Hand Health Instructions for Coronavirus 15-03-2020

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HAND HYGIENE
INFORMATION FOR HEALTHCARE PROFESSIONALS
What is Hand Hygiene?
Hand Hygiene is the "cleanliness of hands", which is carried out by:

1. Water and common soap
2. Water and soap with antiseptic action
3. Direct application of antiseptic in various forms

What is the necessity of its implementation?

Hand hygiene protects both patients and healthcare professionals from colonization and infection by pathogens found in the hospital environment. The hands of health professionals are a means of transferring pathogenic microorganisms from
patient to patient, from the environment to the patient and vice versa, but also from the hospital environment to the health professionals themselves and their relatives. With their hands, they contaminate the inanimate environment of the hospital inside and outside the patients' treatment area (offices, nursing stop, common areas, etc.).

Where does it apply?
Hand Hygiene is applied wherever health care is practiced.
When does it apply?
The 5 steps of Hand Hygiene are the following:

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How is it applied?
1st Method: Washing technique with soap and water

When?
When our hands are visibly soiled
When we have been exposed to a patient with suspected or confirmed infection with Clostridium difficile
or when the health unit we work for is facing an epidemic or endemic from the
specific pathogen.
When we have been exposed to a patient with suspected or confirmed diarrheal syndrome from
norovirus or during an epidemic of the specific pathogen.
Before eating
After using the toilet

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2nd Method: Application technique of alcoholic antiseptic

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When?
• In all other cases except indications concerning hand washing. The use of alcoholic antiseptic is the appropriate method for the application of Hand Hygiene in all clinical circumstances because; The possibility of immediate application of alcoholic antiseptic significantly increases the compliance of health professionals to Hand Hygiene. Its activity against nosocomial pathogens (bacteria, viruses, mycobacteria, fungi, except spore-forming bacteria) is significantly stronger due to the alcohol it contains. The combination of alcohol with other substances with antimicrobial activity such as chlorhexidine increases the residual action of the product. The application of alcoholic antiseptic is shorter than washing with water and soap (20-30 sec vs 40-60 sec).

The application of alcoholic antiseptic is better tolerated by health professionals than washing with water and soap which often causes dry skin problems. What is the importance of applying Hand Hygiene in controlling the spread of
multidrug-resistant pathogens; The majority of colonized patients with multidrug-resistant bacteria at hospital admission are asymptomatic carriers, who have not been diagnosed or information about their colonization is not available. Hand hygiene and basic precautions are the only measures we have in place to control the spread of resistant pathogens in the hospital
environment from asymptomatic carriers. Especially, if systematic colonization surveillance is not applied by the hospital, the diagnosis of carriers may be significantly delayed or not made during their hospitalization.

The control of the spread of multidrug-resistant pathogens requires special prevention and control measures (contact precautions) with Hand Hygiene being a key component. The literature review carried out by the WHO showed that when hand hygiene is the main prevention measure, spread control is effective mainly for MRSA strains. However, the application of contact precautions is effective only if Hand Hygiene is adequately applied.

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What is the relationship between hand hygiene and the use of gloves?

Gloves are the enemy of YX when we do not apply it before and after their use. The reality is that with the use of gloves we feel safe and that our hands remained clean after the manipulations we performed. Our hands are colonized with microorganisms from the environment and therefore can be contaminated during their application. Therefore, we must apply YX before using gloves. During patient care, gloves are contaminated and when discarded we may contaminate our hands. Change gloves from patient to patient Change gloves septic to aseptic area Change gloves when they are visibly damaged Gloves have specific indications for use and do not replace Hand Hygiene.
Skin-Nails-Jewelry

Important measures to avoid dry skin and skin reactions from the application of Hand Hygiene are:
The choice of appropriate products and as tolerated as possible by health professionals Do not systematically wash your hands with water and soap before using antiseptic, because the likelihood of developing dermatitis is high. Always use cold water for washing hands. The use of warm water and soap, especially those containing antimicrobial ingredients, dries and destroys the skin and has absolutely no additional action against microbial load. do not use gloves on wet hands after applying Hand Hygiene

Let your hands dry.
Use skin care creams-ointments of your hands to prevent mainly dry skin but also other dermatological reactions caused by washing with water and soap but also by the use of antiseptics. Make sure these preparations are compatible with the antiseptics you use in your hospital (consult your hospital's Hospital Infections Committee).

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Important points about nails and jewelry to keep in mind:

Bacteria can survive under artificial nails before and after applying Hand Hygiene. For this reason, it is not recommended that health professionals wear artificial nails, especially when they undertake the care of critically ill patients in special nursing departments.

Make sure your nails are less than 0.6cm (< 1⁄4 inch) long Studies have shown that the skin area under the rings is colonized by more bacteria than the corresponding non-ring areas. Protect your hands. Avoid using artificial nails and jewelry

Hand Health Instructions for Coronavirus