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 treatment

Maintaining a clean hand is a prerequisite for all medical personnel. Hand hygienic hands 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 must be provided with 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 undamaged 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, they must first be washed thoroughly with soap and water and dried. After this, they must be treated twice with an antiseptic.

Hand Wash Technique

Do not forget 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 treating the hands looks like this:

1. Foam the soap with the help of intense rubbing of the palms between each other.
2. Rub one palm on the other with reciprocating movements.
3. Rub the back surface of the right hand with your left palm and set.
4. Connect the fingers of the right hand and the interdigital spaces 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. Thoroughly rub the thumb with circular motions, for this, its base should be covered with the thumb and index finger of the other hand.
9. The wrist is treated similarly.
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 nurses. SanPiN( the scheme of 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 to assess the degree of purity of the subungual space. This may 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 performance of a manicure is associated with the production of micro-traumas, 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 hygiene treatment of the hands of nurses 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, 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 can reduce the number of bacteria by 70-80% for the first application and for 99% for 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 handled hygienic hands of medical personnel, it is desirable to equip health facilities with elbow dispensers. They are managed without the involvement of hands.

Also in the 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 the 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 manipulation can be carried out using the same means as hygienic.

It is important to remember that during the entire 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.

Hand treatment rules for antiseptic

After thorough washing of the skin of the hands, wrists and forearms, it is necessary to dry them. After that, the established standard of hand treatment for workers of operating units provides for the need for special disinfectants.

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

The disinfectant is applied 2.5 ml on the wrist and forearm. For one treatment of two hands, about 10 ml of disinfectant liquid should be consumed. The antiseptic must be rubbed into the skin in the same manner as the washing of hands, 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 of the

But this is not all levels of hand processing. It is important after work in gloves to remove them and wash their hands with soap. In this case, there is no need 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 of

It should be noted that the regular use of disinfectants does not have the best effect on the skin of medical workers. 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 either insignificant or 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 the disinfection of the hands. Allergic dermatitis can manifest itself both in a weakly expressed localized and in 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

It is possible to understand the significance of the problem if one knows that such hand treatment methods result in 25% of nurses treating dermatitis symptoms, and 85% reporting that they had skin problems in their history.

It is possible to reduce the irritating effect of antiseptics slightly 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 wash 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 emergence of contact dermatitis. However, as a result of the studies, it was not possible to confirm their unambiguous effectiveness. Many people are stopped and the high price for these creams.