Transcript Hand Hygiene in Mental Health

Hand Hygiene
for Mental Health
5 Moments for Hand Hygiene
National Hand Hygiene Initiative was
instigated by the Australian Commission for
Safety and Quality in Health Care
Based on the World Health Organisation
World Alliance for Patient Safety Campaign
“Save Lives: Clean Your Hands”
Some adaptation may be necessary for the Mental Health setting
Health Care Associated Infection
Definition:
an infection that was not present at the
time of hospital admission/ healthcare
attendance, but was acquired via the
delivery of healthcare
Healthcare Associated Infections
Healthcare associated infections are
one of the most frequent and severe
complications of hospitalisation in
Australia
7-10% of patients will acquire 1 or more
healthcare associated infections
Contributes to 7,000 deaths per annum
Approx. 6.1 infections/100 patients
Majority are preventable
Source:Australian Council for Quality and Safety in Healthcare July 2003
Yung, McDonald, Spelman, Street & Johnson 2001
Victorian Surveillance System (VICNISS) Coordinating Centre Data 2007
Hand Hygiene
Hand Hygiene
• Protects clients from harmful germs that are
carried on your hands
• Protects you & the healthcare environment
from harmful germs
Effective Hand Hygiene is the single
most important strategy in preventing
health care associated infections.
Hand Hygiene
HH means either:
using soap and water to
wash with thorough drying
when your hands are
visibly soiled
or
using a waterless hand
rubs
( e.g.. ABHR) when your
hands are visibly clean
Hand Hygiene reduces transient
micro-organisms
Before
After
Following the 5 Moments
To achieve compliance with the 5
Moments for Hand Hygiene staff need:
Knowledge of the 5 Moments
Easily accessible facilities for Hand
Hygiene
Sinks with soap dispensers
Alcohol based hand rub
Encouragement and support from
management
Role modelling from all staff
Hand Hygiene in Mental Health
Matters
Outbreaks of infective diseases still occur
within MH facilities
Clients are transferred to/from acute facilities
Staff may work on acute wards also
Invasive procedures occur in MH facilities
e.g. injections
MH unit may be within an acute facility
Bugs don’t stop at the door
Infections can exacerbate MH conditions
Simple Message - It’s quick and easy
SQUIRT
one squirt (3 ml) to
your hands
RUB
apply to palm
ROLL
rub hands together covering
all aspects of your fingers &
hands until dry
Why use ABHR’s?
Reduces bacterial count on hands more
effectively than soap and water hand wash
Reduces adverse outcomes and cost
associated with healthcare associated
infections
Requires less time
Less irritating to skin than soap and water
as ABHRs contain an emollient
Can be readily accessible/portable
The 5 Moments
may need to be
adapted to allow
for the
characteristics of
the client
population and
available facilities
Moment 1
Before Touching a Patient
When
Hand Hygiene before touching a patient
Hand Hygiene on entering the patient’s room OR
Hand Hygiene on leaving the staff area
Hand hygiene before:
Any personal care activities
Any non-invasive observations
Any non-invasive treatment
Preparation and administration of oral medications
Why
To protect the patient against acquiring harmful germs from the
hands of the HCW
What is a Procedure?
An act of care for a patient where
there is a risk of direct introduction
of a pathogen into the patient’s
body.
Moment 2
Before a Procedure
When
Hand Hygiene immediately prior to a procedure
Once Hand Hygiene has been done, nothing else in the patient’s environment should
be touched prior to the procedure starting
Hand hygiene before:
Insertion of a needle into a patient’s skin
Preparation and administration of any medications given via an invasive
medical device eg. NG feed
Preparation of sterile materials
Administration of medications where there is direct contact with mucous
membranes
Any assessment, treatment and patient care where contact is made with nonintact skin or mucous membranes
Why
To protect the patient from harmful germs (including their own) from entering
their body during a procedure
What is a Body Fluid Exposure Risk?
Any situation where contact with body
fluids may occur. Such contact may pose
a contamination risk to either the HCW or
the environment
Moment 3
After a Procedure or Body Fluid Exposure Risk
When
Hand Hygiene immediately after a procedure or a body fluid
exposure risk
As hands are likely to be contaminated with body fluid
Hand hygiene:
After any procedure
After any potential body fluid exposure
• Blood, Lochia, Saliva, Tears, Mucous, Wax, Pus, Breast milk,
Colostrum, Vomitus, Urine, faeces, Semen, Meconium
• Tissue samples, including biopsy specimens, organs, bone marrow,
cell samples
Why
To protect yourself and the healthcare surroundings from
harmful patient germs
Moment 4
After Touching a Patient
When
Hand Hygiene after touching a patient
Hand hygiene on leaving the patient’s room OR
Hand hygiene on entering the staff area
Hand Hygiene After:
Any personal care activities
Any non-invasive observations
Any non-invasive treatments
Why
To protect yourself and the healthcare surroundings from
harmful patient germs
Moment 5
After touching a patient’s immediate surroundings when
the patient has not been touched
When
Hand hygiene after touching the patient’s
surroundings even when the patient has not
been touched
Hand Hygiene:
After leaving the patient area
On entering a staff area
Why
To protect yourself and the healthcare
surroundings from harmful patient germs
ABHR Product Placement
A hand hygiene product should be easily
accessible and as close as possible to
where patient care or treatment is taking
place
Given the nature of Mental Health illness
it may not be appropriate to leave ABHR
within reach of the client – this will be a
decision for each facility/ward/patient
ABHR Product Placement
At a MINIMUM Place ABHR in:
Nurses Station
Staff rooms – at exit doors, near desks
Treatment rooms – where procedures will
occur, or where medication is dispensed
Portable treatment trolleys – permanently
fix to the trolley
Carry portable bottles where appropriate
Important Areas to Focus on in
Mental Health
Hand hygiene before and after a
procedure
Hand hygiene on entering and leaving
patient and staff areas
Encouraging regular patient hand
hygiene
Product availability in staff areas
Product availability in all treatment areas
Patient Hand Hygiene
Encourage Mental Health clients to clean
their hands:
Before and after eating
After smoking
After using the toilet
When they are visibly soiled
Looking After Your Hands
Skin Care:
• Cover cuts, scratches, rashes with a water proof
dressing
• Keep your hands healthy and avoid dryness - use
facility supplied compatible moisturiser a minimum of 3
times per shift
Finger nails should be kept short
No chipped polish
No acrylic nails in clinical areas
Limit jewellery worn to work - jewellery should not
inhibit your ability to correctly perform Hand Hygiene
If you have issues with sore, cracked &/or dry hands,
follow your facility guidelines.
Gloves
Gloves should be used as an adjunct to, not
a substitute for hand hygiene.
Hand hygiene is to be performed before &
after all glove use.
Gloves need to be changed & HH performed
after each client procedure and when going
from dirty to clean sites even on the same
client.
Disposable gloves are to be used once only
and never disinfected or washed.
“Clean Between”
Use the alcohol impregnated
wipes/detergent wipes on all
shared non critical equipment
Think about product
placement to encourage use of
wipes e.g near keyboards, on
trolleys, in clinic areas,
treatment rooms
Adhere to a regular cleaning
schedule for shared
equipment/furniture
Summary
Hand Hygiene is important in Mental
Health
Follow the 5 Moments for Hand Hygiene
but be mindful that the 5 Moments may
need to be adapted to allow for the
characteristics of the client population
and available facilities