Hand Hygiene in NICU

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Hand Hygiene and Hand wash for Nurses and doctors in NICU

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Hand Hygiene in NICU Dr Manan Parikh :

Hand Hygiene in NICU Dr Manan Parikh

Improving Hand Hygiene Practice Why?:

Bacteria that cause hospital-acquired infections most commonly transmitted via HCW’s hands Studies have shown that washing hands between patients reduces spread of bacteria in health care HCW handwashing compliance rate 40% Improving Hand Hygiene Practice Why?

Minor Action _ Major Outcome:

Minor Action _ Major Outcome Simple tasks can contaminate hands: Taking a patient’s vital signs Touching the patient’s clothing or linens Touching equipment and furniture nearby

PowerPoint Presentation:

“Hand Hygiene is the SINGLE most important practice to prevent nosocomial infections”

Benefits of Hand Hygiene:

Benefits of Hand Hygiene Reduced number of deaths Reduced number of infections: Decreased antibiotic usage Decreased patient length of stay Decreased use of resources

Definitions:

Definitions Hand Hygiene a general term that applies to either handwashing, antiseptic hand wash, antiseptic hand rub or surgical hand antisepsis. Handwashing washing hands with plain soap and water . Antiseptic Hand Wash washing hands with water and soap or other detergents containing an antiseptic agent . Alcohol-based Hand Rub the alcohol-containing preparation applied to the hands to reduce the number of viable microorganisms.

When To Perform Hand Hygiene?:

When To Perform Hand Hygiene? “High Risk” for Contamination Activities “Low Risk” for Contamination Activities

“High Risk” for Contamination:

Immediately before and after patient contact Immediately before and after a procedure Before and after touching any devices/equipment directly connected to the patient e.g. IV Lines, Umbilical Lines, PICC Lines, Central Lines External Ventricular Drains Urinary Catheters Ventilation Equipment “High Risk” for Contamination

“High Risk” for Contamination:

Moving from contaminated to a clean body site After contact with body fluids After coming from washroom After taking food “High Risk” for Contamination

“Low Risk” for Contamination:

“Low Risk” for Contamination After contact with equipment e.g . patients charts, monitors After removing gloves After contact with own nose/mouth/hair

BEFORE Hand Wash:

BEFORE Hand Wash Nails should be kept short / No Nail Polish Artificial nails should not be worn Remove your footwear , take NICU slippers Remove all your ornaments (rings, bracelet, bangles etc), wristwatch before entering NICU Roll over your sleeves up to elbow Wear ICU Gown, Apron (even if you are not touching the baby) Use antiseptic solution for Hand rub (even if you are not touching the baby) Wear face mask , if you have common cold, cough, URTI

How to do Hand Wash?:

How to do Hand Wash?

Alcohol at EVERY bed helps increase compliance:

Alcohol at EVERY bed helps increase compliance Biscoff WE et al 1998: Abstract K132

How to do Hand Rub ?:

Ensure that hands have no visible contamination Apply product to palm of one hand and rub hands together covering all surfaces and fingers Allow to air dry The process takes about 15 seconds How to do Hand Rub ?

A few tips when using the hand rub:

Continue rubbing hands together until alcohol is dry (should take 10-15 sec). After using an alcohol based product, you will feel a “build up” on your hands. To remove this, wash your hands with soap and water as often as necessary. A few tips when using the hand rub

When to follow Hand Hygiene? :

Before & After EVERY ACT related to patient care When to follow Hand Hygiene?

Before Entering NICU:

Before Entering NICU

When Hands are Visibly Soiled:

When Hands are Visibly Soiled

Before examining the Patient:

Before examining the Patient

Before Touching the Patient:

Before Touching the Patient

In between 2 Patients:

In between 2 Patients

Before VF Insertion:

Before VF Insertion

Before Procedure:

Before Procedure

Before - After IV Injections:

Before - After IV Injections

After Waste Disposal:

After Waste Disposal

Before – After touching Infusion Pump:

Before – After touching Infusion Pump

Before – After touching Monitor:

Before – After touching Monitor

Before – After touching Trolley:

Before – After touching Trolley

Before – After Nappy Change:

Before – After Nappy Change

After Handling Body Fluids / Secretions:

After Handling Body Fluids / Secretions

After Touching Files / Papers:

After Touching Files / Papers

After removing gloves:

After removing gloves

After touching the Mobile:

After touching the Mobile

WHO should follow Hand Hygiene?:

WHO should follow Hand Hygiene? Consultants Outside consultants visiting NICU ( Superspecialist , Radiologist, Neurologist, Physiotherapist etc) In-House Paediatrician Resident Doctors Nurses Health care assistant Support staff X-ray Technician Lab Assistant Mothers / Relatives / Visitors Cleaning Staff Hospital Management Staff Maintenance people of different NICU instruments WHO SO EVER ENTERS THE NICU ---- MUST FOLLOW HAND HYGIENE

Nurse’s Role :

Nurse’s Role Follow the Hand Hygiene Guidelines For every patient For every act In every shift Observe others…. If somebody is not following Hand Hygiene… Even if CONSULTANTS… You have right to tell them to follow Hand Hygiene Guidelines

Single Step to Prevent Infection:

Single Step to Prevent Infection Hand washing Hand washing Hand washing Hand washing Hand washing Hand washing

Questions ?:

Questions ?

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