Hand Hygiene

With the recent swine flu outbreak this is such an important topic. Every person needs to take into account their hand hygiene. Thanks for the posting.

http://www.degreesinhealthcare.org

Kathleen,

This is an enormous problem and one that needs much attention.  In addition to the suggestions and guidelines listed in the blog, Pam had some very practical and helpful recommendations as well.

Barbara  & Cecilia,

Thank you for your comments.   An article published in Infection Control Today on 2/21/2008, "Frequent Handwashing Increases Risk for Irritant Contact Dermitis,

http://www.infectioncontroltoday.com/hotnews/risk-for-irritant-contact-dermatitis.html, they note . . .healthcare workers find that those who washed their hands more than 10 times per day were more likely to develop the condition than those who washed their hands less frequently. And  . . . at the 66th annual meeting of the American Academy of Dermatology, held Feb. 1-5 in San Antonio, dermatologist Susan T. Nedorost, MD, FAAD, associate professor of dermatology at University Hospitals Case Medical Center in Cleveland, Ohio, presented findings that demonstrated a positive link between frequent handwashing and irritant contact dermatitis, or hand dermatitis, among healthcare workers.                                                                                                                                                                                         They recommend  following tips for healthcare workers to help prevent hand dermatitis:

• Cotton gloves should be worn under rubber or vinyl gloves for wet work to prevent perspiration from dampening the skin. The cotton gloves should be changed frequently if wet work is prolonged.

• When appropriate, alcohol-based hand cleansers should be substituted for handwashing. These cleansers are well tolerated, but may cause temporary stinging when in contact with skin cracks.

• A cream or ointment-based emollient should be applied immediately after water exposure before the skin is completely dry. The goal is to prevent rapid drying and cracking, so applying the emollient after the skin is dry is not nearly as beneficial.

Although patients often receive prescriptions for topical corticosteroids to treat symptoms of hand dermatitis, Nedorost cautions that evidence suggests that chronic use of topical steroids may reduce the skin’s ability to tolerate irritants, thins the skin, and increases bruising and tearing. "Topical steroids should never be used long-term as a substitute for emollients," added Nedorost. "Patients should consult a dermatologist for the proper treatment of hand dermatitis, particularly those who suspect their work environment may be the culprit."

We all know what we are supposed to do; but do we do it all the time?

Constant reminders with posters, screen savers are a great help-they are like stop signs that make us think before proceeding.

In parts of the hospital implementation of questionnaires for patients asking them if they see their caregiver washing their hands with feedback to head nurses/infection control help make us all aware more of our actions-and possible outcomes.

Pamela,

Thanks for passing along the screensaver!  I hadn't seen that one yet - great find!

Pamela,

Thanks for passing along the screensaver!  I hadn't seen that one yet - great find!

I work on  a very busy med/surg/telemetry floor. I witness every day the lack of proper handwashing,if any with soap & water. The lack of knowledge among the staff maybe contributes to this. Most will just use the waterless soap. We have Cdiff, VRE etc. on the unit. This is a huge problem.

I absolutely agree w/ Barbara on the understatement of contact dermatitis in Healthcare workers.  An alternative solution should be offered to caregivers who has this problem. Any suggestion ?

I believe that the problem of contact dermatitis and persistent dry, cracked skin is grossly understated.

I think the solution lies in recognizing that these practices are not harmless to the caregiver, and that we must continue to seek solutions that benefit everyone's immune system, including that of the caregiver.

Most staff do get it that hand washing and alcohol based hand sanitizers limit the spread of many undesirable organisms.

This is not a difficult concept to grasp. Isn't it interesting that it is the exception for a physician to employ these

hand cleansing practices?

http://www.cdc.gov/handhygiene/training/interactiveEducation/index2.htm

Check out the SCREEN SAVER!  Never hurts to remind...p