Hand Hygiene is a general term referring to any action of hand cleansing. There are three ways hand hygiene can be performed:
ABHR is gold standard for hand hygiene for all clinical situations where hands are visibly clean.
Wash with soap and water when hands are visibly dirty, when visibly soiled with blood or other body fluids, or when caring for patients with symptoms of gastroenteritis.
When there is no readily available access to hand washing facilities, the approved detergent wipes can be used, followed by ABHR. It is recommended to wash hands with soap and water as soon practical.
Five Moments for Hand Hygiene have been identified as the critical times when hand hygiene should be performed to protect:
“5 Moments for Hand Hygiene (Adapted by the Council of Ambulance Authorities)”
Before Touching A Patient
Before a Procedure
After a Procedure or Body Fluid Exposure
After Touching a Patient
After Leaving the Patient's Environment
It is recognised in the pre-hospital setting there may be times in emergency situations where hand hygiene is secondary to patient safety, however once the risk has been resolved further deviation is not warranted.
Other opportunities to decontaminate hands include (but are not exclusive to):
To minimize the possible barriers to hand hygiene
Skin Irritation and Allergy
All clinical staff and volunteers are screened for skin irritation/conditions and latex sensitivity during the pre-employment interview process.
The main type of occupational skin irritation associated with hand hygiene is irritant contact dermatitis. Symptoms include dryness, irritation, itching, and sometimes cracking of the skin. Allergic contact dermatitis is rare and is due to an allergy from an ingredient in a hand hygiene product.
Report all skin conditions (e.g. dermatitis, allergic eczema, weeping lesions) to your Manager and seek medical advice from GP or attend a St John Health centre.
Staff who have skin conditions such as exudative lesions or weeping dermatitis should be removed from direct patient care until the condition resolves. Seek guidance from your Manager and Safety team.
Refer to Skin Irritation flowchart, adapted from Occupational Dermatology Research and Education Centre flowchart for healthcare workers
|WHAT TO DO IF YOU HAVE SKIN IRRITATION|
|Report problem to your Manager and Safety Team|
|Good Skin Care Practice|
Reduce handwashing (unless hands visibly soiled) and use ABHR where possible. ABHR may sting hands if split/cracked. It does not mean you are allergic to it. At home, use soap substitutes where possible.
Moisturise hands regularly while at work – before the start of the shift, during meal breaks and at end of shift. Moisturise hands regularly at home.
|See GP or Attend a St John Health Clinic|
|If the previous advice has not improved your skin integrity, you will need to assessed by a doctor:
|Referral to a Dermatologist|
|If there has still not been improvement, you may need a referral from your GP to see a dermatologist. You may be referred to a special clinic for patch testing. Patch testing is used to diagnose an allergy to something that your skin is coming into contact with.|
Government of Western Australia. (2013). Operational Directive 0429/13 National Hand Hygiene Initiative in Western Australian Hospitals. Perth: Department of Health.
Hand Hygiene Australia. (2017). Retrieved from http://www.hha.org.au/
Occupational Dermatology Research and Education Centre. (2017). Retrieved from http://www.occderm.asn.au/
World Health Organization. (2009). WHO Guidelines on Hand Hygiene in Health Care. First Global Patient Safety Challenge. Clean Care is Safer Care. Geneva: WHO.