Handwashing Compliance in Healthcare Workers

Hand Hygiene

• Before the program, 51% of healthcare workers complied with handwashing guidelines, and after the intervention, 83% did.
• For nurses, compliance went up from 56% to 89% after the intervention.
• The program included a handout that specified how important handwashing is and described the proper technique as well as the CDC's hand hygiene guidelines.
• Five posters were placed around the nurses' station.

Handwashing Procedure

• Ensure paper towel is hanging down from dispenser.
• Turn on water using foot pedal or faucet so that flow is adequate, but not splashing.
• Adjust temperature to warm, as cold does not facilitate sudsing and cleaning, and hot is damaging to skin.
• Wet hands under clean running water, keeping hands below elbow level, to facilitate distribution of soap over entire skin surface.
• Place a small amount, 1 to 2 teaspoons (3–5 mL) of liquid soap on hands, and thoroughly distribute over hands.
• Soap should come from a dispenser, not bar soap, to prevent spread of microorganisms.

Additional Guidelines

• Remove all fake fingernails, as they serve as a reservoir for microorganisms.
• Clean gloves by rinsing under cold running water, and then removing gloves and completing hand hygiene.

Donning and Removing Clean Gloves

• Complete hand hygiene before donning gloves.
• Remove glove from glove receptacle, hold glove at wrist edge, and slip fingers into openings.
• Pull glove up to wrist, and place gloved hand under wrist edge of second glove.
• Remove glove by pulling off, touching only outside of glove at cuff, so that glove turns inside out.

Infection Control

• Assess for skin integrity, presence of drainage from lesions or body cavity, and ability to deal with oral secretions.
• Assess for compliance to hygiene measures, ability to carry out activities of daily living (ADLs), and extent of barrier techniques needed.
• Implement standard precautions, including donning protective gear, exiting a client's room, and disposing of gown and protective eyewear.
• Evaluate expected outcomes, including preventing the spread of microorganisms and reducing potential for transmission.

Standard Precautions (Tier 1)

• Donning protective gear, including gown, mask, and protective eyewear, to prevent spread of microorganisms.
• Exiting a client's room by following proper procedures, including removing gown, gloves, and protective eyewear, and disposing of them properly.
• Evaluating expected outcomes, including preventing the spread of microorganisms and reducing potential for transmission.

Disposal Precautions

• Client should be instructed to expectorate into a tissue held close to mouth.
• Needles and syringes should be disposable.
• Used equipment or contaminated material should be disposed of in appropriate receptacles.

Vital Signs

• Blood pressure readings provide information about the condition of the heart, arteries, and arterioles, vessel resistance, and cardiac output.
• Respirations vary according to age, with newborns having a range of 30 to 80 breaths/minute, and adults having a slower rate.
• Pain assessment that is ongoing and constant is essential to maintain the client's homeostasis and quality of life.