Standard Precautions for Hand Hygiene in Hospice

Introduction

When hands are visibly dirty or visibly soiled with blood or body fluids, wash with either a non-antimicrobial soap and water or an antimicrobial soap and water. If hands are not visibly soiled, or after removing visible material with non-antimicrobial soap and water, decontaminate hands with an alcohol-based hand rub. Alternatively, hands may be washed with an antimicrobial soap and water. Frequent use of alcohol-based hand rub immediately following hand washing with non-antimicrobial soap may increase the frequency of dermatitis.

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Perform Hand Hygiene

• Before having direct contact with patients.
• After contact with blood, body fluids or excretions, mucous membranes, non-intact skin, or wound dressings.
• After contact with a patient’s intact skin (e.g., when taking a pulse or blood pressure or lifting a patient)
• If hands will be moving from a contaminated-body site during patient care.
• Promptly take care of cuts, scratches and wounds. Clean your hands before and after changing wound dressings (even bandaids). Keep them clean and protected with a clean, dry bandage. Larger wound dressings may require the use of gloves.
• Clean your hands before and after touching IV lines or other medical equipment inserted into the body.

Proper Hand Washing

• Use soap and plenty of running water if your hands are visibly soiled:
• Wet hands with warm water and work soap into a lather.
• Rub your hands vigorously for 15 seconds or longer. Get in between fingers and around fingernails. Don’t forget to scrub the wrists.
• Rinse your hands with warm running water keeping them pointed down and pat them dry with a clean towel paper towel. Used towels with put germs right back on your hands.
• Use a clean paper towel to turn off the water faucet, and discard it in a trash can.

Proper Use of Hand Sanitizers

Use a hand sanitizer for routine hand cleaning only if your hands aren’t visibly dirty. Apply the hand sanitizer to the palm of one hand. Rub your hands together until they’re dry, making sure the sanitizer covers every spot on your hands and figures. It should take about 15 seconds to rub your hands dry. If not, you didn’t apply enough hand sanitizer.

Gloves

• Wear gloves when it can be reasonably anticipated that contact with blood or other potentially infectious materials, mucous membranes, non-intact skin, or potentially contaminated intact skin (e.g., of a patient incontinent of stool or urine) could occur.
• Wear gloves with fit and durability appropriate to the task.
• Wear disposable medical examination gloves for providing direct patient care.
• Wear disposable medical examination gloves or reusable utility gloves for cleaning the environment or medical equipment.
• Remove gloves after contact with a patient and/or the surrounding environment (including medical equipment) using proper technique to prevent hand contamination.
• Do not wear the same pair of gloves for the care of more than one patient.
• Change gloves during patient care if the hands will move from a contaminated body-site (e.g., perineal area) to a clean body-site (e.g., face)

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