Treatment of the hands of medical personnel hygienic: means, rules

The issue of the need to conduct hand hygiene by medical personnel was raised for the first time only in the middle of the 19th century. At that time, because of unsanitary conditions in Europe, almost 30% of women in labor were dying in hospitals. The main cause of death was the so-called postpartum fever. It often happened that the doctors went to the women giving birth after the dissection of the corpses. At the same time, they handled nothing, but simply wiped them with a handkerchief.

Types of processing

Maintaining a clean hand is a prerequisite for all medical personnel. Hand hygiene can be performed in two ways:

• Removing contaminants and reducing the number of microorganisms on the skin of hands with soap and water;
• Use of special alcohol-containing skin antiseptics, which allow to reduce the number of bacteria on the skin to a minimum level.

Only the second method can be called hygienic hand treatment. The first is only hygienic washing. Wash hands with a liquid soap dispenser and wipe with an individual disposable towel. But disinfection is done with skin antiseptics.

According to the rules, medical personnel should always have hand treatment facilities available. In addition, they need to provide creams, balms, lotions, designed for skin care. After all, with constant hygienic treatment, the risk of developing contact dermatitis increases. Also the selection of detergents and antiseptics should be carried out taking into account individual intolerance.

Important conditions

Every hospital employee should know when the hygienic hands should be handled. This is necessary in the following situations:

• Before and after contact with each patient;
• Before and after putting on gloves, which are used during medical manipulations, contact with excreta or secretions of the body, bandages, mucous surfaces;
• After contact with intact skin, for example, after measurement of blood pressure, pulse, shifting patient;
• After working with equipment that is located in close proximity to the patient;
• After treatment of patients with various purulent-inflammatory processes.

If there is an obvious contamination of the skin of the hand with blood or secretions of the patient, then first they must be thoroughly washed with water and soap and dried. After this, they must be treated twice with an antiseptic.

Technique of washing hands

Do not forget about the importance of skin cleansing, not only in hospitals, but also in other places. The technique of hand treatment everywhere remains unified. Before proceeding to the procedure, you must remove all rings, watches and bracelets. Any foreign objects make it difficult to remove pathogenic microorganisms. It is desirable to wash your hands with moderately warm water.

To increase the effectiveness of the procedure, you must first wet your hands and squeeze liquid soap onto them . The algorithm for processing hands looks like this:

1. Foam the soap with the help of intense rubbing of the palms between each other.
2. Rub one hand on the other with reciprocating movements.
3. Rub the back surface of the right hand with the left palm and set.
4. Connect the fingers of the right hand and the interdigital intervals left, carefully process them.
5. It is necessary to pass and the inner surface of the fingers.
6. Cross the spread fingers and rub palms together.
7. Hold your hands in the lock and walk with the back of your fingers in the palm of your hand.
8. Carefully rub in a circular motion of the thumb, for this, its base must be covered with the thumb and forefinger of the other hand.
9. In a similar pattern, the wrist is also treated.
10. With circular movements rub your palm with your fingertips.

Each movement must be repeated at least 5 times, and the total duration of this wash should be about a minute.

Rules for medical personnel

Every worker in hospitals and clinics should know how to handle the hands of medical personnel. SanPiN (the scheme of the correct washing is given above) establishes the order not only of cleaning the skin, but also their disinfection. Also, health workers should remember the following requirements:

• Short-cut nails without varnish;
• Absence of rings, rings and other similar ornaments.

Nail polish can cause unwanted dermatological reactions that could lead to secondary infection. In addition, the dark varnish does not allow you to assess the degree of purity of the subungual space. This can cause poor quality processing. The most dangerous is the cracked varnish. After all, in this case, removing microorganisms from the surface of the hands becomes more difficult.

The very implementation of a manicure is associated with the production of microtraumas, which are easy to infect. This is one of the reasons why medical workers are forbidden to wear false nails.

Any jewelry or costume jewelery can cause the hand hygiene treatment of hands to be less effective. In addition, because of them, gloves can be damaged, and the process of putting them on is complicated.

Nuances for Surgeons

The treatment of the hands of people participating in surgical interventions is carried out according to a slightly modified scheme. So, for example, the washing time for them is extended and is 2 minutes. The following algorithm for processing hands looks like this. After mechanical cleaning, it is necessary to drain the skin with a tissue sterile or disposable paper towel.

In addition to washing, treatment with an antiseptic is also important. Attention must be paid not only to the hands, but also to the wrists and forearms. During the set treatment time, the skin should remain moist. Wipe your hands can not wait until the antiseptic dries completely. Only after this, surgeons can wear gloves.

Selection of hygiene products

Many now choose their antibacterial soap. But it is important to follow the technique of cleaning the skin. If everything is done correctly, then washing with normal soap will be just as effective. In surgical practice, special means are used for antiseptic treatment of hands. The soap contains chlorhexidine gluconate or povidone-iodine. These substances are able to reduce the number of bacteria by 70-80% at the first application and by 99% at the second application. In this case, when using povidone-iodine, the microflora grows faster than when it comes into contact with chlorhexidine.

In order to fully comply with regulatory requirements, the hygienic treatment of the hands of medical personnel was carried out, it is desirable to equip health facilities with elbow dosage devices. They are managed without the involvement of hands.

Also, in surgical practice, brushes can be used to clean hands, but this is not considered mandatory. They should be either sterile disposable, or capable of withstanding autoclaving.

Time intervals

In surgical practice, special rules for cleaning the skin. After the usual thorough washing according to the established protocol, their disinfection must be carried out.

The processing of the hands of medical personnel must be carried out without fail. SanPin (washing scheme remains the same) provides that skin cleaning before surgical manipulations can be carried out using the same means as hygienic.

It is important to remember that during the whole period of disinfection of hands they must remain moist. For the procedure, as a rule, more than 6 ml of antiseptic should be used. As a result of the research it was found that for a qualitative destruction of bacteria, a five-minute treatment of the skin is sufficient. It was also confirmed that the performance of this procedure for three minutes reduces the number of microorganisms to an acceptable level.

Rules for processing hands with an antiseptic

After thoroughly washing the skin of the hands, wrists and forearms, it is necessary to dry them. After this, the established standard of hand treatment for workers of operational units requires the use of special disinfectants.

Before this, if necessary, it is necessary to treat nail beds and okolonogtevye rollers. For these purposes, use sterile disposable wooden sticks, which must be additionally moistened with antiseptic.

Disinfectant is applied 2.5 ml on the wrist and forearm. About 10 ml of disinfectant liquid should be used for one treatment of two hands. The antiseptic must be rubbed into the skin in the same way that the hands are washed, with the correct sequence of movements.

Only after full absorption / evaporation of the product can you wear gloves. If the surgery lasts more than 3 hours, then the treatment is repeated. After all, under the gloves, pathogenic microorganisms can start multiplying again.

The final stage

But this is not all levels of hand treatment. It is important after work in gloves to remove them and wash their hands with soap. In this case, it is no longer necessary to use a disinfectant solution. It is sufficient to wash with liquid soap, it is desirable that its pH is neutral.

After cleaning the skin, they must be moistened. For these purposes, various creams, lotions are used. Their main purpose is to prevent the drying effect of alcohol-containing disinfectants.

Separately it is worth noting that hygienic treatment of hands in the absence of visible contaminants can be performed without washing. In most cases, it is sufficient to use antiseptic solutions for 30-60 seconds.

Possible complications

It is worth noting that the regular use of disinfectants does not have the best effect on the skin of health professionals. There are two main types of reactions experienced by hospital staff. Most often they complain of itching, dryness, irritation, the appearance of cracks with bleeding. These symptoms can be both insignificant and noticeably affect the general condition of workers.

There is also another type of complication - allergic dermatitis. They occur when intolerance of any components of the funds intended for hand disinfection. Allergic dermatitis can manifest itself both in the weakly expressed localized and in the severe generalized form. In the most neglected cases, they can be combined with respiratory distress syndrome or other manifestations of anaphylaxis.

Prevalence of complications and their prevention

You can understand the significance of the problem if you know that such hand treatment methods result in 25% of nurses treating dermatitis symptoms, and 85% reporting that they had skin problems in their history.

A little to reduce the irritating effect of antiseptics is possible if you add emollients to them. This is one way to reduce the prevalence of contact dermatitis. Also, the risk of their occurrence can be minimized by using after each washing moisturizers, which are intended for the care of the skin of hands.

To prevent the development of complications, do not wash your hands every time before treating them with an antiseptic. In addition, it is important to ensure that gloves are worn only when the skin is completely dry.

Do not neglect the use of moisturizers. In the market, you can find special protective cream designed to prevent the appearance of contact dermatitis. However, as a result of the studies, it was not possible to confirm their unambiguous effectiveness. Many people are stopped by the high price of these creams.