LESSON NOTES

AUDIO-
TEACHER VISUAL/
CONTENTS
ACTIVITIES TEACHING
AIDS
Assalammualaikum, good morning and Salam
1Malaysia. I'm Norlida Bt Mohd Nor from
semester 4 want to teach hand hygiene topic.

Students,
Disease-causing microorganisms can
Introduction/ Power point
frequently be isolated from the hands. Hand
explanation slide and
carriage of bacteria is an important route of
handout
(1 minutes) transmission of infection between patients or
from the health care worker to the patient.
Appropriate hand washing results in a reduced
incidence of both nosocomial and community
infections. Guidelines from national and
international infection prevention and control
organizations have repeatedly acknowledged
that hand washing is the single most important
procedure for preventing infections. Despite
this, health care providers’ compliance with
hand washing is poor.

What is Hand Hygiene?

Hand hygiene is a general term referring to any

Power point
Explanation
action of hand cleaning. Hand hygiene relates
slide and
Definition
to the removal of visible soil and removal or
handout
(1 minutes) killing of transient microorganisms from the
hands while maintaining good skin integrity.
Hand hygiene includes surgical hand
 antisepsis.

Types Of Hand Hygiene

1. Hand hygiene
Explanation Power point
Performing hand washing, antiseptic hand
slide and
(1 minutes) wash, alcohol-based hand rub, surgical hand
handout
hygiene/ antisepsis.

2. Hand washing
Washing hands with plain soap and water

3. Antiseptic hand wash

Washing hands with water and soap or other
detergents containing an antiseptic agent.

4. Alcohol-based hand rub

Rubbing hands with an alcohol-containing
preparation.

5. Surgical hand hygiene/antisepsis

Hand washing or using an alcohol-based hand
rub before operations by surgical personnel.

History Hand Hygiene

Power point
Explanation
slide and
(1 minutes) handout

Proper hand washing has been proven the best

way to prevent infection for many years.
 According to the Center for Disease Control Power point
(CDC), article “Wash Your Hands,” Dr. Ignaz slide and
Explanation
Semmelweis (1800s) noticed that death rates in handout
a hospital’s maternity clinic staffed by student
physicians were five times higher than death
rates at another clinic not attended by the
student physicians. The student physicians
were working on corpses in an anatomy class
immediately before beginning rounds in the
maternity clinic. After Dr. Semmelweis insisted
that the student physicians wash their hands
before treating the maternity patients, the death
rate decreased fivefold.

Microbial Inhabitant Of Hands

Power point
slide and
Explanation handout

(1 minutes)

Human skin is colonized with bacteria and the

total bacteria count on the hands of healthcare
workers (HKWs). Those bacteria can be
categorize into two groups:

1. Transient flora
 Colonized the superficial layer of the skin, are Power point
more amenable to remove by routine hand slide and
Explanation
washing. They are often acquired during direct handout
contact with patients of contaminated
environmental surfaces of objects (fomites)
within close proximity of the patient.

(E. coli, Klebsiella, Pseudomonas aeruginosa)

2. Resident flora
Power point
Attached to the deeper layers of skin and are
slide and
more resistant to removal by hand washing.
handout
Less likely to be associated with Healthcare
Associated Infections (HAIS).

(Coagulase negative staph, Corynebacterium )

Why Is Hand Hygiene Important?

1. To remove dirt, debris and reduce

microorganisms from hands.
Explanation 2. To reduce cross contamination or
infections.
(1 minutes)
3. To break the chain of infection from
patients, from patient to Health Care
Workers (HCWs) and vice- versa.
4. Image of cleanliness, credibility of Health
Care Workers (HCWs).
 The golden rules for hand hygiene

Explanation  Hand hygiene must be performed exactly Power point

slide and
where you are delivering health care to
handout
patients.

 During health-care delivery, there are 5

moments when it is essential that you

perform hand hygiene

 To clean your hands, you should prefer

handrubbing with an alcohol-based

formulation, if available. Why? Because it

is possible right at the point of care, it is

faster, and it is more effective, and better

tolerated. You should wash your hands

with soap and water only when visibly

soiled.

 You must perform hand hygiene using the

appropriate technique and time duration.

Factors For Poor Adherence With Hand

Hygiene Power point
 • Hand washing agents cause irritation and
Explanation slide and
dryness. handout
• Sinks are inconveniently located/lack of sinks.
• Lack of soap and paper towels.
• Too busy/insufficient time.
• Understaffing/overcrowding.
• Patient needs take priority.

• Low risk of acquiring infection from patient

AUDIO-
TEACHER VISUAL/
CONTENTS
ACTIVITIES TEACHING
AIDS
Illustration and Power point
explanation slide and
handout
(2 minutes)

STEP-STEP 5 MOMENTS FOR HAND

HYGIENE

AUDIO-
TEACHER VISUAL/
CONTENTS
ACTIVITIES TEACHING
AIDS

Illustration and To protect the patient against Power point

explanation harmful germs carried on your hands! slide and
 handout

Example: Taking pulse, blood pressure, chest

auscultation, abdominal palpation.

Illustration and
To protect the patient against harmful germs,
explanation Power point
including the patient’s own, entering his/her
slide and
body!
handout

Example: Skin lesion care, wound dressing,

subcutaneous injection preparation of

food, medication, dressing sets.

AUDIO-
TEACHER VISUAL/
CONTENTS
ACTIVITIES TEACHING
AIDS
Illustration and Power point
explanation slide and
handout

To protect yourself and the

health-care environment from harmful germs!

Example: After glove removal, handling waste

(bandages) cleaning of contaminated and visibly
soiled material (medical instruments) .

Power point
Illustration and
slide and
explanation
handout

To protect yourself and the

health-care environment from harmful germs!

Example: taking pulse, blood pressure and

helping a patient to move around.

AUDIO-
TEACHER VISUAL/
CONTENTS
ACTIVITIES TEACHING
AIDS
Illustration and To protect yourself and the Power point
explanation health-care environment from harmful germs! slide and
handout

Example : Changing bed linen, perfusion speed

adjustment, monitoring alarm, holding a bed rail
and clearing the bedside table.

Using an Alcohol-Based Hand Rub Takes

Explanation Less Time than Hand washing

( • Time required for ICU nurses to go to a

sink, wash and dry their hands, and
return to patient care activities: average
= 62 seconds

• Estimated time required to clean hands

with an alcohol-based hand rub available
at patient’s bedside: average = 15
seconds

• One advantage of using alcohol-based

hand rubs is that they require much less
time to use.
 When Should You Use an Alcohol-Based
Hand Rub?

• If hands are not visibly soiled or

contaminated with blood or body fluids,
use an alcohol-based hand rub for
routinely cleaning your hands

Hand Washing Recommended Technique

Power Point
Slides, handout,

Sink and pipe.

(1 minut
1. Palm to palm

2. Right palm over left dorsum and left palm

over right dorsum

Skill/
demonstration,
explanation and
return
demonstration by
students Power Point
Slides, handout
and Alcohol
Hand Rub

3. Palm to palm fingers interlaced

4. Back of fingers to opposing palms with

finger interlocked

Skill/
demonstration,
explanation and
5. Rotational rubbing of right thumb clasped
return
 In left palm and vice versa
demonstration by
students

Power Point
Slides, handout
and Alcohol
Hand Rub

6. Rotational rubbing, backwards and

forwards with clasped fingers of right
hand in left palm and vice versa

7. Rotational rubbing of right wrist and vice

versa. Rinse and dry thoroughly

Alcohol Hand Rub Recommended Technique

1. Pouring alcohol rub in the right palm

2. From alcohol rub that is poured upper right
palm is poured to left palm and Cup your
hand and apply product. Clasp your fingers
of the other hand and be sure to apply
product under your nails and cuticles.

3. Rub your hands with your palms together

with your fingers interlaced.

4. Rub your fingers with your opposing palms to

ensure you apply the top of your fingers.

5. Rub your thumbs in a rotation with your

 palms and vice versa.

6. Rotational rubbing of right wrist and vice

versa.

All student can make hand hygiene technique

properly and if incorrect need to do until
succeed. Emphasis on importance of hand
hygiene given to students if they all can perform
correctly and improved hand hygiene can
reduce infection rates, reduce healthcare
acquired infections, reduce LOS, reduce
resources and improve the quality of care.
Failure to perform appropriate hand hygiene is
considered to be the leading cause of HCAI and
spread of multi resistant organisms, and has
been recognized as a significant contributor to
outbreaks.

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