Notes: Hand Hygiene, Gloves, and Gowns - Essential Infection Control
Hand Hygiene: Foundational Principles and Practices
Importance of Hand Hygiene
Effective hand hygiene is paramount in healthcare settings, primarily because it prevents the transmission of germs. It is essential to practice hand hygiene diligently both before and after client care. Many facilities implement specific protocols, such as the "4_moments of hand hygiene$$", which dictate hand washing before entering a patient's room, before initiating care, during care, upon completing care, and after exiting the patient's room. Adherence to these protocols is critical for maintaining a sterile environment and preventing the spread of infection.
Methods of Hand Hygiene
There are two primary methods for hand hygiene, each with specific applications:
- Waterless Alcohol-Based Sanitizer: This method effectively kills germs and is convenient for routine use. However, prolonged or frequent use of sanitizer can lead to a residue or layer forming on the hands, necessitating a more thorough cleaning.
- Hand Washing with Soap and Water: This method is crucial when hands are visibly soiled. For instance, if there is direct contact with blood or other bodily fluids on the skin, hand washing with soap and water is imperative. Using sanitizer in such situations is insufficient and could potentially spread contaminants rather than remove them. It is the most effective way to prevent the transmission of infection to healthcare providers and patients alike.
Gloves: An Additional Layer of Protection
Gloves serve as a vital additional protective measure in specific situations. It is essential to understand when and why gloves are necessary, as well as their limitations.
When to Wear Gloves
Gloves must be worn whenever there is a potential for contact with body secretions, excretions, or fluids. These can manifest in various forms, including:
- Blood
- Any fluid oozing from the body
- Secretions from the mouth, ears, eyes, or nose
- Feces
- Vaginal secretions
- Urine
Gloves are also necessary when providing care to patients with non-intact skin (e.g., cuts, tears, wounds, rashes, bites) or if the healthcare provider has any compromised skin integrity, such as a cut, rash, bite, or broken fingernail. In such cases, applying a Band-Aid to the compromised area before donning gloves provides an extra layer of protection, preventing germ entry into the provider's body or transmission to others.
Proper Glove Use and Limitations
Before donning gloves, ensure they are clean and free from any tears. The primary purpose of gloves is to protect the wearer from direct contact with potentially infectious materials. It is crucial to remember that gloves are an additional precaution and not a substitute for handwashing. This is a critical distinction.
Ethical and Practical Implications
Failing to wash hands and relying solely on gloves or neglecting proper hand hygiene can have severe consequences. Healthcare providers might inadvertently become carriers of infection, spreading pathogens to their homes, potentially endangering immunocompromised family members, elderly individuals, or young children. This risk extends to other patients on the floor, creating a cycle of transmission. The analogy of how quickly viruses, like measles, spread among school children highlights the rapid and far-reaching impact of inadequate hygiene practices in any communal setting.
Other Personal Protective Equipment (PPEs): Gowns
Beyond hand hygiene and gloves, other PPEs, such as gowns, play a critical role in protecting both healthcare personnel and patients from deadly viruses, bacteria, and germs.
When to Wear a Gown
A gown should be worn when there is a chance of contact with bodily fluid splashes, secretions, or contaminated surfaces. A common example is during procedures like suctioning a patient, where splashes of bodily fluids are highly possible. The practice of dentists routinely wearing face shields, masks, and gowns during their work serves as a practical illustration of protecting against splashes.
Gown Requirements and Use
For effective protection, a gown must completely cover the uniform from the neck to the knees. Gowns are typically disposable and designed for one-time use. If a gown becomes wet or contaminated during care, it must be immediately changed to maintain an aseptic barrier. Proper donning and doffing (removal) procedures for gowns, along with other PPEs, are essential and will be elaborated upon in lab classes.