Universal Precautions & Hand Hygiene

Study Notes

Universal Precautions: are steps taken to prevent the spread of infectious diseases from one person to another, regardless of known infection status.
Standard Precautions: are a subset of universal precautions, applied to all patients at all times. They focus on preventing the transmission of infectious diseases, like patient-to-nurse or patient-to-patient
Transmission Based Precautions: are specific measures used to prevent the spread of infection when a patient has or is suspected to have an infectious disease. They are based on the pathogen's mode of transmission (contact, airborne, droplet).

Defined by the WHO as hand washing, antiseptic hand washing, antiseptic hand rub or surgical hand antisepsis.
Purpose: Reduce germs, prevent germ spread, prevent contamination of patient's environment, promote comfort.
Five Moments of Hand Hygiene
- Before touching a patient
- Before a procedure
- After touching a patient
- After a procedure or a body fluid exposure risk
- After touching patient surroundings

Routine hand washing: Using water and non-antimicrobial soap for 40-60 seconds to remove soil and transient microorganisms.
Antiseptic hand washing: Using water and antimicrobial soap (chlorhexidine or iodine).
Antiseptic hand rub: Using alcohol-based hand rub (20-30 seconds). This is the recommended method for healthcare settings when hands are not visibly soiled.
Surgical antisepsis: Using water and antimicrobial soap (chlorhexidine or iodine) for 3-5 minutes to remove or destroy transient microorganisms and reduce resident flora. This is done before surgeries.

Equipment:
- Running water
- Towel
- Soap and soap dish
- Tissue paper
Steps:
- Prepare equipment
- Remove jewelry and roll sleeves above elbow
- Stand in front of the sink and avoid touching the sink with clothes
- Adjust water flow and temperature
- Wet hands with water
- Apply soap
- Rub hands together vigorously: palm to palm, fingers interlaced, palm to palm with fingers interlaced, back of fingers to opposing palm with fingers bent and interlaced, each thumb clasped in opposite hand, tip of fingers in opposite palm, each wrist
- Rinse hands from fingertips to wrist
- Use elbow to turn off tap
- Dry thoroughly with single-use towel

Equipment:
- Alcohol (70% concentration)
Procedure:
- Apply a palmful of hand sanitizer to dry hands and cover all surfaces
- Rub hands palm to palm
- Rub right palm up and down the back of the other hand with interlaced fingers
- Rub palms together with interlaced fingers
- Rub back of fingers to opposing palm with fingers bent and interlaced
- Rub each thumb clasped in the opposite hand
- Rub tips of fingers in opposing palm in circular motion
- Rub each wrist
- Continue rubbing until hands are dry