Improvement
3. Prevention of Health-care
Acquired Infections
About 1/3 of all Health-care Acquired
infections are Preventable
Infection Control measures are
VERY Cost Effective
* Hand Hygiene (HH)
* Alcohol Sanitation
* Antimicrobial Soaps *
Personal Protective Equipment (PPE)
4. Benefits of Hand Hygiene
can decrease infection rates
is the most important procedure for
preventing health-care acquired
infections
can prevent transmission of bacteria to
other Health Care Workers and their
families
Bryan, Infection Control in Critical Care, 1996:7:617
MMWR, 1987:37:24 – Copyright UPMC Institute for
Performance Improvement
5. CDC Recommendations for
Alcohol Based Hand Rub
If hands are not visibly soiled, use an
alcohol based hand rub
* apply golf ball size portion to
palm of one hand and rub hands
together, covering all surfaces of hands
and fingers until hands are dry.
6. CDC Recommendations for
Hand Washing (Soap &
Water)
If hands are visibly soiled or
contaminated with proteinaceous
material, blood or other body fluids:
wash hands with either a non-microbial
soap and water or an antimicrobial soap
and water for at least 15 seconds.
Soap and Water must if patient is
diagnosed with C. difficile.
7. Hand Washing Technique
Avoid hot water – hot water may increase the
risk of dermatitis
Wet hands with water
Apply soap
Rub hands together for at least 15 seconds
Rinse hands
Dry thoroughly with a disposable towel
Use towel to turn off the faucet
8. When To Perform Hand
Hygiene - THE BEFORES
Before having direct patient contact.
Before donning gloves when performing
phlebotomy.
NOTE: Always dispose of gloves
before leaving the patient’s room.
9. When To Perform Hand
Hygiene – THE AFTERS
After contact with patient’s intact skin.
After contact with bodily fluids or
excretions, mucous membranes, non-
intact skin or wound dressings.
After contact with inanimate objects
(i.e., medical equipment) in the
immediate vicinity of the patient.
After removing gloves.
10. Making a Difference
It is estimated that in US hospitals, appropriate
hand hygiene only occurs about 50% of the time.
Some ICU’s rates have been reported as low as 17%
Most attempts to improve hand hygiene are only
associated with a short lived improvement.
CHANGING THE CULTURE IS THE ONLY
WAY TO MAKE A DIFFERENCE.
CHANGING THE CULTURE REQUIRES
ACTIVE INVOLVEMENT FROM ALL WITH A
COMMITMENT TO PERFORM
APPROPRIATE HAND HYGIENE 100% OF
THE TIME.
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Notas do Editor
Only vigorous washing with soap and water can get rid of the spores from C difficile (a spore forming microbe). C difficile is highly contagious and can be passed from patient to patient if hands are not properly washed.