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Hand hygiene
Healthcare-associated infections (HAIs) are a challenge to patient safety. They can occur in any healthcare setting and affect the health and well-being of patients and the cost of care. Multiple factors contribute to the risk of HAI including ageing population, complexity of therapies and emergence of antibiotic-resistant bacteria. HAI can be caused by endogenous or exogenous infectious agents, transmited by hands as a one of many common transmission route.
Hand hygiene is known to be able to prevent and control HAIs. Any healthcare worker, caregiver or person involved in direct or indirect patient care needs to be concerned about hand hygiene and should be able to perform it correctly at the right time.
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HAIs are estimated to occur in acute care hospitals in Europe annually.[6]
More than
0%
of HAIs can be avoided by disrupting infection transfer through touching hands with environmental cleaning programs.7
Hand care
In winter months cold and dry air can result in drier hands as water evaporates from the epidermis quicker. Use of a hand cream can both provide protection and help insulate the skin, locking the moisture in.
Washing with too hot water can add to dryness of the skin. Better reduce the temperature of the water to lukewarm in order to protect the skin from transepidermal water loss.
Soap is generally known to have the potential to disturb skin integrity, particularly in elderly people. In contrary to syndets or amphoteric surfactants soap intensifies skin dryness. Its pH impairs the skin barrier. Soap can dissolve lipophilic components from the skin and thereby contribute to skin irritation. If soap is used for handwashing appropriate rinsing to all soap residues is crucial.
Heavy abrasion against the skin can mechanically irritate and inflame dry skin. Avoid excessive rubbing of the hands with towels. Abrasion is also known to enhance the epidermal permeability and make the skin more susceptible for substances and solutes on the skin, especially for hydrophilic penetrants. Thus, better use soft materials, e.g. terrycloth and better tab one's skin than rub it.
Occupational skin dryness with or without irritant contact dermatitis is associated with glove wearing. Especially, applying gloves to wet hands can irritate the skin and cause dryness. Always dry hands thoroughly before donning gloves. Check with your occupational health team if irritation continues.
You have an excellent hand hygiene program in your hospital? Apply now for the prestigous Hand Hygiene Excellence Award. Demonstrate your skills in successfully reducing HAI (hospital acquired infections) rates by implementing a hand hygiene programme. The award is conceived as a platform to identify, recognize, honour and celebrate those hospitals and health care work groups which have contributed to improving patient safety through excellence, enthusiasm and innovatory methods.
[1] Stewart S, Robertson C, Kennedy S, Kavanagh K, Haahr L, Manoukian S, Mason H, Dancer S, Cook B, Reilly J. Personalized infection prevention and control: identifying patients at risk of healthcare-associated infection. J Hosp Infect. 2021 Aug;114:32-42. doi: 10.1016/j.jhin.2021.03.032. PMID: 34301394.
[2] World Health Organization. Report on the burden of endemic health care-associated infection worldwide. Geneva: WHO; 2011. Available at: http://apps.who.int/iris/handle/10665/80135 [last accessed December 2022]
[3] Graves N, Weinhold D, Tong E, Birrell F, Doidge S, Ramritu P, Halton K, Lairson D, Whitby M. Effect of healthcare-acquired infection on length of hospital stay and cost. Infect Control Hosp Epidemiol. 2007 Mar;28(3):280-92. doi: 10.1086/512642. Epub 2007 Feb 20. PMID: 17326018.
[4] Graveto JMGDN, Rebola RIF, Fernandes EA, Costa PJDS. Hand hygiene: nurses' adherence after training. Rev Bras Enferm. 2018 May;71(3):1189-1193. Portuguese, English. doi: 10.1590/0034-7167-2017-0239. PMID: 29924172.
[5] Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, Pittet D. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet. 2011 Jan 15;377(9761):228-41. doi: 10.1016/S0140-6736(10)61458-4. Epub 2010 Dec 9. PMID: 21146207
[6] WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. Geneva: World Health Organization; 2009. PMID: 23805438.
[7] Everett BR, Sitton JT, Wilson M. Efficacy and Cost-Benefit Analysis of a Global Environmental Cleaning Algorithm on Hospital-Acquired Infection Rates. J Patient Saf. 2017 Dec;13(4):207-210. doi: 10.1097/PTS.0000000000000141. PMID: 25162207.
[8] Visscher MO, Randall Wickett R. Hand hygiene compliance and irritant dermatitis: a juxtaposition of healthcare issues. Int J Cosmet Sci. 2012 Oct;34(5):402-15. doi: 10.1111/j.1468-2494.2012.00733.x. Epub 2012 Jul 5. PMID: 22691060.
[9] Green M, Kashetsky N, Feschuk A, Maibach HI. Transepidermal water loss (TEWL): Environment and pollution-A systematic review. Skin Health Dis. 2022 Feb 25;2(2):e104. doi: 10.1002/ski2.104. PMID: 35677917; PMCID: PMC9168018.
[10] Peer R, Burli A, Maibach H. Unbearable transepidermal water loss (TEWL) experimental variability: why? Arch Dermatol Res. 2021.
[11] Lichterfeld-Kottner A, El Genedy M, Lahmann N, Blume-Peytavi U, Büscher A, Kottner J. Maintaining skin integrity in the aged: A systematic review. Int J Nurs Stud. 2020 Mar;103:103509. doi: 10.1016/j.ijnurstu.2019.103509. Epub 2019 Dec 23. PMID: 31945604.
[12] Akomeah FK, Martin GP, Muddle AG, Brown MB. Effect of abrasion induced by a rotating brush on the skin permeation of solutes with varying physicochemical properties. Eur J Pharm Biopharm. 2008 Mar;68(3):724-34. doi: 10.1016/j.ejpb.2007.06.005. Epub 2007 Jun 14. PMID: 17618097.
[13] West DP, Zhu YF. Evaluation of aloe vera gel gloves in the treatment of dry skin associated with occupational exposure. Am J Infect Control. 2003 Feb;31(1):40-2. doi: 10.1067/mic.2003.12. PMID: 12548256.
[14] WHO: "Evidence of hand hygiene to reduce transmission and infections by multidrug resistant organisms in health-care settings"; https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/infection-prevention-and-control/mdro-literature-review.pdf?sfvrsn=88dd45c7_2 (accessed 01.02.2016)
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