1	HANDS HYGIENE modern trends
2	The Facts Why do we need to improve hand hygiene practices?” • Serious nosocomial infections • 90,000 patient deaths per year • Costs of treatment: $4.5 Billion per year in the U.S. • Hand washing compliance rates are unacceptably low (average 40 percent)
3	Does improved hand hygiene really reduce the spread of bacteria in healthcare settings? Yes! A scientific study performed in a hospital nursery found that babies acquired staphylococci more frequently when cared for by nurses who didn't wash their hands than babies cared for by nurses who washed their hands between patient contacts with an anti-microbial soap. Numerous studies show that proper hand hygiene reduces the spread of bacteria in various healthcare settings.
4	You may not realize you have germs on your hands! Nurses, doctors and other healthcare workers can contaminate their hands by doing simple tasks, including: · taking a patient’s blood pressure or pulse; · assisting patients with mobility; · touching the patient’s gown or bed sheets; and · touching equipment, including bedside rails, over bed tables, IV pumps. The photo shows a blood agar plate 24 hrs after an ICU nurse placed her hand on plate”
5	What kind of contaminants can I be exposed to? Patients often carry resistant bacteria on their skin. Patients with resistant bacteria like methicillin-resistant S. aureus (MRSA) or vancomycin-resistant enterococci (VRE) often carry the organism on many areas of their skin, even when they don’t have any wounds or broken skin. Patients often carry the MRSA organism on the skin under their arms, on their hands or wrists, or in the groin area.
6	When should you wash your hands with soap and water? Wash your hands with plain soap and water; or with antimicrobial soap and water if: · your hands are visibly soiled (dirty); · hands are visibly contaminated with blood or body fluids; · before eating; and · after using the restroom.
7	Modern practices recommend frequent use of alcohol-based hand rubs New guidelines developed by the Centre for Disease Control and Prevention (CDC) and infection-control organizations recommend that healthcare workers use an alcohol-based hand rub (a gel, rinse or foam) to routinely sanitize their hands between patient contacts, as long as the hands are not dirty.
8	Hands Disinfection Standard These may vary from country to country The test is performed on the product ‘as is’ Temperature 37ºC Test Organisms load 10⁷/ml: Escherichia Coli Staphylococcus Aureus Contact Time: 1 minute Requirement to pass: Minimum log reduction of 3 (kill rate > 99.9%)
9	QUICK HAND DISINFECTION ISOGEL 10 % n-propanol 50% ethanol (v/v) 0.5% chlorhexidine (m/v) Quick disinfection Test result Log reduction > 8 (>99.999999%) Staphylococcus Aureus Pseudomonas Aeruginosa
10	LONG LASTING PROTECTION ISOGUARD Cross cationic polymers based invisible skin containing no detergent. Active: 1.5% Chlorhexidine Delivery system ensures continuous bactericidal activity combined with retention of skin natural oils and moisture Test results of a field test performed on 9 individuals: Average kill rate after 3 minutes: 100% Average kill rate after 3 hours: 98.88% (97.89%-99.59%) Average kill rate after 4 hours: 93.43% (81.38%-99.44%)
11	ISOGUARD – BEFORE
12	ISOGUARD – AFTER
13	CHLORHEXIDINE Most popular skin disinfectant Very little toxicity Active on wide range of Gram+ and Gram- Active on yeast and lipophilic viruses (HIV-SARS-Hepatitis B) Chlorhexidine gluconate is widely recommended as a handwash in the management of SARS. Dr Angela Merianos SARS Focal Point/Epidemiology Global Alert and Response World Health Organization
14	Key To Efficient Hands Hygiene Management in Hospital The PTP principle Right Procedure at the Right Time with the Right Product
15	. Right Procedure Normal Hands Wash with Water and Soap Surgical Hands Scrub Waterless Fast Hands Disinfection Long Lasting Antibacterial Hands Treatment
16	Normal Hands Wash with Water and Soap a) Open the tap b) Apply liquid or solid soap
17	"c" c) Massage hands for 1 minutes completely d) Rinse hands
18	"e" e) Dry hands with paper towel f) Close water tap with paper towel
19	2. Surgical Hands Scrub (Classic) Open the tap Apply liquid bactericidal hands scrub and water to both hands Spread and massage the solution onto fingers paying particular attention to the spaces between the fingers, cover evenly up to the wrists Rinse hands Repeat the operation with a new dose of bactericidal hands scrub from b) to d) Dry hands with sterile towel
20	3. Waterless Fast Disinfection On CLEAN HANDS ONLY Apply sufficient quantity to both hands Massage the gel evenly to hands, specially finger tips and space between fingers Allow 30 seconds contact time (drying time)
21	4) Long Lasting Antibacterial Hands Treatment ISOGUARD Apply on clean and dry hands and forearms Dispense one pump into the palm of one hand
22	"Apply to fingernails of both..." Apply to fingernails of both hands
23	"Dispense one pump into the..." Dispense one pump into the palm of one hand and apply to opposite forearm and repeat for the other forearm. Do not wipe, allow to dry.
24	Right Time On starting work Long lasting antibacterial treatment To prevent the importation of germs from the environment In between patients Waterless fast disinfection To prevent the transmission from one patient to another Before going to the toilet Hygienic hands wash with water and soap To prevent contamination from hospital germs After going to the toilet Long lasting antibacterial treatment To prevent the transmission of faecal germs to patients
25	"Before a gloved procedure" Before a gloved procedure Long lasting antibacterial treatment Ensure good hands asepsis and protect from latex irritation After a gloved procedure Hygienic wash with water and soap Freshening of hands On finishing work Long lasting antibacterial treatment Protect the worker and family from hospital germs Classic surgical hand scrub is no longer indicated if long lasting treatment is adopted
26	Right Product The ideal products for hands hygiene must be: EFFICIENT (comply with the standards) ECONOMICAL (their usage must save costs in nosocomial infections and their price must be competitive). COSMETICALLY ACCEPTABLE (the lack of acceptability is inducing the health worker to be non compliant). PACKAGED CONVENIENTLY
27	"DUROTEC PROPOSES A FULL RANGE..." DUROTEC PROPOSES A FULL RANGE OF PROFESSIONAL HANDS PRODUCT FOR THE HEALTH PRACTITIONERS ISOSCRUB – Chlorhexidine-based scrub ISOGUARD – Long lasting antibacterial hands treatment and surgical hands preparation. ISOGEL – Waterless fast hands disinfection