Hand Hygiene is No. 1 Weapon Against Infections
Q: How can healthcare workers best curtail hospital-acquired infections?
"I am fairly new to infection control, but by studying and learning, I have discovered handwashing is the No. 1 line of defense for fighting nosocomial infections. Since becoming an infection control nurse almost two years ago, a main component of my staff education has been hand hygiene. Physicians and nurses have the knowledge but laxity of practice overrides. Nurses complain about high patient assignments that relate to time, (with) no time to wash hands. If handwashing is done, it usually is not done properly. Proper hand hygiene is one of the best methods to decrease the transmission of pathogens in healthcare facilities. Vigorously washing of hands with soap and water is the most defensive way to help prevent nosocomial infections."
Sonya Kay Ehrhardt, RN
Infection Control Nurse, The Regional Medical Center of Orangeburg and Calhoun Counties, S.C.
A: "I recommend compliance with four very basic and effective infection control interventions:
1. Hand hygiene. Make every effort to keep hands free of cuts, hangnails or abrasions and cover those you already have. When soap and water are not readily available, the Centers for Disease Control and Prevention (CDC) recommends using waterless antimicrobial hand gels. Limit hand jewelry to wedding bands and simple, loose bracelets. Jewelry can prevent proper hand disinfection. Artificial fingernails have no place in any patient care area, particularly in ICU, OR, NICU or ER.
2. Respiratory secretions. Every effort must be made to educate staff, visitors and families about containing coughs and sneezes in tissues, particularly when working or visiting in hospitals.
3. Personal habits. Make a conscious effort not to touch your eyes, nose or mouth. Healthcare workers (HCWs) can contract patients' infections and patients can contract HCWs' infections. HCWs must keep their immune systems healthy by keeping vaccinations up to date and leading healthy lifestyles.
4. Personal protective equipment (PPE). Know when to wear PPE (masks, gowns, gloves, etc.) and when and where to remove and properly dispose of used equipment."
John "Bugs" Hunziker, MPS, MT, CIC
Administrative Manager, Environmental Infection Control/Education, St. Luke's Cornwall Hospital, N.Y.
A: "Everyone is interested in preventing hospital-acquired infections. An important consideration often overlooked is educating patients and family in addition to hospital employees in the use of standard precautions. Handwashing, one of the most basic infection control practices, is a key in preventing infection, particularly by secondary route (i.e., environmental and equipment). Appropriate work practices and engineering controls assist all users in preventing the transmission of infection. Helping employees, patients and visitors realize infection is a real risk and teaching how to protect against this risk is a step in the right direction. Good infection control practices, performed often and well, helps everyone stay healthy and is key to deterring hospital acquired infection."
Denise Leaptrot, CIC
Infection Control Coordinator, Coliseum Medical Centers, Macon, Ga.
A: "It is not a high-tech answer. Your mother told you to do it as a child, every public restroom has a sign reminding employees to do it and we have a hospital competency on it ... you're your hands! It is common sense, good hygiene and the No. 1 way to prevent the spread of infection in a hospital. Good handwashing keeps you from transferring contamination from your hands to other areas of your body or surfaces with which you come in contact. Hepatitis B can live on what appears to be a clean, dry surface for seven days just waiting for you to make the transfer. Wash your hands and wrists thoroughly under running water using a nonabrasive soap. Wash under your rings and fingernails. Rinse completely. Dry with a paper towel. Discard it, then turn off the faucet with another clean, dry paper towel. If possible, use a clean, dry paper towel to open the door. Set the example and stop the spread of infection. We are in the process of starting a handwashing awareness campaign using "GlitterBug." I can't wait to illuminate people who are eating and don't wash their hands. Hopefully, it will improve our compliance. I read that healthcare works think they wash their hands 80 percent of the time, but when observed it is only 30 percent to 40 percent of the time. We have a long way to go."
Dana McKelvain, RN
Infection Control Manager, Eastland Memorial Hospital, Eastland, Texas
A: "In the healthcare setting, each of us has the right to know about hazards that present a risk to us, but we also bear the responsibility to know about risks to patients. Healthcare-acquired infections are considered a type of medical error, and like any other errors, they can be prevented or managed through education. Clinical and non-clinical healthcare workers can stop nosocomial infections in many ways, some obvious, others more subtle.
Learn about the types of infections occurring, patient risks for infection and the role the environment and workers have in transmission of disease. Observe all recommended practices and procedures from handwashing to housekeeping to sterilization procedures. The consequences for shortcuts are serious and should not be underestimated. Be an advocate for patient safety in terms of freedom from infection. Question the choice of antibiotics or the continued need for a device such as a foley. Teach patients how they can prevent disease, including vaccination. Model safe practices. Get a flu shot annually and remind others. We should use every day in the healthcare workplace as an opportunity to apply our knowledge and skills toward infection prevention."
Patty Carson, BA, SM, (ASCP), CIC
Infection Control Practitioner, Cary Medical Center, Caribou, Maine
Compiled by Michelle Gardner