The importance of hand hygiene in hospitals and medical clinics

Hygiene in the healthcare sector plays an important role in the safety of patients and medical staff alike. The primary goal is to measure and reduce latent forms of infection, and to diagnose, investigate, and limit epidemics. Hospital hygiene – more accurately termed “infection control” – is a specific form of quality management that focuses on preventing healthcare-associated infections.

Why is hand hygiene so important in hospitals?

We carry millions of germs on our hands. Although some microorganisms are harmless, others can be dangerous. If the hands of hospital staff are not disinfected when caring for patients, pathogens can be transmitted very quickly. Therefore, hand hygiene in hospitals is a very effective and inexpensive way to fight infections. And by avoiding infections, the use of antibiotics is less often necessary. Consequently, hand hygiene also contributes to the fight against antibiotic resistance.

It should be noted that germs that cause infections are mainly transmitted via hands. For this reason, the use of soap and water or disinfection with a hydroalcoholic solution is mandatory. Thus, hand hygiene involves two methods. Studies have shown that using a disinfectant is one of the most effective ways to eliminate microorganisms. However, especially when there is visible dirt, sanitizing with soap and water must be the first step. KLINIDERM® – Fragrance-free antimicrobial liquid soap

Gloves offer good protection and keep hand contamination to a minimum. But hand hygiene in hospitals is still necessary, even with gloves. Furthermore, gloves must be removed (and replaced) at the right time.

For proper hand hygiene, doctors, nurses, and paramedical staff (e.g., physiotherapists, medical assistants, medical imaging technologists, pulmonary function technologists, etc.) must meet several basic conditions:

• No jewelry, watches, or bracelets on hands and wrists/forearms
• Clean, short-trimmed nails (no nail polish and no artificial nails)
• Short sleeves
• Covering any wounds

It is important for medical staff to disinfect their hands with a hydroalcoholic solution at very specific moments to protect themselves, but especially to protect the patient. ALCHOSET® – Hand and skin disinfectant

When is hand disinfection required?

• Before touching a patient.
• Before performing a procedure or an invasive act: blood draw, placement of a catheter or urinary catheter, etc.
• Upon leaving the patient, if there has been direct contact.
• After exposure to bodily fluids or patient mucous membranes, for example, when emptying a urine bag.
• After contact with objects or surfaces in the patient's immediate environment: bed, bedside table, etc.

What is the correct handwashing process?

• Wet hands with water.
• Use enough liquid soap to cover your palms, fingers, and also your wrists.
• Rub hands palm to palm.
• Rub the palm of the right hand over the back of the left hand and vice versa.
• Rub the palm of the right hand over the back of the left hand, interlacing your fingers, and vice versa.
• Place the backs of the fingers against the opposite palm and rub the fingers with a back-and-forth motion against that palm.
• Carefully rub the thumb of each hand with the palm of the other hand.
• Rub the tips of the fingers of each hand while rotating in the palm of the other hand.
• Rinse your hands thoroughly with water and dry them with a single-use towel.
• Turn off the faucet with the towel so that your hands do not become re-contaminated with germs from the faucet.

What is the correct hand disinfection process?

For disinfection, a professional disinfectant approved by the Ministry of Health should be used. Use a sufficient amount to completely cover the fingers, palms, backs of the hands, and wrists. KLINTENSIV® – Hand disinfectant gel

Selecting hand hygiene products for healthcare facilities

The main determinants for selecting products are the antimicrobial profile, user acceptance, and the costs involved. Post-contamination hand hygiene products must have at least bactericidal, fungicidal (yeasts), and virucidal (enveloped viruses) activity.

Since hands are frequently contaminated with blood, especially in intensive care units and operating rooms, activity against pathogens must be included in the minimum activity spectrum of a hand hygiene agent. Additional activity against fungi (including molds), mycobacteria, and bacterial spores may be relevant in high-risk departments or during outbreaks.

Preoperative hand hygiene should be at least bactericidal and fungicidal (yeasts), as the hands of most healthcare workers are carriers of yeasts, and surgical site infections have also been associated with yeast carriage on hands during an outbreak.

In the selection and purchasing stage of disinfectants, user acceptability (odor, feel, skin irritation) and the allergen potential of the product should also be considered.

Reasons for poor hand hygiene practices in hospitals

Unfortunately, in some healthcare institutions, adherence to recommended handwashing practices remains low, rarely exceeding 40% of situations where hand hygiene is indicated. Hand hygiene reflects attitudes, behaviors, and beliefs.

Recent studies support the fact that interactive educational programs combined with the free availability of hand disinfectants have significantly increased the level of hand hygiene compliance. A single lecture on basic hand hygiene protocols had a significant and sustained effect on increasing hand hygiene compliance in a Swedish hospital. European Union member states that implemented national hand hygiene campaigns found that the following strategies were extremely useful in their countries: government support, the use of indicators for benchmarking hand hygiene, the development of national surveillance systems to audit the consumption of alcohol-based hand rubs, and auditing hand hygiene compliance.

Other factors, such as positive role models (the hand hygiene behavior of experienced medical staff) and the use of performance indicators, also remarkably improve hand hygiene compliance. In addition, hospitals must ensure an adequate supply of hand hygiene products, lotions and creams, single-use towels, and handwashing facilities where necessary. Hand disinfectants should be available in sufficient quantities at the point of care. It must be emphasized that wearing gloves does not replace the need for hand hygiene and that contamination can occur during the removal of gloves.

Studies have shown a remarkable and long-lasting improvement in hand hygiene compliance through the use of a multimodal strategy, which was adopted by the WHO's first global patient safety challenge to develop hand hygiene strategies. The availability of individual, pocket-sized bottles also increased compliance. KLINTENSIV® – Hand disinfectant gel, 40 ml

Aside from this, all hospitals should have a dynamic infection control team, a robust surveillance system, and adequate staff to disseminate evidence-based knowledge in a way that is easy to understand for all staff members. At a more local or regional level, institutional frameworks or programs are needed to deal with infections associated with hospital-acquired infections.