Antiseptics for surgical processing of hands. Hand hygiene

Faculty of Economics and Management
Department of Pedagogy and Psychology

COURSE WORK

by discipline _____ Pedagogy with teaching methods ____

on the topic of: "hand treatment"

Supervisor
_______________________ FULL NAME

"____" _______________ 2010

"____" _______________ 2010

NOVOSIBIRSK 2010

Plan:

Introduction

Skin microflora: resident flora, transient flora;
Hand treatment:

Social level;

Hand processing is a necessary sequence of movements;

Hygienic level;
Surgical level;

Possible complications associated with frequent hand washing;

Measures that reduce the likelihood of complications;
Use of gloves:

Sequence of actions when putting on gloves;

The sequence of actions when removing gloves;

Purpose of the lesson

Consolidation and generalization of knowledge and skills correct processing hands in daily activities medical staff.

Levels of hand treatment: social (goals, indications, the necessary conditions, hand washing technique); hygienic (stages, goals, indications, necessary conditions); surgical (stages, goals, indications, necessary conditions, hand washing technique);
Rules and duration of hand treatment at all levels, differences;
The sequence of movements in the processing of hands;
Possible complications in the processing of hands and their prevention;
Use of gloves (goals, indications, contraindications, necessary conditions, possible complications, the sequence of actions for putting on and taking off gloves).

Correct handling of hands;
Correctly carry out the technique of putting on and removing medical gloves.

Introduction

The most important component of infectious safety is the prevention of the possibility of transfer of microorganisms from the patient to the medical staff and vice versa.

Infectious diseases of medical staff associated with professional activities occupy a certain place in the structure of infectious morbidity.

Infection of medical personnel occurs as a result of:

natural transmission mechanisms;
An artificial transmission mechanism (i.e. an artificial transmission mechanism created by medicine - various invasive and therapeutic procedures).

Proper and timely processing of the hands of medical personnel is one of the leading measures in the fight against infectious diseases and a guarantee of the safety of personnel and patients.

Skin microflora

The surface layer of the epidermis (top layer of the skin) is completely replaced every 2 weeks. Every day, up to 100 million skin scales are peeled from healthy skin, of which 10% contain viable bacteria. The microflora of the skin can be divided into two large groups:

Resident flora
Transient flora

Resident microflora are those microorganisms that constantly live and multiply on the skin without causing any diseases. That is, it is a normal flora. The number of resident flora is approximately 10 2 -10 3 per 1 cm 2. The resident flora is represented mainly by coagulase-negative cocci (primarily Staphylococcus epidermidis) and diphtheroids (Corinebacterium spp.). Despite the fact that Staphylococcus aureus is found in the nose of about 20% of healthy people, it rarely colonizes the skin of the hands (if it is not damaged), but in hospital conditions it can be found on the skin of the hands of medical personnel with no less frequency than in the nose.

Transient microflora- These are those microorganisms that are acquired by medical personnel as a result of contact with infected patients or contaminated objects. environment. Transient flora can be represented by much more epidemiologically dangerous microorganisms (E.coli, Klebsiella spp., Pseudomonas spp., Salmonella spp. and other gram-negative bacteria, S.aureus, C. albicans, rotaviruses, etc.), including hospital strains of pathogens of nosocomial infections. Transient microorganisms remain on the skin of the hands for a short time (rarely more than 24 hours). They can easily be removed with normal hand washing or destroyed with antiseptics.

If the integrity of the skin is broken, then the transient microflora can cause an infectious disease (for example, panaritium or erysipelas). You should be aware that in this case, the use of antiseptics does not make hands safe in terms of infection transmission. Microorganisms (most often staphylococci and beta-hemolytic streptococci) remain with the disease on the skin until a cure occurs.

Hand treatment

Hand treatment for the prevention of wound infection was first used by the English surgeon J. Lister in 1867. The treatment of the surgeon's hands was carried out by disinfecting them with a solution of carbolic acid (phenol). In addition, Lister used a solution of carbolic acid to irrigate instruments, dressings, and to spray in the air over the surgical field.

Sir Joseph Lister's method (1827-1912) was a triumph of 19th century medicine. In the 21st century, handwashing - this simple method of preventing infections (primarily intestinal ones) - is unfortunately often ignored by both the public and some medical professionals.

Meanwhile, Correct and timely processing of hands is the key to the safety of medical personnel and patients.

Hand treatment is divided into three levels:

Household or social level (mechanical processing of hands);

Hygienic level (treatment of hands using skin antiseptics);

Surgical level (a special sequence of manipulations in the treatment of hands, followed by putting on sterile gloves).

Social level of hand treatment

after visiting the toilet;
before eating or before working with food;
before and after physical contact with the patient;
with any contamination of the hands.

Liquid dosed neutral soap or individual disposable soap in pieces. It is desirable that the soap does not have a strong odor. Open liquid or bar reusable non-personal soap quickly becomes infected with germs.
Napkins measuring 15x15 cm are disposable, clean for getting your hands wet. The use of a towel (even an individual one) is not desirable, because it does not have time to dry out and, moreover, is easily seeded with microbes.

All jewelry, watches are removed from the hands, as they make it difficult to remove microorganisms. Hands are soaped, then rinsed warm running water and everything repeats from the beginning. It is believed that during the first soaping and rinsing with warm water, microbes are washed off the skin of the hands. Under the influence of warm water and self-massage, the pores of the skin open, therefore, with repeated soaping and rinsing, microbes are washed away from the opened pores.
warm water promotes more effective action of antiseptic or soap, while hot water removes the protective fatty layer from the surface of the hands. In this regard, you should avoid using too hot water for washing your hands.
Hand treatment - the necessary sequence of movements:

Rub one palm against the other palm with reciprocating movements (Appendix 1);
Rub the back surface of the left hand with the right palm, change hands (Appendix 2);
Connect the fingers of one hand in the interdigital spaces of the other, rub the inner surfaces of the fingers with up and down movements (Appendix 3);
Connect the fingers into a “lock”, rub the palm of the other hand with the back of the bent fingers (Appendix 4);
Grasp the base of the thumb of the left hand between the thumb and index fingers right hand, rotational friction. Repeat on the wrist. Change hands (Appendix 5);
Rub the palm of the left hand with the fingertips in a circular motion. right hand, change hands (Appendix 6).

It is very important to follow the described handwashing technique, since special studies have shown that during routine handwashing, certain areas of the skin (fingertips and their inner surfaces) remain contaminated.
After the last rinse, the hands are wiped dry with a napkin (15x15 cm). The faucets are closed with the same napkin. The tissue is discarded into a container with a disinfectant solution for disposal.
In the absence of disposable wipes, it is possible to use pieces of clean cloth, which, after each use, are discarded into special containers and, after disinfection, sent to the laundry. Replacing disposable wipes with electric dryers is impractical, because. with them, there is no rubbing of the skin, which means that there is no removal of detergent residues and desquamation of the epithelium.

Hygienic level of hand treatment

The purpose of hygienic treatment is the destruction of the microflora of the skin with the help of antiseptics (disinfection).

Such hand treatment is carried out:

before putting on gloves and after removing them;
before caring for a patient with a weakened immune system or when making rounds in the wards (when it is not possible to wash hands after examining each patient);
before and after performing invasive procedures, minor surgical procedures, wound care or catheter care;
after contact with body fluids (e.g. blood emergencies).

Liquid dosed pH-neutral soap or individual disposable soap bars.
Napkins size 15x15 cm disposable, clean.
Napkins are clean (7x7 cm), for treating hands with skin antiseptics.
Skin antiseptic. It is advisable to use alcohol-containing skin antiseptics (70% ethyl alcohol solution; 0.5% solution of chlorhexidine bigluconate in 70% ethyl alcohol, AHD-2000 special, Sterillium, etc.
Gloves are disposable.

Hand treatment rules:

Hygienic processing of hands consists of two stages: mechanical cleaning of hands (see above) and disinfection of hands with a skin antiseptic.

After the end of the stage of mechanical cleaning (double soaping and rinsing), the antiseptic is applied to the hands in an amount of at least 3 ml and carefully rubbed into the skin until completely dry(Do not wash your hands.) If the hands were not contaminated (for example, there was no contact with the patient), then the first stage is skipped and an antiseptic can be applied immediately. The sequence of movements in the processing of hands corresponds to(Appendices 1-6).
etc.................

The purpose of the household level of hand treatment is the mechanical removal of most of the transient microflora from the skin (antiseptics are not used).

Such hand treatment is carried out:

• after visiting the toilet;
• before eating or before working with food;
• before and after physical contact with the patient;
• with any contamination of the hands.

Required equipment:

1. Liquid dosed neutral soap or individual disposable soap in pieces. It is desirable that the soap does not have a strong odor. Open liquid or bar reusable non-personal soap quickly becomes infected with germs.
2. Napkins measuring 15x15 cm are disposable, clean for getting your hands wet. The use of a towel (even an individual one) is not desirable, because it does not have time to dry out and, moreover, is easily seeded with microbes.

Hand treatment rules:

All jewelry, watches are removed from the hands, as they make it difficult to remove microorganisms. Hands are lathered, then rinsed with warm running water and everything repeats from the beginning. It is believed that during the first soaping and rinsing with warm water, microbes are washed off the skin of the hands. Under the influence of warm water and self-massage, the pores of the skin open, therefore, with repeated soaping and rinsing, microbes are washed away from the opened pores.

Warm water makes the hand sanitizer or soap work more effectively, while hot water removes the protective fatty layer from the surface of the hands. In this regard, you should avoid using too hot water for washing your hands.

Hand treatment - the necessary sequence of movements

1. Rub one palm against the other palm in a reciprocating motion.

1. Rub the back surface of the left hand with the right palm, change hands.
2. Connect the fingers of one hand in the interdigital spaces of the other, rub the inner surfaces of the fingers with up and down movements.
3. Connect the fingers into a “lock”, rub the palm of the other hand with the back of the bent fingers.
4. Grab the base of the thumb of the left hand between the thumb and forefinger of the right hand, rotational friction. Repeat on the wrist. Change hands.
5. In a circular motion, rub the palm of the left hand with the fingertips of the right hand, change hands.

Each movement is repeated at least 5 times. Hand treatment is carried out within 30 seconds - 1 minute.

It is very important to follow the described handwashing technique, since special studies have shown that during routine handwashing, certain areas of the skin (fingertips and their inner surfaces) remain contaminated.

After the last rinse, the hands are wiped dry with a napkin (15x15 cm). The faucets are closed with the same napkin. The tissue is discarded into a container with a disinfectant solution for disposal.

In the absence of disposable wipes, it is possible to use pieces of clean cloth, which, after each use, are discarded into special containers and, after disinfection, sent to the laundry. Replacing disposable wipes with electric dryers is impractical, because. with them, there is no rubbing of the skin, which means that there is no removal of detergent residues and desquamation of the epithelium.

Maintaining hygiene and cleanliness is a guarantee of health in all spheres of life. If we are talking about medicine, then the cleanliness of hands should be an inalienable rule, because the life of both the entire medical staff and the patient depends on such a trifle at first glance. The nurse is obliged to ensure that the condition of her hands is satisfactory and meets the medical standards of public health. It is important to get rid of micro cracks, burrs, clean nails and remove any, if any. Why is this so important, and what are the requirements?

In order for all staff to comply with the European medical standard, it is important for each employee to tell about the existing requirements for the disinfection of hands, instruments and other medical supplies. For nurses, there are separate rules for caring for hands, these include the following requirements:

• do not paint or glue artificial nails
• nails should be neatly trimmed and cleaned
• it is not recommended to wear bracelets, watches, rings or any other Jewelry, as they are sources of bacteria and microbes

It was found that it is non-observance of hands among doctors and nurses that contributes to the development and rapid spread of nosocomial infectious agents throughout the clinic. Touching with unclean hands manipulation tools, devices, patient care items, devices for taking tests, technical equipment, clothing, and even medical waste can adversely affect the health of the patient and all those in the hospital for a long period of time.

To prevent the spread of microorganisms and reduce the risk of infection through hands, there are rules and means of disinfection. These recommendations must be followed by any hospital employee, especially those who work closely with sources of infection and infected patients.

In medicine, several methods have been developed for disinfecting the hands of all medical staff:

• hand treatment soapy water and ordinary water, without the use of additional funds
• washing hands with antiseptic hygiene products
• surgical disinfection standards

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However, there are rules for washing hands in this way. It has been observed that in frequent cases, after processing the skin of the hands on inner surface and fingertips remain a lot of bacteria. To avoid this, you must follow the following recommendations:

1. To begin with, you need to remove all unnecessary items: watches, jewelry, other little things that contribute to the reproduction of microorganisms.
2. The next step is to lather your hands, so that the soap penetrates all areas.
3. Wash off the foam under running warm water.
4. Repeat the procedure several times.

When the washing procedure is performed for the first time, dirt and bacteria on the surface of the skin are removed from the hands. With repeated treatment with warm water, the pores of the skin open, and the cleaning is carried out deeper. It is useful when soaping to do a light self-massage.

Cold water is less useful in this case, because it is the elevated temperature that allows soap or other hygiene product to penetrate deep into the skin and remove a thick fat layer from both hands. Hot water also not suitable, it can only lead to a negative result.

Surgical Disinfection Rules

Surgery is an area where neglect of hand hygiene can cost a patient's life. Hand treatment is carried out in such situations:

• Before any type of surgery
• During invasive procedures such as vascular puncture

Of course, the doctor and all assistants during the operation wear disposable sterile gloves on their hands, but this does not give the right to forget about hygienic protective equipment and hand treatment.

Surgical treatment includes not only the disinfection of the hand, but also the entire arm up to the forearm. The specified parts of the body are washed under a tap with warm water, antiseptic agents are used, liquid soap, disposable wipes and sterile towels. Movement and sequence is carried out according to the local standard specified in the medical sanitary book.

Modern methods of disinfection

Medicine is moving forward and disinfection techniques are improving every day. On this moment a mixture is widely used, which includes the following components:, distilled water and formic acid. The solution is made daily, stored in an enamel bowl. Hands are immediately washed with ordinary soap, and then washed with this solution for a couple of minutes (the part from the hand to the elbow is processed for 30 seconds, the rest of the time the hand itself is washed). Hands are wiped with a napkin and dried.

Another way is disinfection with chlorhexidine, which is initially diluted with 70% medical alcohol (dosage one to forty). The processing procedure takes about three minutes.

Iodopyron is also used for hygienic treatment of the hands of medical staff. The whole process follows a similar pattern: hands are washed with soapy water, then nails, fingers and other areas are disinfected with cotton swabs.

Ultrasonic treatment. The hands are lowered into a special one through which they pass ultrasonic waves. Processing takes less than a minute.

All methods are good, it is only important not to neglect the general recommendations.

So, hand disinfection in medicine plays important role. It is not enough to simply wash your hands with water. The treatment of the brush is carried out in different ways, various hygiene products are used, depending on the situation. Neglect of elementary rules can lead to negative consequences from which not only patients, but also medical personnel will suffer.

Jun 22, 2017 Violetta Doctor

The hygiene of the hands of medical workers - doctors, nurses and other hospital staff is a mandatory procedure.

During it use special means approved by the Committee of Pharmacology of Russia.

Hands are always treated before and after physical contact with the patient.

Cleansing the skin is aimed at preventing nosocomial infections, removing microbes and other decay products from the hands. It provides protection to the patient and the physicians themselves from infections.