Good hand hygiene should be second nature both in a clinical environment, and everyday life. The skin on the hands is the first defence against infection from pathogens, as any cuts or lesions on it are easy sources of entry for bacteria and viruses. It is because of this good hygiene practices are crucial to reducing the risk of infection.
Washing hands with just soap and hot water can kill up to 95 per cent of micro-organisms, however this method is only effective when performed properly.
The only effective hand washing technique is:
- Palm to palm (including wrists)
- Right palm over left dorsum, and left palm over right dorsum
- Palm to palm, with fingers interlaced
- Backs of fingers to opposing palms with fingers interlaced
- Rotational rubbing of thumbs clasped in opposite palms
- Rotational rubbing of fingertips in palms.
It is important this is done in the order stated, using hot water and soap. This must be carried out in the following instances: when entering the surgery, before putting on gloves, after removing gloves, before leaving the surgery, after visiting the toilet, before and after handling food or drink and
before and after clearing the work area or handling instruments.
To minimise the risk of spreading infection, certain protocols must be followed when washing hands:
- Rings must be removed (or at least be able to slide up the finger to enable the area underneath to be cleaned).
- Nails must be kept short, with no nail extensions.
- Wrists must be free of watches and jewellery. If jewellery must be worn for religious or medical reasons, it must be pushed as far up the arm as possible, and secured with tape.
- Long sleeves must be pushed up and secured.
- Broken skin or open wounds must be securely covered with a waterproof dressing.
If these procedures are all followed, soap and hot water should remove most of the micro-organisms found on the hands. Coupled with effective infection control procedures within the practice, good hand hygiene should help ensure the spread of infection is kept under control.
However, this will only be achieved with a dedicated industry-wide education campaign and full staff participation. Industry sales statistics show that the hand disinfection market in 2008 was valued at £800K. With the number of dental staff across the UK being over 100,000, this equates to less than £8 per year, per person being spent on the correct ‘CE’ marked products suitable for the industry.
According to a study carried out by the British Medical Journal in 2002, use of an alcohol-based hand rub reduced the presence of the MRSA virus on the hands of a range of medical staff from 22.7 per cent to just under three per cent. Alcohol rubs are now a common sight in all medical environments. Whilst they should never be used in the place of thorough hand washing and certainly never whilst wearing gloves, when applied to visibly clean hands an alcohol-based rub is another way of making sure that healthcare staffs’ hands are as bacteria-free as possible.
A waterproof occlusive dressing must cover all areas of broken or damaged skin, and gloves should be worn at all times for added protection.
Regular washing, and the use of alcohol rubs can compromise the condition of the skin on the hands and arms. It is important to take restorative action to help minimise dryness and irritation, as weaker skin is more prone to skin complaints and cracking. Regular use of a water-based moisturising cream or lotion is essential. However, staff who work in the sterilising department should not use hand creams whilst at work, as they can potentially contaminate instruments during handling and inspection, and may compromise packaging integrity.
More information on infection control training is available from schülke on 0114 254 3500 or by visiting www.s4dental.com