In Spain, between 5-10% of patients will get an infection related to healthcare, according to the Epine study

The doctor of the Preventive Medicine Service of the Hospital Quirónsalud Infanta Luisa, Sacred Heart and Field of Gibraltar Nuria López Ruiz points out, in the framework of the World Hand Hygiene Day that is celebrated on May 5, the importance of hand hygiene when it comes to preventing the transmission of infections in health care.

And it is that the specialist says that “washing hands saves lives”, since the hands are “the main route of transmission of germs during health care.” In Spain, as extracted from the Prevalence Study of Nosocomial Infections in Spain (Epine), between 5-10% of patients will get an infection related to healthcare and thousands of people die daily worldwide because of infections acquired while receiving health care, as highlighted by WHO.

As indicated in a statement, some examples of diseases in which transmission can be reduced by hand washing are common colds, the flu, hepatitis A, some gastroenteritis, infections with microorganisms resistant and not resistant to antibiotics, herpes Whooping cough, among others.

Specifically, this year, World Hand Hygiene Day is celebrated under the slogan ‘Prevent septicemia is in your hands’. Sepsis arises when an infection disrupts the normal response of the body and damage to organs and tissues.

Thus, each hospital in Quirónsalud periodically performs an observation of hand hygiene according to the five moments of the World Health Organization (WHO) – before contact with the patient, before aseptic tasks, after aseptic tasks, after contact with patient and after patient environment.

As for the general population, López highlights the importance of raising public awareness of hand washing whenever they are visibly dirty, after using the bathroom, after eating, before preparing food, among other times. He also states that “it is very important to have respiratory hygiene”, that is, to sneeze in tissues and never in the palms of your hands, cough towards the elbow, cover your mouth when coughing, among other measures to take.

“All populations must have good hand hygiene, although more vulnerable populations must, in general, be especially careful, such as children, the elderly and immunocompromised people,” he adds.

To do this, he explains the benefits of the hydroalcoholic solution (alcohol-based disinfectant), in the hospital setting, as a usual preferred means to disinfect the hands when they are not visibly dirty. “It is faster, more effective and better tolerated by the hands than washing them with soap and water,” says the preventive doctor, who indicates that, at home, “soap and water can be used, but remember that for washing be effective, you have to take the right time, about 40 or 60 seconds in total. ”

In addition, in the facilities of the Quirónsalud Infanta Luisa, Sagrado Corazón and Campo de Gibraltar hospitals, Dr. López is going to carry out activities, from this Thursday until next Monday, May 7, for the World Hand Hygiene Day aimed at sensitize health professionals and the general population that “good hand hygiene saves lives”.

Some of these activities will consist of giving information and carrying out practical exercises to learn to wash your hands correctly, using a black box with ultraviolet light to see if the hand hygiene technique is done correctly, training health professionals in hospitalization plants and ICU or the visit to the area of ​​Pediatrics to also raise awareness among children through games.

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Worldwide, millions of people are affected annually by at least one infection associated with health care. It is estimated that in developing countries 15% of patients admitted to hospitals and 34% of patients in intensive care units develop an infection associated with their health care.

This situation translates into significant financial losses for health systems, mainly due to the increase in days of hospital stay, and the fact that it is necessary to prescribe more expensive medications, but the most serious of the infections associated with health care. Health are its consequences on people, since they affect the most fragile patients, usually induce long-term disabilities and in many cases, they result in a significant increase in avoidable mortality.

The fact that infections are the most common adverse effect of health care in the world is very worrying and unacceptable, since most of these infections can be prevented through simple, low-cost interventions such as hand washing . Hands are the most powerful tools of health professionals. With them we feel our patients, identify their medical conditions and provide them with support and hope. However, our hands can also be a source of danger for our patients because they are the main route of infection transmission.

Hand hygiene at the right time saves lives and is an indicator of the quality and biosecurity of health services. Therefore, we must continue to strengthen their practice and ensure that hand washing is done with the correct technique at five key moments:
1. before touching the patient,
2. before performing a clean / aseptic task,
3. After being exposed to body fluids,
4. after touching the patient, and
5. After being in contact with the patient’s environment.

Today, handwashing is even more important as it is key to addressing one of the biggest challenges we face today that can put decades of progress in medicine and public health at risk. This great challenge is that of antimicrobial resistance.

The misuse and overuse of antimicrobials has increased the number of microorganisms resistant to treatments that historically helped save millions of lives. For example, although on a global scale the incidence of tuberculosis has been declining since 2000, this progress is threatened by the increase in cases of multi-drug resistant and extremely resistant tuberculosis. Likewise, the increasingly frequent occurrence of methicillin-resistant Staphylococcus golden infections is observed, with a probability of dying 64% higher than patients with non-resistant infections.

Recognizing the seriousness of this situation, in recent years the issue of antimicrobial resistance has acquired great relevance on the international agenda, with the adoption of Resolutions and action plans by PAHO Member States and WHO (WHA67 .25, WHA 68.7 of 2015, and CD54.R15). Moreover, the world leaders gathered at the General Assembly of the United Nations in 2016 pledged to adopt a comprehensive and coordinated strategy to address the root causes of antimicrobial resistance in multiple sectors, especially in human health, Animal health and agriculture.

On the other hand, on February 27, the WHO published its first list of antibiotic resistant priority pathogens. This list includes the 12 families of bacteria most dangerous to human health for having acquired resistance to a high number of antibiotics. This list seeks to promote and guide the research of new antibiotics and therefore these 12 families of bacteria are categorized according to the degree of urgency with which new antibiotics are needed. Bacteria have been classified in those with critical priority, high priority or medium priority. It is important to note that the critical priority group includes bacteria such as Klebsiella, E. Coli, Serratia, and Proteus, which are especially dangerous in contexts where health services are provided because they can cause serious and lethal infections, such as sepsis and pneumonia.

Recognizing that deficiencies in infection prevention and control favor the emergence of antimicrobial resistance, the Global Plan of Action on Antimicrobial Resistance, approved at the 68th World Health Assembly, calls for improved prevention and control of Infections both in the community and in healthcare centers, using proper hand hygiene as one of the main strategies.

We can all help promote proper hand hygiene at the right time. Our call to action is addressed:

To the health personnel to clean their hands at the right times and thus stop the spread of antibiotic resistance.
To the Directors, Managers and Administrators of the hospitals, to implement infection prevention and control programs designed to protect their patients from resistant infections.
To decision makers and policy makers, to make infection prevention and hand hygiene a national political priority.
To the leaders in infection prevention and control, so that they implant the essential components for the prevention and control of WHO infections, including hand hygiene, in the care establishments, in order to combat antimicrobial resistant infections.
Failure to take urgent and forceful actions to combat this global problem, the list of resistant pathogens can grow and endanger millions of lives. In this context, antimicrobial resistance represents a political and social challenge that we must address not only from the health sector, but from an intersectoral perspective.

Our colleagues in the agriculture, livestock, veterinary, economics and research and development promotion sectors must join this effort. We also need to add the population, sensitizing the general public about the danger it represents today and for future generations to lose the effectiveness of antimicrobials. The fight against antimicrobial resistance is in the hands of all of us.

Links of interest:

WHO publishes the list of bacteria for which new antibiotics are urgently needed
Campaign page “Save Lives: clean your hands”
PAHO page on antimicrobial resistance

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Six-step hand hygiene 30 seconds

Six-step hand hygiene 15 seconds

Three-step hand hygiene 30 seconds

Three-step hand hygiene 15 seconds

All participants are assigned to each group.

Three, 15 seconds of three-step technology is just as effective

The results showed that the 15-second three-step technique was as effective as reducing the bacterial count on the volunteer’s hand for a 30-second three- or six-step protocol.

Four-step, 15-second three-step technology is simple and convenient

Professor Tschudin-Sutter said in a statement: “The time pressure and heavy workload experienced by medical workers have reduced adherence to the health standards of our opponents. Our results show that shortening hand rub time and simplifying hand rubbing techniques It may be a safe alternative to adapting to their busy day-to-day work, improving the overall quality of hand hygiene performance and having a positive impact on compliance. Further research is needed to verify the shortened application time in daily clinical practice. which performed.”

The research team agreed that unless research was conducted in the actual clinical setting, the study could not provide a comprehensive statement of the ability of the three-step protocol to prevent microbial transmission.

5. Hand hygiene and reduction of staphylococcal infections

In 2009, the Australian National Hand Health Initiative (NHHI) was implemented, and since then, the reduction in staphylococcal infections in health care facilities has improved significantly. The results of this new study are entitled “Improving Hand Hygiene Compliance (HHC) is associated with a significant reduction in medical-related Staphylococcus aureus bacteremia (HA Sab) in 132 largest hospitals in Australia: Australian National Hand Health Initiative The results (NHHI) were published at the European Conference on Clinical Microbiology and Infectious Diseases (ECCMID) in Amsterdam, the Netherlands, from April 13th to 16th.

Sixth, hand hygiene management significantly reduces bacterial infections

The report shows that hand hygiene and its compliance with Australian health care workers have improved significantly. This reduces the risk of the transmission of commonly fatal medical-related S. aureus infections. The researchers noted a 10% increase in compliance with hand hygiene guidelines and a 15% reduction in the incidence of S. aureus bloodstream infections in 132 of the largest public hospitals in Australia. They added that these hospitals served more than 15 million patients nationwide in 2016-17. This is equivalent to more than three-quarters of hospitalizations in Australia.

Seven, 5 moments of hand hygiene

The team is following up on the WHO campaign called “5 moments of hand hygiene”, which will reduce the risk of medical-related infections.

These five moments include;

Before contacting the patient

After touching the patient

After touching the environment

Before the cleaning process

After exposure to body fluids/wounds

Health and hygiene, starting from a doctor, is responsible for both yourself and the patient.

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