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Infection Control News for the Health of Your Practice
HAND HYGIENE
Fall/Winter Edition 2011
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Table of Contents Hand Hygiene Definition of Terms ....................3 CDC Guidelines for Hand Hygiene in Healthcare Settings ............4–5 Hand Hygiene Sanitizers (Alcohol Based) ....................6–9 Proper Hand Hygiene Techniques with Alcohol-Based Formulation ................................8 Hand Hygiene Products (Soaps)................10–13 Proper Hand Hygiene Techniques with Soap and Water........................12 Surgical Cleanser Products and Scrub Products............14–18 Proper Surgical Hand-washing Techniques ........................16–17 Value-Added Services ............19 Glo Germs ................................20
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At Henry Schein Medical, we support your efforts in working toward maintaining the total health of your patients and your practice by providing you with the products and services that enhance your clinical capabilities. Hand hygiene is a number one step to keep your practice healthy. The key to staying healthy is really in YOUR HANDS. According to CDC, the single most important thing we can all do to keep from getting sick and spreading illness to others is to clean our hands. During this time of year it is vitally important to be aware of this and take the appropriate precautions within your medical practice to keep your patients and staff healthy. Hand to face contact has a surprising impact on health. Germs can enter the body through breaks in the skin or through the membranes of the eyes, mouth and nose. Shaking hands aids in the spread of germs between patients and co-workers so it is very important to wash / sanitize the hands often throughout the day. Cover Your Cough Stop the spread of germs that can make you and others sick! Influenza (flu) and other serious respiratory illnesses like respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS) are spread by cough, sneezing, or unclean hands. Most experts believe that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or nose. To help stop the spread of germs– • Cover your mouth and nose with a tissue when you cough or sneeze. • Put your used tissue in the waste basket. • If you don’t have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands. • You may be asked to put on a facemask to protect others. • Wash your hands often with soap and warm water for 20 seconds. • If soap and water are not available, use an alcohol-based hand rub. The American Society for Microbiology has downloadable educational hand hygiene materials, including posters and brochures for children and adults, available at www.washup.org. The site also contains information on ordering printed materials which may of interest to your practice. Let Henry Schein Medical help maintain the health of your practice with the latest infection control products and supplies. Whether it is providing flu vaccine for your office staff and patients; supplying disposable and infection control prevention products; or diagnostic test kits and treatments, Henry Schein is your total resource. We have whatever you need to fight the good fight and avoid those infection causing germs. Get Vaccinated The single best way to prevent the flu is to get a flu vaccine each season. The 2011-2012 flu vaccine will protect against H1N1, and two other influenza viruses (an H3N2 virus and an influenza B virus). Visit our Flu Resource Center website at www.henryschein.com/flu for the latest information about influenza and all the products you need. For more information on infection control and hand hygiene visit the CDC website: www.cdc.gov HENRY SCHEIN BRAND – DEPEND ON US Look for the Henry Schein Seal of Excellence icon to identify Henry Schein Brand products that are exceptional in quality and reasonably priced. From hand sanitizers, hand soaps to skin cleansers you’ll find diverse products that support you in achieving greater hand hygiene compliance within your practice. Satisfaction guaranteed!
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HAND HYGIENE – Definition of Terms Hand hygiene. A general term referring to any action of hand cleansing.
HAND HYGIENE PRODUCTS Alcohol-based (hand) rub. An alcohol-containing preparation (liquid, gel or foam) designed for application to the hands to inactivate microorganisms and/or temporarily suppress their growth. Such preparations may contain one or more types of alcohol, other active ingredients with excipients, and humectants. Antimicrobial (medicated) soap. Soap (detergent) containing an antiseptic agent at a concentration sufficient to inactivate microorganisms and/or temporarily suppress their growth. The detergent activity of such soaps may also dislodge transient microorganisms or other contaminants from the skin to facilitate their subsequent removal by water. Antiseptic agent. An antimicrobial substance that inactivates microorganisms or inhibits their growth on living tissues. Examples include alcohols, chlorhexidine gluconate (CHG), chlorine derivatives, iodine, chloroxylenol (PCMX), quaternary ammonium compounds, and triclosan. Antiseptic hand wipe. A piece of fabric or paper pre-wetted with an antiseptic used for wiping hands to inactivate and/or remove microbial contamination. They may be considered as an alternative to washing hands with non-antimicrobial soap and water but, because they are not as effective at reducing bacterial counts on HCWs’ hands as alcohol-based handrubs or washing hands with an antimicrobial soap and water, they are not a substitute for using an alcohol-based handrub or antimicrobial soap. Detergent (surfactant). Compounds that possess a cleaning action. They are composed of a hydrophilic and a lipophilic part and can be divided into four groups: anionic, cationic, amphoteric, and non-ionic. Although products used for handwashing or antiseptic handwash in healthcare represent various types of detergents, the term “soap” will be used to refer to such detergents in these guidelines. Plain soap. Detergents that contain no added antimicrobial agents, or may contain these solely as preservatives. Waterless antiseptic agent. An antiseptic agent (liquid, gel or foam) that does not require the use of exogenous water. After application, the individual rubs the hands together until the skin feels dry. Chlorhexidine (CHG). Chlorhexidine gluconate produces its antimicrobial activity by increasing the permeability of the microbial cell, disrupting cytoplasmic membranes, and precipitating cell contents. A major disadvantage of chlorhexidine gluconate is its slow onset and relatively narrow range of antimicrobial activity. Its major advantage is its superior residual activity. It is most commonly used in combination with other hand hygiene products. Chlorhexidine gluconate is associated with a relatively low incidence of skin irritation but has been reported to cause isolated cases of contact dermatitis and anaphylactic allergic reactions Chloroxylenol. Chloroxylenol, also known as parachlorometaxylenol, derives its antimicrobial action by deactivating bacterial enzymes. Most commonly used as an antimicrobial agent in soaps, parachlorometaxylenol does not consistently demonstrate a broad spectrum of antimicrobial effectiveness or residual activity as compared with many of the other commercially available antiseptics. Iodophors. Iodophors are complexes composed of iodine and a carrier such as polyvinylpyrrolidone (or povidone). The iodine exerts its antimicrobial action by crossing cell walls and substituting microbial contents with free iodine. Iodophors have a relatively wide range of antimicrobial activity. Problems associated with iodophor use are a relatively high incidence of skin irritation and allergic reactions, and the partial neutralization of activity in the presence of organic materials such as blood or sputum. Triclosan. Triclosan is a diphenyl ether. Its antimicrobial activity results from the entry into the bacterial cell where it impedes the synthesis of RNA and proteins. In common clinical usage, triclosan is more bacteriostatic than bacteriocidal and has limited efficacy against Pseudomonas aeruginosa and most fungi. It is minimally affected by the presence of organic matter or blood and has the advantage of excellent persistent activity. Source: World Health Organization
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CDC Guidelines for Hand Hygiene in Healthcare Settings This Guideline advises that to maximize acceptance of hand-hygiene products, employers should solicit input from healthcare workers regarding the feel, fragrance, and skin tolerance of these products. These recommendations are designed to improve hand-hygiene practices and to reduce transmission of pathogenic microorganisms.
CDC now recommends: • An alcohol-based handrub is recommended for routinely decontaminating hands of caregivers before and after clinical contact with the patient and after contact with inanimate objects (including medical equipment) in the vicinity of the patient. • Healthcare facilities should implement a comprehensive, multi-modal hand hygiene education and compliance program in order to overcome obstacles to hand hygiene compliance.
1 2 3 4 5
BEFORE TOUCHING A PATIENT BEFORE CLEAN/ASEPTIC PROCEDURE AFTER BODY FLUID EXPOSURE RISK AFTER TOUCHING A PATIENT AFTER TOUCHING PATIENT SURROUNDINGS
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The CDC notes that at least one third of all healthcare related infections can be prevented, and that hand hygiene is the single most important practice in preventing the spread of infection. In an effort to raise attention to this aspect of care, the U.S. Centers for Disease Control and Prevention (CDC) recently released its Guideline for Hand Hygiene in Healthcare Settings stating that all healthcare organizations must improve and sustain adherence with recommended hand-hygiene practices. Source: www.cdc.gov
In order to implement the CDC’s hand hygiene recommendations, healthcare facilities will have recurring expenses that will be easily offset by the savings that result from preventing infections. In addition, healthcare facilities reduce the risk of any fines resulting from improper hygiene and infection control which can lead to the healthcare facility losing their status as a participating provider of Medicare and Medicaid. According to the CDC, researchers have identified numerous obstacles to hand washing compliance: • Poor quality hand washing agents that cause irritation and dryness • Sinks are inconveniently located • Empty soap and paper towel dispensers • Insufficient time • Lack of knowledge on proper hand-hygiene protocols • Lack of facilities’ priority on hand hygiene.
HELPFUL CHECKLIST TO IMPLEMENT PROPER HAND HYGIENE PROTOCOL Is there a primary administrative resource available to develop and maintain infection control policies that adhere to proper hand hygiene practices? Does the healthcare facility have an allocated budget to meet hand hygiene policies? Are healthcare workers regularly monitored to ensure proper hand hygiene compliance? Does the healthcare facility provide healthcare workers with up-to-date education on proper hand hygiene? Are healthcare workers compensated on hand hygiene compliance? Are proper hand hygiene reminders posted throughout the facility to ensure compliance from healthcare workers and patients? Are patients encouraged to remind healthcare workers to follow hand hygiene compliance?
CHOOSING HAND HYGIENE PRODUCTS • Is product efficacy and skin compatibility taken into consideration when selecting a hand-hygiene product? • Are feel, fragrance and skin tolerance considered by the healthcare worker when selecting a hand-hygiene product? • Are soap and water or alcohol-based hand rubs easily accessible for all healthcare workers? • Are alcohol-based hand rubs conveniently located throughout the facility; exam rooms, entrances/exits, waiting rooms? • Does the healthcare facility provide hand lotions or creams to healthcare workers in order to minimize irritated skin conditions? Source: CDC – Guidelines for Hand Hygiene in Healthcare Settings
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Guidelines & Recommendations: CDC Recommendations • Alcohol-based hand rubs are strongly recommended for routinely decontaminating hands if they are not visibly soiled. • In order to improve handhygiene compliance, make alcohol-based hand rubs easily available. • Provide healthcare workers with hand lotions and creams to minimize skin dryness and irritation. • Provide staff education and training regarding proper hand hygiene practices and methods. • Monitor healthcare workers’ hand hygiene compliance and provide feedback.
Sanitize...when hands are not visibly soiled BEFORE: • Patient contact • Donning sterile gloves prior to inserting a central intra-vascular catheter • Inserting indwelling catheters and other invasive devices that do not require a surgical procedure • Moving from a contaminated-body site to a clean-body site during patient care AFTER: • Contact with a patient’s skin • Contact with bodily fluids or excretions • Contact with non-intact skin • Contact with wound dressings • Contact with inanimate objects, including medical equipment in the immediate vicinity of the patient • Removing gloves
Source: Metrex.com
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GBG AloeGel™ Instant Hand Sanitizer Kills 99.9% of broad-spectrum microorganisms in 15 seconds without water. Moisturizes and conditions skin with vitamin E and aloe to help prevent drying, cracking, or irritation of skin. Unique formula helps soften hands, yet leaves no sticky residue. Fresh scent. 4-fl-oz Flip-Top Bottle (365-5030) ..............................ea 18-fl-oz Pump Dispenser (923-8209) ..............................ea 800-mL Bag-in Box Refill (300-4126) ..............................ea Wall Dispenser for 800-mL Refill (366-2110) ..............................ea
VioNexus™ No-Rinse Spray TotalCare featuring Metrex Products A moisturizing, waterless skin sanitizer. Repeated applications enhance microbial effects as they moisturize and soothe the skin. Dispensed in a revolutionary no-touch system, helps eliminate cross contamination. The 66% ethyl-alcohol, 0.08% benzalkonium-chloride formula contains emollients and is recommended for repeated use. #10-1802, Handwash Solution, 2-oz Bottle (176-2443) ..............................ea #10-1800, Handwash Solution, 1-Liter Bottles (176-9583) .........................2/box No-Touch™ Dispenser Battery operated (included). Dispenses a premeasured atomized application over the surface of the hands. (176-0730) ..............................ea VioNexus™ Drip Tray For use with No-Touch™ Dispenser. (640-6607) ..............................ea Manual Dispenser Manual alternative to the No-Touch™ Dispenser. It dispenses a premeasured amount of solution. (176-0415) ..............................ea Tray For Manual Dispenser (176-2196) ..............................ea
QUICK WIPES Nonallergenic, premoistened, ready-touse hand towelettes. Pleasant fragrance with lanolin, alcohol, and aloe. Refreshing aid for the office, home, or car. Use for easy, gentle cleansing of hands and face. • Soft, strong towelettes: allow easy and gentle cleansing of hands and face • Effective and gentle formulation that contains aloe: formulated for fast drying and gentleness • Convenient packaging: towelettes easily dispensed through orifice; each towelette is saturated with cleansing liquid Pop-Up Container, 9" x 51/2" (104-4176).....................150/cont
HAND SANITIZER • Alcohol-based waterless hand gel • Kills 99.9% of most common disease-causing germs spread by the hands • Rinse-free; no water required • Fresh clean scent and soothing emollients leave hands soft and clean 8-oz Pump Bottle (900-4443)..............................ea
VioNex® Antimicrobial Skin Wipes TotalCare featuring Metrex Products Cleans hands and kills germs when soap and water are not available. Gentle and nonirritating. 0.5% PCMX. #25100, Individually Wrapped (176-5471) .......................50/box
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Hand hygiene is one of the most important measures to prevent the spread and acquisition of healthcareassociated infections. Alcohol-based hand rubs also known as hand sanitizers, antiseptic hand rubs, and healthcare personnel hand rubs, are a critical component of a comprehensive hand-hygiene program. Alcohol-based hand rubs have various advantages over washing hands with soap and water, such as increased antimicrobial efficacy, and potential for increased compliance, because hand rubbing requires less time, results in less skin irritation and does not require access to water. Touchless dispensing systems provide added protection against the inadvertent transmission of germs. Alcohol-based hand rubs are recommended as the primary means of hand hygiene when hands are dry and free from visible soiling and when soap and water are not available.
The Help Center: Hand Hygiene Interactive Training Course
Avagard™ D Instant Hand Antiseptic with Moisturizers It's the waterless hand antiseptic that feels like a moisturizer. This latex-glovecompatible antiseptic offers more moisturizing, less redness, and less skin breakdown than other comparable products. Featuring a unique rich emollient base that feels smooth on hands, it won't leave hands sticky or impact glove performance.
Kimcare® Moisturizing Instant Hand Sanitizer Gel #93056, White Contains aloe and skin conditioners to moisturize and prevent dry skin. Active ingredient: 62% ethyl alcohol. 8-oz Pump (643-3683) ..............................ea 4-oz Bottle (643-1235) ..............................ea
3 oz (493-9176) ..............................ea #9222, 500 mL, 16.9-oz Pump Bottle (493-5108) ..............................ea
FOAMING HAND SANITIZER • Alcohol-free formulation that is nondrying to the skin • Kills 99.9% of most common diseasecausing germs spread by the hands • Rinse-free, no water required • Fresh clean scent and soothing emollients leave hands soft and clean 2-oz Pump Bottle (900-4445)..............................ea 18.6-oz Pump Bottle (900-4444)..............................ea
Purell® Instant Hand Sanitizer with Moisturizers Refreshing sanitizer that kills 99.9% of germs on the hands without water or towels. Leaves hands feeling soft. Contains 62% ethyl alcohol. 4-fl-oz Bottle (313-1626) ..............................ea 8-fl-oz Pump Bottle (590-6751) ..............................ea 12-fl-oz Pump Bottle (590-7594) ..............................ea 250-mL Refill, Original (770-4870) .....................12/case 800-mL Refill, Original (274-7896)........................6/case Dispenser for 800 mL (415-2214) ..............................ea Dispenser NXT, Plastic 1000-mL Wall Mount (590-1177) ..............................ea /2-fl-oz Bottles in Fishbowl Dispenser (898-0170)......................60/case Packets (590-3688) .....................100/box 4.25 oz Squeeze Bottle (313-1626) ..............................ea
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This course and promotional materials review key concepts of hand hygiene and other standard precautions to prevent healthcare-associated infections http://www.cdc.gov
Measuring Hand Hygiene Adherence: Overcoming the Challenges Released by the Joint Commission, this program was created to help healthcare organizations target their efforts in measuring hand hygiene performance. The monograph is designed to address "everything you ever wanted to know about handhygiene measurement but were afraid to ask." http://www.cdc.gov
Podcast: New Frontiers in Hand Hygiene Practices This podcast is an overview of the Clinician Outreach and Communication Activity (COCA). http://www2c.cdc.gov/podcasts
Webinar Report – Patient Hand Hygiene Addresses healthcare-associated infections (HAIs), and the challenges of healthcare worker hand-hygiene compliance. http://www.infectioncontroltoday.com
Alcohol-based Planning Hand Rub and Costing Tool The tool provides guidance for healthcare facilities to help senior managers conceptualize the necessary steps for implementation and assists in making decisions in relation to infrastructural and economic information. http://www.who.int
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Proper Hand Hygiene Techniques with Alcohol-Based Formulation
Duration of the entire procedure: 20–30 seconds
1a
1b
2
Rub hands palm to palm;
Apply a palmful of the product in a cupped hand, covering all surfaces;
3
Right palm over left dorsum with interlaced fingers and vice versa;
6
Rotational rubbing of left thumb clasped in right palm and vice versa;
4
5
Palm to palm with fingers interlaced;
Backs of fingers to opposing palms with fingers interlocked;
8
7
Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa;
Once dry, your hands are safe.
Source: World Health Organization
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Protecting your every touch… Hand hygiene is the single most important intervention to reduce the transmission of flu. In addition, the regular disinfection of high-touch environmental surfaces will remove potentially dangerous pathogens from the medical office environment.
SANI-HANDS® ALC & SANI-HANDS FOR KIDS Antimicrobal Alcohol Gel Hand Wipes • Contains 65.9% alcohol, which meets the CDC recommendations for hand hygiene • Kills 99.99% of germs and bacteria • Contains aloe, glycerin, and vitamin E. Clinically proven to moisturize hands after repeated use
Description Sani-Hands ALC Medium Sani-Hands ALC Large Sani-Hands for Kids Medium Sani-Hands for Kids Large
Reorder # 610-0540 610-0877 113-9799 113-2067
Packaging 220/can, 6 cans/cs 100/Box Packets 135/can, 12 cans/cs 220/can, 6 cans/cs
© 2011 Pofessional Disposables International, Inc. Sani-Hands® is a registered trademark of Professional Disposables International, Inc. PDI Touchpoints™ is a trademark of Professional Disposables International, Inc. 20526
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Guidelines & Recommendations: CDC Recommendations •
• •
•
•
•
• •
•
Hand-washing facilities should be accessible and sufficient for the maximum anticipated attendance and configured for use by children (low enough for them to reach or equipped with a stool), adults, and those with disabilities. Hand-washing stations should be conveniently located Maintenance should include routine cleaning and restocking to ensure adequate supply of paper towels and soap. Running water should be of sufficient volume and pressure to remove soil from hands. Volume and pressure might be substantially reduced if the water supply is furnished from a holding tank. Therefore, a permanent pressured water supply is preferable. The hand-washing station should be designed so that both hands are free for hand washing by having operation with a foot pedal or water that stays on after turning on hand faucets. Hot water is preferable, but if the handwashing stations are supplied with only cold water, a soap that emulsifies easily in cold water should be provided. Liquid soap dispensed by a hand or foot pump is recommended. Signs with proper hand-washing instructions should be posted at hand-washing stations and restrooms to encourage proper practices. Depending on the setting, hand washing signs might need to be available in different languages.
VioNex® Antimicrobial Liquid Soap Broad-spectrum antimicrobial soap with 99.94% germ reduction in 30 seconds. Moisturizing, lotion-based formula for frequent use without irritation. Fresh scent. Active ingredient: 0.5% PCMX with nonoxynol-9. 18-oz Bottle with Pump (176-3829) ..............................ea Gallon #25128, Refill Bottle, 1 gal (176-5139) ..............................ea
Liquid Dial® Antibacterial Soap with Moisturizer and Vitamin E Broad-spectrum antimicrobial soap with extra moisturizers to protect against dry skin. Active ingredient: 0.2% triclosan. 1-liter Pump Bottle (390-7465) ..............................ea 1 gal Refill (390-4201) ..............................ea
Contains:
Wall-Mount Bracket for Pump Bottle (176-2701) ..............................ea 800-mL Bag System (176-1875) ..............................ea Wall-Mount Dispenser for 800-mL Bag System (176-2254) ..............................ea
Liquid Dial® Gold • Helps protect better than ordinary liquid hand soap • Kills germs such as staph, salmonella, and E. coli • Antibacterial AND antimicrobial–kills bacteria and certain strains of yeast #2340084014, 71/2-oz Pump Bottle (390-7666) ..............................ea #2340080790, 16-oz Pump Bottle (390-3681) ..............................ea #2340088047, 1-gal Refill Bottle (390-4396) ..............................ea 1-liter Refill Bottle (390-3922) ..............................ea Dispenser for 1-liter Refill (100-9187) ..............................ea 31/2-oz Bar (390-1734) ..............................ea
When should you wash your hands? • Before preparing or eating food • After going to the bathroom • After changing diapers or cleaning up a child who has gone to the bathroom • Before and after caring for a sick patient • After blowing your nose, coughing, or sneezing • After handling garbage • Before and after treating a cut or wound • When your hands are visibly soiled
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Lysol® I.C.™ Antimicrobial Soap Broad-spectrum antimicrobial activity in a mild, nondrying formula. Light, pleasant fragrance. Active ingredient: 0.3% triclosan. 171/2-oz Prefilled Pump Bottle (358-4358) ..............................ea 1-gal Refill Bottle (358-1603) ..............................ea
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Everyday more than 4,600 American patients become infected from their medical care. Healthcare-associated infections affect nearly 2 million individuals and are responsible for approximately 80,000 deaths each year. The Centers for Disease Control and Prevention (CDC) have identified hand hygiene as the single most important intervention to reduce the transmission of infection. Keeping hands clean through improved hand hygiene is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water. Source: www.cdc.gov The Help Center: CDC - New Interactive Training Course This course links to “Hand Hygiene Saves Lives” video. Healthcare professionals learn at their own pace to review key concepts of hand hygiene to prevent healthcare associated infections. http://www.cdc.gov/handhygiene/training FOAMING ANTIBACTERIAL HAND SOAP 18.6-oz Pump Bottle (900-4441)..............................ea
Safe Care Campaign
Hibiclens® Antiseptic/Antimicrobial Skin Cleanser Indicated for use as: • Broad-spectrum antimicrobial activity: including MRSA (in vitro testing) and other staph infections; effective in the presence of organic material; iodine is neutralized by organic material; alcohol is diluted by organic material • Long lasting: bonds to skin for effective residual kill up to 6 hours; superior to alcohol, iodine, and PCMX Hand Wash, Bottle, 4 oz (107-8796) ..............................ea Skin Cleanser, 8-fl-oz Bottle (555-3169) ..............................ea Hand Wash, 16-fl-oz Bottle (107-1746)...............................ea Hand Wash, 32-fl-oz Bottle (107-4860) ..............................ea ANTIBACTERIAL LIQUID HAND SOAP 8-oz Pump Bottle (900-4439)..............................ea 16-oz Pump Bottle (900-4438)..............................ea 1-gal Refill Bottle (900-4440)..............................ea
Hand Wash, 1-gal Bottle (107-4972) ..............................ea 15 mL (107-6936)........................50/box 32 oz (310-0075) ..............................ea
PROVON® Foaming Medicated Handwash Germ-killing foam handwash with a light floral fragrance in a convenient pump bottle. Meets guidelines for healthcare handwash protocol. Contains moisturizers and 0.5% triclosan. 18-oz Pump Bottle (590-9025) ..............................ea
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The goal of the Safe Care Campaign is to help prevent healthcare- and communityacquired infections through awareness, education, and better practices. It’s Web site has a full spectrum of materials , including streaming videos on hand hygiene. http://www.safecarecampaign.org
Hand Hygiene Saves Lives (Buttons) These hand-hygiene buttons 1.5" x 1.5" serve as a reminder to physicians, nurses, and other healthcare personnel of the importance of proper hand hygiene, and are part of an overall strategy from the Centers for Disease Control and Prevention (CDC) to reduce infections in healthcare settings and to promote patient safety. http://bookstore.phf.org/
Clean Hands Save Lives (Posters) Provides access to posters that can be displayed throughout your facility to encourage proper hand hygiene. Designed to reduce infections in healthcare and other settings, this 19" x 29" horizontal poster colorfully promotes the Centers for Disease Control and Prevention's hand hygiene guidelines. The poster promotes provider and patient safety by highlighting various "bugs" that may be found on unclean hands that can lead to infection. http://bookstore.phf.org/
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Proper Hand Hygiene Techniques with Soap and Water
Duration of the entire procedure: 40–60 seconds
0
1
Wet hands with water;
Apply enough soap to cover all hand surfaces;
3
7
Rotational rubbing of left thumb clasped in right palm and vice versa;
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Palm to palm with fingers interlaced;
6
Dry hands thoroughly with a single use towel; Source: World Health Organization
Rub hands palm to palm;
4
Right palm over left dorsum with interlaced fingers and vice versa;
9
2
Backs of fingers to opposing palms with fingers interlocked;
8
Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa;
Rinse hands with water;
10
11
Use towel to turn off faucet;
Your hands are now safe.
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Protected?
The CDC recommends washing hands with an antimicrobial soap or an alcohol-based hand sanitizer.*
WATER
NO WATER AloeGuard®
(833-8374) 18 oz. Pump (each) (306-9953) 800ml bag-in-box (bag) (300-6331) Gallon Refill (each)
GBG AloeGel®
(923-8209) 18 oz Pump (each) (300-4126) 800ml bag-in-box (bag)
GBG FOAMING™ (437-0002) 7oz Can
(can)
*www.cdc.gov
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Guidelines & Recommendations: Characteristics of a Surgical Scrub – Performance characteristics for a surgical scrub agent generally fall into four categories: 1. Antimicrobial Action–an ideal agent would have a broad spectrum of antimicrobial activity against pathogenic organisms. This agent would have to work rapidly. An agent that does not work rapidly may not provide adequate bacterial reduction before being rinsed off. 2. Persistent Activity–an agent offering persistent activity keeps the bacterial count low under the gloves. It is not unusual for a surgery to last in excess of two hours. Studies have shown the rate of glove failures (non-visible holes) increases with the duration of surgery. In addition, studies show bacteria grow faster under gloved than ungloved hands. 3. Safety–the ideal agent would be nonirritating and non-sensitizing. It must have no appreciable ocular or ototoxicity, be safe for use on the body, and not be damaging to the skin or environment. 4. Acceptance–probably most important to achieving compliance in using a new product is its acceptance by the healthcare worker. A product that has ideal antimicrobial action and an excellent safety profile is of little value to good infection control if the user population fails to support its use. Although each is important in its own right, all four characteristics should be present for a complete package. Surgical scrub agents come in many forms Not all forms meet all characteristics. 1. Liquid or foam soaps. These are the most common products for surgical scrubs and are used in conjunction with water and dry scrub brushes or sponges. The most common antimicrobial agents in these products are CHG (chlorhexidine gluconate), iodophor, or PCMX (parachlorometaxylenol). These agents are very drying and with repeated scrubbing with the scrub brush can cause skin damage. 2. Impregnated scrub brushes/sponges. Scrub brushes/sponges are preloaded with CHG, iodophor, or PCMX and are wateraided products. 3. Brush-free surgical scrub. These products use an antimicrobial agent and water but no scrub brush.
Source: infectioncontroltoday.com
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Triseptin Water-Aided Surgical Hand Scrub An alcohol-based antiseptic that works with water to remove microorganisms on skin. Triseptin hand scrub can be used with a brush or water alone, providing skinconditioning benefits and antimicrobial action. Triseptin is an ideal complement to Surgicept® waterless surgical hand scrub when a water-aided scrub is needed. 32-oz Bottle (227-6114) ........................6/case 32-oz Bottle (840-2629) ..............................ea Triseptin Nail Pick (104-3088)......................12/case Dispenser Accessory for 32-oz Bottle (935-2956) ..............................ea Foot Pump Bulb Replacement, Green (104-7495) ..............................ea
MAXICLENS® ANTIMICROBIAL/ ANTISEPTIC SKIN CLEANSER • Clear, viscous liquid, 4% chlorhexidine gluconate • Formulated with detergents, moisturizers, skin protectors, and humectants that cleanse without drying • Fast acting, proven effective at 15 seconds against a broad spectrum of bacteria • Persistent; effective for up to 6 hours after use; high level residual action 1 Quart (431-0032) ..............................ea 1 Gallon (431-0099) ..............................ea Hand Pump for Quart Bottle (431-1478) ..............................ea
Endure® 400 4% chlorhexidine gluconate formula. Emollient-rich formula with pleasant floral fragrance. Immediate and persistent kill.
E-Z Scrub® Premium Surgical Brushes Sterile, 30 Scrub Brushes/Dispenser This line of products offers a wide range of efficacious antimicrobial formulations specifically designed to enhance performance as they reduce irritation to skin. With PCMX, Deluxe (987-0287)........................30/box With 4% CHG (987-6022)........................30/box With Iodophor (780-3379) .......................30/box Wet-Pack Iodophor (780-3946) .......................30/box Dry, without Solution (780-4291) .......................30/box Ultradex Scrub with PCMX (987-1041)........................30/box
1-gal Refill (120-0241) ..............................ea 1000 mL (Scrubmate Dispenser) (120-4239) ..............................ea 1000 mL (DisposaCare Dispenser) (120-0604)......................12/case
Betadine® Surgical Scrub Microbicidal sudsing cleanser that contains 7.5% povidone-iodine. Broad-spectrum microbicide that kills most gram-positive and gram-negative bacteria, including antibiotic-resistant strains, as well as most viruses, fungi/yeasts, mycobacteria, and protozoa. 4 oz (690-3564) .....................36/case 16 oz Refill (690-4214) ..............................ea With Dispenser, 16 oz (690-5432) ..............................ea Refill, 32 oz (690-0581) ..............................ea 1 gal (690-6863) ..............................ea
Surgicept Waterless Surgical Hand Antiseptic Effective and convenient, with a unique, patented formulation proven to meet FDA testing requirements for surgical hand scrubs. Its rapid and broad-spectrum activity kills 99.99% of bacteria in vitro in 15 seconds and prevents regrowth of bacteria under gloved hands for up to six hours. 800 mL (827-0002) ..............................ea
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With healthcare reform's desire to reduce infection rates for economic purposes and with additional concerns on quality assurance to benefit the patient, the most cost-effective solution for healthcare facilities is to evaluate and focus on preoperative scrubbing techniques that are employed prior to each surgical procedure. During such a procedure no micro-organisms should be transmitted. All surgical procedures require each surgical team member working within the sterile field to perform a scrub prior to every patient case as a necessary part of aseptic practice. The surgical scrub will be carried out with an antimicrobial product which is rapid acting and has residual effects and broad spectrum. The purpose of aseptic/clinical hand hygiene is to remove transient micro-organisms and inhibit the growth of resident micro-organisms prior to any care activity that implies a direct or indirect contact with a mucous membrane, nonintact skin or an invasive medical device. Source: infectioncontroltoday.com
The Help Center:
BETASEPT® Scrub 4% Chlorhexidine Gluconate (CHG) Indicated for surgical hand scrubbing, healthcare personnel hand washing, preoperative patient prepping, and general skin degerming. Chlorhexidine gluconate 4% provides rapid antiseptic action with a persistent antimicrobial effect against a wide range of microorganisms. 4-fl-oz Bottle (690-2253) .....................48/case 16-fl-oz Bottle (690-3189)......................12/case 32-fl-oz Bottle (690-3076)......................12/case 1 gal (690-9306) .......................4/case
Purell® Surgical Scrub with Moisturizers Broad-spectrum, fast-acting agent significantly reduces microorganisms on skin. Persistent antimicrobial activity decreases rebound of microbial growth for up to 6 hours. Does not impact the integrity of latex, neoprene, or polyisoprene surgical gloves and is compatible with ÇHG. Mild, nonirritating formula with 5 skin conditioning agents and no CHG to help maintain healthy skin. Everything you have come to expect from waterless, brushless surgical scrub, and more. 2-oz Bottle (590-0047) .....................24/case 1200-mL Refill (590-6210) ..............................ea 1200-mL Refill (108-3552)........................4/case Touch-Free Dispenser (590-0008) .....................12/case With Foot Pump 1200-mL Refill (109-9387)........................3/case Foot Pump Dispenser (590-0009)..............................ea
Excelle™ Hospital Grade Antimicrobial Hand Wash and Cleanser Formulated with moisturizers and emollients that remain effective for up to 6 hours. Fastacting 15-second formula contains 4% chlorhexidine gluconate. 8-oz Bottle, Green Soap (102-6558) ..............................ea Gallon, Excelle Antimicrobial Soap (991-0259) ..............................ea 1-pt Bottle, Green Soap (102-9916) ..............................ea 1-gal Bottle, Green Soap (102-9999) ..............................ea
Surgeons' Super Scrub Brush Autoclavable, with nonslip nylon bristles. (100-2331) ..............................ea
Surgeon's Disposable Scrub Brush #3000 • Individually wrapped • Ethylene oxide-gas treated (507-8603)........................30/box
Bacti-Stat® Offers the ultimate combination of effectiveness and cosmetic properties. The 0.3% triclosan provides proven infection prevention, and the aloe vera and vitamin E promote hand-washing compliance. 18-oz Pump Bottle (120-3367) ..............................ea 1-gal Refill (120-2130) ..............................ea
Infection Control Surveyor Worksheet The worksheet contains the list of items that a surveyor must assess during the onsite survey. Specific areas for observation include, hand hygiene compliance, injection practices, sterilization and high-level disinfection, and environmental infection control. www.unc.edu Institute for Healthcare Improvement (IHI) A not-for profit-organization that focuses on motivating and building the will for change; identifying and testing new models of care in partnership with both patients and healthcare professionals; and ensuring the broadest possible adoption of best practices and effective innovations. www.ihi.org Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) APIC is recognized as the leader in infection prevention and control by practitioners, policy makers, healthcare executives, and consumers. www.apic.org International Federation of Infection Control (IFIC) The goal of IFIC is to minimize the risk of infection within the healthcare setting worldwide through development of a network of infection control organizations for communication, consensus building, education and sharing expertise. www.theific.org Surgical Handwashing Video Reviews the procedure for the timed five minute scrub http://questgarden.com/110/84/2/1010081 84658/process.htm
(690-6606) 8 oz ......................ea (690-6950) 16 oz ....................ea (690-6727) 32 oz ....................ea (690-7281) 1 gal .....................ea
Infection Prevention Online Course
With Dispenser, 16 oz (690-5432) ..............................ea Refill, 32 oz (690-0581) ..............................ea
www.engenderhealth.org
For an Interactive Survey, Incentives & Information, logon to:
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Designed to help healthcare providers strengthen prevention practices in low- resources settings.
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1.
Regulate the flow and temperature of the water.
2.
Pre-tear package containing brush; lay the brush on the back of the scrub sink.
3.
Wet hands and arms for an initial pre-up a heavy lather, and then wash the hands and arms to a point about two inches above the elbow.
4.
Rinse hands and arms thoroughly, allowing the water to run from the hands to the elbows. Do not retrace or shake the hands and arms let the water drip from them.
5.
Remove the sterile brush and file, moisten brush and work up lather. Soap fingertips and clean the spaces under the fingernails of both hands under running water; discard file.
6.
Lather fingertips with sponge under the fingernails of the right or left hand 30 circular strokes. When scrubbing, slightly bend forward, hold hands and arms above the elbow, and keep arms away from the body.
7.
Lather digits; scrub 20 circular strokes on all four sides of each finger.
8.
Lather palm, back of hand, heel of hand, and space between thumb and index finger. Choosing either of the surfaces, scrub 20 circular strokes on each surface.
9.
You are now ready to scrub the forearm. Divide your arm in three inch increments. The brush should be approximately three inches lengthwise. Use the sponge to apply soap around wrist. Scrub 20 circular strokes on all four then scrub, ending two inches above the elbow.
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10. Soap and/or water may be added to the brush at any time
11. Repeat steps (6) through (9) above for the other arm.
12. Discard brush.
13. Rinse hands and arms without retracing and/or contaminating.
14 Allow the water to drip from your elbows before entering the operating room.
15. Slightly bend forward, pick up the hand towel from the top of the gown pack on the table. Grasp the towel and don’t allow the towel to touch any unsterile part of your body.
16. Holding one end of the towel with one of your hands, dry your other hand and arm with a blotting, rotating motion. Work from your fingertips to the elbow. DO NOT retrace any area.
17. Dry all sides of the fingers, the forearm, and the arms thoroughly. If moisture is left on your fingers and hands, donning the surgical gloves will be difficult. Moisture left on the arms may seep through surgical cloth gowns, thus contaminating them.
18. Grasp the other end of the towel and dry your other hand and arm in the same manner as above. Discard the towel into a linen receptacle (the circulator may take it from the distal end). Get more nursing-related downloads at http://nursingpad.blogspot.com Source: infectioncontroltoday.com
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3M Avagard ™
™
(Chlorhexidine Gluconate 1% Solution and Ethyl Alcohol 61% w/w)
Surgical and Healthcare Personnel Hand Antiseptic with Moisturizers
More Choices
Proven Persistence.
3M™ Avagard™ waterless, brushless surgical hand scrub is now available in two convenient sizes. 777-0117 777-0091 102-5064 641-0661 600-4327
16 oz. Dispenser Bottle Hands-free Wall Dispenser Nail Cleaners Wall Bracket and Foot Pump Wall Bracket and Hand Pump
Each 4/Case 6/Boxes of 150 per Case Each Each
© 3M 2011. All rights reserved. 3M, Avagard and the Avagard wedge shape are trademarks of 3M.
MAXICLENS™
SURGEONS SCRUB SOLUTION
Antimicrobial/Antiseptic Skin Cleanser Formulated with detergents, moisturizers, skin protectors, and humectants that cleanse without drying. Fast-acting formula that is proven effective at 15 seconds against a broad spectrum of bacteria. Effective for up to 6 hours after use. Active ingredient: 4% cholorhexidine gluconate. 1-qt Bottle (431-0032) ................................................ea 1-gal Bottle (431-0099) ................................................ea Pump Dispenser Only for 1-qt Bottle (431-1478) ................................................ea
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11MS5366
Glo Germ™ Oil
The #1 Product for teaching handwashing, isolation techniques, aseptic techniques, and general infection control.
Oil is bright orange under UV light and is used to demonstrate proper hand washing. Used in the medical field where greater accuracy is required. Each 8-oz bottle is good for 75 to 100 applications. 8-oz Bottle (115-6113)...............................ea
Glo-Brush Applicator
Glo-Brush lets you apply a thin layer of powder to any surface quickly and without waste. Refillable powder reservoir and a cover to protect bristles. Comes with a 4-oz container of Glo Germ™ powder that will last for hundreds of demonstrations. (115-6106)...............................ea
Glo Germ™ Mini Gel
For greater convenience, we now offer the new 2-oz Mini Gel. Same great product as the 8-oz version. Used to demonstrate proper hand washing. 30 to 50 applications. 2-oz Bottle (115-6116)...............................ea
Glo Germ™ Powder Glo Germ Kit 1003–Gel Complete Kit (115-6101)...............................ea Contains: handheld 9-LED ultraviolet flashlight, 1–8-oz bottle of Glo Germ gel, 1–1.9-oz bottle of Glo Germ powder & battery with case.
Glo Germ™ Gel Gel is brilliant blue-white under UV light. Used to demonstrate proper hand washing and is recommended where staining may be of concern. Each 8-oz bottle is good for 75 to 100 applications. 8-oz Bottle (115-6115)...............................ea
Used to demonstrate proper surface cleaning as well as the spread of germs, especially in the area of cross contamination. Good for hundreds of demonstrations. Brilliant white (also available in orange by special order; contact us for details). 1.9-oz Bottle (115-6117)...............................ea
