Antiseptics for surgical treatment 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 treatment is the necessary sequence of movements;

Hygienic level;
Surgical level;

Possible complications associated with frequent hand cleaning;

Measures that reduce the likelihood of complications;
Using gloves:

Sequence of actions when putting on gloves;

Sequence of actions when removing gloves;

Purpose of the lesson

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

Hand treatment levels: 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;
Sequence of movements when processing hands;
Possible complications when treating hands and their prevention;
Use of gloves (purposes, indications, contraindications, necessary conditions, possible complications, the sequence of putting on and taking off gloves).

Hand sanitize correctly;
Proper technique for putting on and taking off medical gloves.

Introduction

The most important component of infection safety is preventing the possibility of transmission of microorganisms from patient to medical staff and vice versa.

Infectious diseases of medical personnel 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;
Artificial transmission mechanism (i.e. artificial, medically created transmission mechanism - various invasive and therapeutic procedures).

Correct and timely disinfection of the hands of medical personnel is one of the leading measures in the fight against infectious diseases and guarantees the safety of personnel and patients.

Skin microflora

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

Resident flora
Transitory flora

Resident microflora- these are those microorganisms that constantly live and multiply on the skin without causing any diseases. That is, this is normal flora. The number of resident flora is approximately 10 2 -10 3 per 1 cm 2. The resident flora is represented predominantly by coagulase-negative cocci (primarily Staphylococcus epidermidis) and diphtheroids (Corinebacterium spp.). Despite the fact that Staphylococcus aureus is found in the nose of approximately 20% of healthy people, it rarely colonizes the skin of the hands (if it is not damaged), however, 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 be easily removed by regular hand washing or destroyed by using antiseptics.

If the integrity of the skin is compromised, then transient microflora can cause an infectious disease (for example, whitlow or erysipelas). You should be aware that in this case, the use of antiseptics does not make your hands safe from the point of view of transmission of infection. Microorganisms (most often staphylococci and beta-hemolytic streptococci) remain on the skin during the disease until recovery occurs.

Hand treatment

Hand cleaning to prevent wound infection was first used by the English surgeon Joseph Lister in 1867. The surgeon's hands were treated 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, hand washing - this simple method of preventing infections (primarily intestinal) - unfortunately, is often ignored by both the population and some medical workers.

Meanwhile, Correct and timely hand cleaning 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 when treating hands followed by putting on sterile gloves).

Social level of hand treatment

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

Liquid dosed neutral soap or individual disposable soap in pieces. It is desirable that the soap does not have a strong odor. Opened liquid or bar reusable non-individual soap quickly becomes infected with germs.
Napkins measuring 15x15 cm are disposable, clean for blotting hands. Using a towel (even an individual one) is not advisable, because it does not have time to dry and, moreover, is easily contaminated with germs.

All jewelry and watches are removed from hands, as they make it difficult to remove microorganisms. Hands are soaped and then rinsed warm running water and everything repeats itself from the beginning. It is believed that the first time you soap and rinse with warm water, germs are washed off from the skin of your hands. Under the influence of warm water and self-massage, the pores of the skin open, so when repeated soaping and rinsing, germs are washed away from the opened pores.
Warm water promotes a more effective effect of antiseptic or soap, while hot water removes the protective fat layer from the surface of the hands. Therefore, you should avoid using too hot water to wash your hands.
Hand treatment - the necessary sequence of movements:

Rub one palm against the other palm in a back-and-forth motion (Appendix 1);
Rub the back surface of the left hand with your 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 your fingers into a “lock” and rub the palm of your other hand with the back of your bent fingers (Appendix 4);
Cover 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 your left hand in a circular motion with your fingertips right hand, change hands (Appendix 6).

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

Hygienic level of hand treatment

The purpose of hygienic treatment is to destroy skin microflora using antiseptics (disinfection).

A similar hand treatment is carried out:

before putting on gloves and after taking them off;
before caring for an immunocompromised patient or during ward rounds (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 (eg blood emergencies).

Liquid dosed pH-neutral soap or individual disposable soap in pieces.
Napkins measuring 15x15 cm are disposable, clean.
Clean wipes (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.
The gloves are disposable.

Hand treatment rules:

Hand hygiene consists of two stages: mechanical hand cleaning (see above) and hand disinfection with a skin antiseptic.

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

The purpose of household hand treatment is to mechanically remove most of the transient microflora from the skin (antiseptics are not used).

A similar hand treatment is carried out:

• after visiting the toilet;
• before eating or working with food;
• before and after physical contact with the patient;
• for any contamination of 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. Opened liquid or bar reusable non-individual soap quickly becomes infected with germs.
2. Napkins measuring 15x15 cm are disposable, clean for blotting hands. Using a towel (even an individual one) is not advisable, because it does not have time to dry and, moreover, is easily contaminated with germs.

Hand treatment rules:

All jewelry and watches are removed from hands, as they make it difficult to remove microorganisms. Hands are soaped, then rinsed with warm running water and everything repeats all over again. It is believed that the first time you soap and rinse with warm water, germs are washed off from the skin of your hands. Under the influence of warm water and self-massage, the pores of the skin open, so when repeated soaping and rinsing, germs are washed away from the opened pores.

Warm water makes the antiseptic or soap work more effectively, while hot water removes the protective fat layer from the surface of the hands. Therefore, you should avoid using too hot water to wash your hands.

Hand treatment - the necessary sequence of movements

1. Rub one palm against the other palm in a back-and-forth motion.

1. Rub the back of your left hand with your right palm and switch 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. Place your fingers in a “lock” and rub the palm of your other hand with the back of your bent fingers.
4. Cover the base of the thumb of the left hand between the thumb and index finger of the right hand, rotational friction. Repeat on the wrist. Change hands.
5. Rub the palm of your left hand in a circular motion with the fingertips of your right hand, switch hands.

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

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

After the last rinse, wipe your hands dry with a napkin (15x15 cm). The same napkin is used to close the water taps. The napkin is dumped into a container with a disinfectant solution for disposal.

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

Maintaining hygiene and cleanliness is the key to health in all areas of life. If we are talking about medicine, then cleanliness of hands should be an integral rule, because the life of both the entire medical staff and the patient depends on such a seemingly trifle. The nurse is responsible for ensuring that the condition of her hands is satisfactory and meets medical health standards. It is important to get rid of micro cracks, hangnails, clean your nails and remove any nails, if any. Why is this so important and what are the requirements?

In order for all personnel to comply with the European medical standard, it is important for each employee to be told about the existing requirements for disinfection of hands, instruments and other medical supplies. There are separate rules for hand care for nurses, these include the following requirements:

• you cannot paint your nails or glue artificial ones
• nails should be neatly trimmed and clean
• It is not recommended to wear bracelets, watches, rings or any other Jewelry, since they are sources of bacteria and microbes

It was found that it is the lack of proper care among doctors and nurses that contributes to the development and rapid spread of nosocomial infectious pathogens throughout the clinic. Touching manipulation devices, devices, patient care items, test equipment with unclean hands, technical equipment, clothing and even medicinal waste can negatively affect the health of the patient and everyone 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. Any hospital employee must follow these recommendations, 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 soap solution and plain water, without the use of additional products
• washing hands with antiseptic hygiene products
• surgical disinfection standards

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However, there are rules for washing hands this way. It was noticed that in frequent cases, after treating the skin of the hands on inner surface and there are a lot of bacteria left on your fingertips. 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 soaping your hands; you need the soap to penetrate all areas.
3. Rinse 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 to do light self-massage when soaping.

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 will not work, it can only lead to a negative result.

Surgical rules for disinfection

Surgery is an area where neglect of hand hygiene rules can cost the patient’s life. Hand treatment is carried out in the following situations:

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

Of course, the doctor and everyone assisting during the operation put on disposable sterile gloves on their hands, but this does not give the right to forget about hygienic means of protection and hand treatment.

Surgical treatment includes not only 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. The movement and sequence are performed 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. Immediately wash your hands with ordinary soap, and then rinse with this solution for a couple of minutes (the part from the hand to the elbow is treated for 30 seconds, the rest of the time the hand itself is washed). Hands are wiped with a napkin and dried.

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

Iodopirone 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.

Ultrasound treatment. The hands are lowered into a special one through which they pass ultrasonic waves. Processing lasts no more than a minute.

All methods are good, it’s just important not to neglect the general recommendations.

So, hand disinfection plays a role in medicine important role. It is not enough to simply wash your hands with water. Hand treatment is carried out in different ways, various hygiene products are used, depending on the situation. Neglecting basic rules can lead to negative consequences that will affect not only patients, but also medical personnel.

Jun 22, 2017 Violetta Doctor

Hand hygiene for medical workers - doctors, nurses and other hospital staff is a mandatory procedure.

During it they use special means, approved by the Russian Pharmacology Committee.

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

Skin cleansing is aimed at preventing hospital-acquired infections and removing germs and other decay products from hands. It protects the patient and the doctors themselves from infections.