Hand hygiene best practices to help prevent infection

Hand hygiene is key in reducing the transmission of infectious agents in the healthcare setting and is an essential element of standard precautions. Soap and water should be used when hands are visibly soiled with blood or bodily fluids, but in all other clinical situations, alcohol-based hand rub is preferred¹. The CDC recommends washing hands with non-antimicrobial soap between the majority of patient contacts and washing with antimicrobial soap before and after performing invasive procedures or caring for patients at high risk. You should practice hand hygiene whenever hands are visibly dirty or contaminated and before contact with patients or performing an aseptic technique. Hand hygiene should be practiced after contact with patients, blood or bodily fluids, contact with objects in the immediate vicinity of the patient, when removing personal protective equipment (PPE) or moving from contaminated body site to clean body site.

Gloves

Gloves reduce hand contamination by 70-80%, preventing cross-contamination and helping ensure that you, your staff and your patients are protected from infection.⁵

• Exam gloves: Generally less tight-fitting for easy donning and removal, come in fewer sizes and can be worn on either hand
• Surgical gloves: Typically, surgical gloves are sterile, packaged in pairs and “handed” with left and right gloves in each pair. They can be made of many materials, including nitrile, neoprene, polyisoprene and latex. They come in many sizes and surgeons sometimes double-glove for extra protection from viral contamination or in procedures that involve heavy instruments, like orthopedics

Gowns

Surgical and isolation, or procedure, gowns are used to protect the healthcare workers’ arms and exposed body areas and prevent contamination of clothing with blood, body fluids and other potentially infectious material. If fluid penetration is likely, a fluid-resistant gown should be used. Gowns are rated according to their AAMI level, which indicates how a gown performs against a series of barrier performance criteria and ranges from 1 to 4, with level 4 providing the highest barrier to fluids and microorganisms. Most isolation gowns used in post-acute care fall into AAMI 1 or 2. AAMI levels are used in both surgical and procedure gowns.⁷ The highest barrier protection is in the primary “critical zones” of the gown, in the front and on the sleeves, where direct contact with blood, body fluids and other infectious material is likely to occur. Higher-level gowns have larger critical zones and the sleeves and seams are fully sealed, not sewn, to prevent fluid penetration.