Healthcare associated infections (HCAIs) can develop either as a direct result of healthcare interventions such as medical or surgical treatment, or from being in contact with a healthcare setting. The term HCAI covers a wide range of infections. The most well-known include those caused by Meticillin-Resistant Staphylococcus Aureus (MRSA), Meticillin-Sensitive Staphylococcus Aureus (MSSA), Clostridium difficile (C.diff) and Escherichia coli (E. coli).
HCAIs cover any infection contracted:
- as a direct result of treatment in, or contact with, a health or social care setting
- as a direct result of healthcare delivery in the community
- as a result of an infection originally acquired outside a healthcare setting (for example, in
the community) and brought into a healthcare setting by patients, staff or visitors and transmitted to others within that setting (for example, norovirus)
The rise and spread of antimicrobial resistance (AMR) is creating a new generation of ‘superbugs’ that cannot be treated with existing medicines. The impacts of leaving AMR unchecked are wide-ranging and extremely costly, not only in financial terms but also in terms of global health, food sustainability and security, environmental wellbeing, and socio-economic development.
Already, AMR infections are estimated to cause 700,000 deaths each year globally.
Therefore, hand hygiene is the most important measure to avoid the transmission of harmful germs and prevent HCAIs.
NB: Sinks for hand washing must be used solely for that purpose and not for disposing of any liquids.
Hand hygiene technique.
Before performing hand hygiene:
- expose forearms (bare below the elbow)
- remove all hand and wrist jewellery (a single, plain metal finger ring is permitted but should be removed (or moved up) during hand hygiene
- ensure fingernails are clean and short, and do not wear artificial nails or nail products
- cover all cuts or abrasions with a waterproof dressing.
To perform hand hygiene:
Alcohol-based handrubs (ABHRs) must be available for staff as near to the point of care as possible. Where this is not practical, personal ABHR dispensers should be used.
Perform hand hygiene:
- before touching a patient
- before clean or aseptic procedures
- after body fluid exposure risk
- after touching a patient; and
- after touching a patient’s immediate surroundings.
NB: perform hand hygiene before putting on and after removing gloves.
Wash hands with non-antimicrobial liquid soap and water if:
- hands are visibly soiled or dirty
- caring for patients with vomiting or diarrhoeal illnesses
- caring for a patient with a suspected or known gastrointestinal infection, eg norovirus or a spore-forming organism such as Clostridium difficile.
In all other circumstances, use ABHRs for routine hand hygiene during care. Where running water is unavailable, or hand hygiene facilities are lacking, staff may use hand wipes followed by ABHR and should wash their hands at the first opportunity.
Use the following video and resources to help you perform hand hygiene correctly:
- Dry hands thoroughly after hand washing, using disposable paper towels
- Use an emollient hand cream during work and when off duty
- Do not use or provide communal tubs of hand cream in the care setting
- Staff with skin problems should seek advice from occupational health
All children should understand how to wash hands, prevent infections and use antimicrobials appropriately; the following video may be used to help educate younger, primary school aged children: