Hand Hygiene

Unified visuals for “My five moments for hand hygiene”

The patient zone, health-care area, and critical sites with inserted time-space representation of “My five moments for hand hygiene”

Indication for hand hygiene defined by CDC and WHO

1. before touching a patient 
2. after touching a patient
3. after touching objects located in the vicinity of the patient
4. before touching nonintact skin
   manipulating invasive devices
5. after contact with body fluids, mucous membrances, nonintact skin or wound dressings

Situations requiring and not requiring glove use

1.  STERILE GLOVES INDICATED

• Any surgical procedure; vaginal delivery; invasive radiological procedures; performing vascular access and procedures (central lines); 
• preparing total parental nutrition and chemotherapeutic agents

2.   EXAMINATION GLOVES INDICATED IN

CLINICAL SITUATIONS

• Potential for touching blood, body fluids, secretions, excretions and items visibly soiled by body fluids

DIRECT PATIENT EXPOSURE:

• contact with blood, muscous membrane and with non-intact skin
• potential presence of highly infectious and dangerous organism; epidemic or emergency situations
• IV insertion and removal; drawing blood; discontinuation of venous line
• pelvic and vaginal examination
• suctioning non-closed systems of endotracheal tubes

INDIRECT PATIENT EXPOSURE:

• emptying emesis basins
• handling/cleaning instruments
• handling waste
• cleaning up spills of body fluids

3.  GLOVES NOT INDICATED (except for CONTACT precautions)

No potential for exposure to blood or body fluids, or contaminated environment

DIRECT PATIENT EXPOSURE:

• taking blood pressure; temperatureand pulse
• performing SC and IM injections
• bathing and dressing the patient
• transporting patient
• caring for eyes and ears (without secretions)
• any vascular line manipulation in absence of blood leakage

INDIRECT PATIENT EXPOSURE:

• using the telephone
• writing in the patient chart
• giving oral medications
• distributing or collecting patient dietary trays
• removing and replacing linen for patient bed
• placing non-invasive ventilation equipment and oxygen cannula
• moving patient furniture

How to Handrub

How to Handwash

Reference:

Hand Hygiene. 
N Engl J Med 2011;364:e24.

WHO guidelines on hand hygiene in health care. 
Geneva: World Health Organization, 2009.