How to monitor the hand hygiene effect?

Normative requirements: “Medical staff hand hygiene standards” 2009:

1. The hand disinfection effect should meet the following requirements:

a) Sanitary hand cleaning, the total number of bacterial colonies monitored should be ≤10cfu/cm2

b) Surgical hand disinfection, the total number of bacterial colonies monitored should be ≤ 5cfu/cm2

2. Concept of sanitary hand disinfection and surgical hand disinfection

a) What is hygienic hand disinfection? Refers to the medical staff using quick-drying hand disinfectant to rub both hands to reduce the process of temporary hand-dwelling bacteria.

b) Surgical hand disinfection? Before the operation, the medical staff washes the hands with soap (soap) and running water, and then removes or kills the temporary bacteria and reduces the resident bacteria by hand disinfectant. The hand sanitizer used can have sustained antibacterial activity.

3. Hand washing and sanitation hand disinfection should follow the following principles:

a) Wash hands with soap (soap) and running water when there is visible contamination of the hands such as blood or other body fluids.

b) When there is no visible contamination of the hand, it is advisable to use a quick-drying hand disinfectant to disinfect the hands instead of washing hands.

4. Medical staff should wash their hands first in the following situations, and then disinfect the hands:

a) After contact with the patient’s blood, body fluids and secretions, and items contaminated with infectious pathogenic microorganisms.

b) After directly inspecting, treating, caring for or treating the infected patient’s dirt.

5. Hand hygiene monitoring sampling time and method:

a) Sampling time is sampled before contacting the patient and conducting a diagnosis and treatment activity.

b) Sampling method The subject is close to the fingers, and the cotton swab soaked with the sterile eluate containing the corresponding neutralizing agent is rubbed twice from the finger to the fingertip on the double-finger surface, one hand is coated. The rubbing area is about 30cm2, and the cotton swab is rotated at the same time during the rubbing process; the cotton swab is cut off from the operator’s part, and 10 ml of the sterile eluent test tube containing the corresponding neutralizing agent is put into the test tube, and the test is promptly sent.

Hand hygiene and effect monitoring analysis

There is no standard for monitoring the total number of bacterial colonies after washing hands in the “Health Code for Medical Staff Hand”.

In the Prevention and Control of Infection in Primary Care Institutions, the advantage of hand disinfectant is that it can kill potential pathogens more effectively than running water soap. The monitoring shows that the bacterial count is significantly reduced, and the time required is shorter and more convenient. Liquid and running water can improve skin allergies and dryness. Frequent hand washing and hand disinfection can cause skin damage. The hand washing effect is better than the hand sanitization effect, and the hand disinfection effect monitoring is superior to the hand washing effect.

Based on the above analysis, there is no monitoring standard for running water washing national regulations, and there are monitoring standards for hand disinfection regulations. At the same time, in order to increase hand hygiene compliance and ensure hand hygiene, there is no visible pollution in the hands (except for C. difficile infection). It is recommended to use hand sanitizer for hand hygiene.

Although the hand hygiene effect monitoring after washing hands is not routinely carried out, it is possible to check from time to time to understand the effect of washing hands and the contamination of hand washing water. Therefore, it is not recommended to routinely monitor the hand hygiene after washing hands.