MUDr. Markéta Petrovová Dpt. of occupational medicine LF MU Brno 2011 žWHY?? žWHO?? ž žaffect hundreds of millions of patients worldwide ževery year. ž Infections ž lead to more serious illness ž prolong hospital stays ž induce long-term disabilities ž add high costs to patients and families ž contribute to additional financial burden ž on the health-care system ž often result in tragic loss of life. ž ž VAP = ventilator-associated pneumonia ž žCLA-BSI = central line-associated bloodstream infection ž žCR-UTI = catheter-related urinary tract infection ž žSSI = surgical site infection ž ANd9GcQtGKS_v47nvGHPp1zfSfrlCTG3EJvjrQ893q34xFgozJ11xMdG ANd9GcTxwo5_MazAUPgihJn2je1UsWSU0R5gTt2H-Z9g1lj0Oe6gImjS2A ANd9GcR05Dej3EG4GB4d9QdfiVtXGd1eFLF6huVNIpfEzTO4OY0rn1Kspw žHCAI is a major problem for patient safety and its prevention must be a first priority for settings and institutions committed to making health care safer. ž ž Hand hygiene is the primary measure to reduce ž infections and the spread of antimicrobial resistance. ž žWHO: New global Guidelines on Hand ž Hygiene in Health Care ž žconcerns 5–15% of hospitalized patients žcan affect 9–37% of those admitted to intensive care units. žPrevalence rates of infection: žEurope: from 9 to 37% when assessed 12 žUSA: with trude mortality rates ranging from 12% to 80%. ž Device-associated infections have a great economic impact; for example catheter-infection caused by methicillin-resistant Staphylococcus aureus (MRSA) may cost as much as US$ 38 000 per episode. ž ANd9GcQaXmxi1TP1OYkvtg5tIM2WwcqjKP2a0uAgJgzUdZKAhKgH2sQd žThe risk for patients to develop surgical site infection (SSI), the most frequently type in developing countries, is significantly higher than in developed countries ž že.g. 30.9% in a paediatric hospital in Nigeria ž23% in general surgery in a hospital in the United Republic of Tanzania ž19% in a maternity unit in Kenya source of infection susceptible patient direct transmission (STD) dirty hands area/surface subject water food soil insect … non-direct transmission organism droplets transmission (influenza) žobservance of hygienic rules ž implementation of disinfection and sterilization ž žcan reduce the presence of microorganisms ž HAND HYGIENE AREAS AND SUBJECTS DISINFECTION TOOLS DISINFECTION Prevention of nosocomial infections Cost-effective method of preventing the spread of hospital infections HANDS TRANSMITS UP TO 60% INFECTIONS ANd9GcT2Qaz-Ox89wzaKA4AWRj8fAQvXKz_yof4QE1-SY5dWhVzzwIkA žA. Wash hands with soap and water when visibly dirty or visibly soiled with blood or other body fluids or after using the toilet. ž ž B. If exposure to spore-forming pathogens is strongly suspected or proven (Clostridium difficile, hand washing with soap and water is the preferred means. ž žC. Use an alcohol-based handrub for routine hand antisepsis in all other clinical situations. If it is not obtainable, wash hands with soap and water. ž ž ž personal – doctor, nurse … ž patient ž visitors ž ž = all in hospital žbefore and after touching the patient ž žbefore handling an invasive device for patient care, regardless of whether or not gloves are used ž žafter contact with body fluids or excretions, mucous membranes, non-intact skin, or wound dressings ž žif moving from a contaminated body site to another body site during care of the same patient ž žafter contact with inanimate surfaces and objectes (including medical equipment) in the immediate vicinity of the patient after removing sterile or non-sterile gloves ž žbefore handling medication or preparing food perform hand hygiene using an alcohol-based handrub or wash hands with either plain or antimicrobial soap and water ž ž žThe use of gloves does not replace the need ž for handhygiene (HR, HW) ž žWear gloves when is possible contact with ž blood or other potentially infectious materials, ž mucous membranes or non-intact skin žRemove gloves after caring for a patient. Do not wear the same pair of gloves for the care of more than one patient žWhen wearing gloves, change or remove gloves during patient care if moving from a contaminated body site to either another body site within the same patient or the environment ž žThe reuse of gloves is not recommended. žSoap and alcohol-based handrub should not be used concomitantly. ž žDo not wear watch, rings and artificial fingernails when having direct contact with patients. ž žKeep natural nails short (less than 0.5 cm long) ANd9GcSAwClCgBryEKxh_lqmPZ9CDXsl32rm1E4Apjy5xxLpvFCwmyU- ANd9GcSpg9KXXu4H7dAi74buJ1UIeobwEHwuhD3NDlV5yIF0PsnRPb9djw ANd9GcQn4Cxjvqq-uOv89nT3Bevq41Yf-o8sZOe0Y9n213E5XCFKVyzX3w ždefines the key moments when health-care žworkers should perform hand hygiene. ž žThis approach recommends to clean their hands ž ž before touching a patient, ž before clean/aseptic procedures, ž after body fluid exposure/risk, ž after touching a patient, and ž after touching patient surroundings. ž My 5 Moments for Hand Hygiene žWASH HANDS WHEN VISIBLY SOILED! ž žOTHERWISE, USE HANDRUB Hygiena žRUB HANDS FOR HAND HYGIENE! žWASH HANDS WHEN VISIBLY SOILED ž Often forgotten places palm of the hand back of the hand ž ž“Clean Care is Safer Care” ž žis not a choice ž žbut ž ža basic right. THE END followed by a practical demonstration of their own hands… Thank you for attention ANd9GcRHBse74XDQ_KrxraHTssTMvZez2dJCADPTUSuqNro5wpKhP3G5zg