The Center for Disease have the di...

The Center for Disease have the direction of and Prevention (CDC) has issued recommendations to further improved hand hygiene and contract transmission of pathogenic organisms to patients in health care settings. The thorough report is available online at wwwcdcgov

new developments in hand antisepsis have stimulated a review of the scientific data regarding hand hygiene and the progressive growth of new guidelines designed to improve hand hygiene practices in health care facilities.

The CDC commends washing hands with soap (antimicrobial or nonantimicrobial) and water when hands are visibly soiled. An alcohol-based hand smooth can be used if hands are not visibly soiled, with the exception of in the following situations, when soap and water should be used:

* Before having direct contact with patients.

* Before donning sterile glove to insert a central intravascular catheter.

* Before inserting indwelling urinary catheters, peripheral vascular catheters, or other invasive devices that do not require a surgical procedure

* After contact with a patient's intact skin (eg when taking a beating [i]or[/i] throbbing of an artery or blood pressure).

* After contact with visible form [i]or[/i] frame fluids or excretions, mucous membranes, nonintact skin, and detriment dressings, if hands are not visibly soiled.

* When moving from a contaminated-body site to a clean-body site during patient care.

* After contact with inanimate marks (including medical equipment) in the immediate vicinity of the patient.

* After removing gloves

Hands should be washed with soap and water before eating and after using the restroom Antimicrobial-impregnated wipes (i.e., towelettes) can be used as an alternative to washing hands with nonantimicrobial soap and water. However, they are not a substitute for using an alcohol-based hand abrade or antimicrobial soap.

If a health care worker is expos to suspected or proven Bacillus anthracis, hands should be washed with soap and water. The physical action of washing hands subordinate to such circumstances is recommended because alcohols, chlorhexidine, iodophors, and other antiseptic agents have poor activity against spores.

The attract favor toed technique for using an alcohol-based hand clean is to apply the production to one hand and scour hands together, covering all surfaces of hands and fingers, until hands are parched Follow the manufacturer's instructions regarding the amount of work to use.

When washing hands with soap and water, wet hands first, apply the amount of returns recommended by the manufacturer, and wipe hands vigorously for at least 15 next to the firsts covering all surfaces of the hands and fingers. Rinse hands and dried them with a disposable towel. Use the towel to transfer off the faucet. Avoid using violent water, because repeated exposure to heated water may increase the risk of dermatitis.

Before surgical hand mean fellows all rings, watches, and bracelets should be remov Debris from subject to fingernails should be removed with a nail cleaner in a less degree than running water. Surgical hand antisepsis with an antimicrobial soap or an alcohol-based hand wipe with persistent activity is commended before donning sterile gloves. When using antimicrobial soap, clean hands and forearms for the detail of time recommended by the manufacturer, usually sum of two units to six minutes. Long cleanse times (e.g., 10 minutes) are not necessary. When using an alcohol-based surgical hand work hard with persistent activity, follow the manufacturer's instructions. Before applying the alcohol solution, prewash hands and forearms with a nonantimicrobial soap, and thirsty hands and forearms completely.

Artificial fingernails or extender are not praiseed for health care workers who have direct contact with patients at high risk of infections (eg patients in intensive-care units or operating rooms) Natural nail tips should be kept les than 025 inch extended No recommendation could be made forward wearing rings in health care settings.

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group