a) When there is contamination of the hands visible to the naked eye, such as blood or other bodily fluids, handwashing should be done with soap (suds) and running water.
b) When there is no visible contamination on the hands, it is advisable to use quick-drying hand sanitizer to sanitize the hands instead of washing them.
6.2 Healthcare workers shall choose to wash their hands or use quick-drying hand sanitizers in accordance with the principles of 6.1 in the following situations:
a) Before and after direct contact with each patient, when moving from contaminated to clean areas of the same patient's body.
b) Before and after contact with a patient's mucous membranes, broken skin, or wounds, and after contact with a patient's blood, body fluids, secretions, excretions, and wound dressings.
c) Before and after putting on and taking off isolation gowns, and after removing gloves.
d) After contact with the patient's surroundings and objects.
e) After contact with the patient's surroundings and objects.
f) Before handling medications or dispensing meals.
6.3 Healthcare workers should wash their hands, followed by hand hygiene disinfection, when:
a) After contact with the patient's blood, bodily fluids, and secretions, and items contaminated with infectious disease-causing microorganisms.
b) After directly examining, treating, caring for or handling infectious patients' dirt.
6.4 Methods of hand washing for medical personnel, see Appendix a
6.5 Disinfection shall be accomplished as follows:
a) Take an appropriate amount of quick-drying hand sanitizer in the palm.
b) Strictly follow the steps in Appendix a Handwashing Methods for Medical Personnel a. 3 Rubbing.
c) Ensure that the hand sanitizer completely covers the skin of the hand while rubbing until the hand is dry.
7 Surgical hand disinfection
7.1 Surgical hand disinfection should follow the following principles:
a) Wash hands first, then disinfect.
b) Surgical hand disinfection should be repeated between surgeries on different patients, when gloves are broken or hands are contaminated.
7.2 Handwashing Methods and Requirements
7.2.1 Prior to handwashing, hand ornaments should be removed and nails should be trimmed to a length not exceeding the fingertips.
7.2.2 Take appropriate amount of detergent to clean both hands, forearms and the lower 1/3 of the upper arm, and rub carefully. When cleaning the hands, care should be taken to clean the dirt under the nails and the folds of the hand skin.
7.2.3 Rinse the hands, forearms and lower 1/3 of the upper and lower arms under running water.
7.2.4 Dry the hands, forearms and lower 1/3 of the upper arms with a hand-drying article.
7.3 Surgical hand disinfection methods
7.3.1 Rinse hand disinfection methods Take an appropriate amount of hand disinfectant and apply it to each part of the hands, forearms and lower 1/3 of the upper arms, and Rub carefully for 2min~6min, rinse both hands, forearms and lower 1/3 of upper arm with flowing water, and dry thoroughly with sterile towel. The flowing water should meet the provisions of gb 5749. Special circumstances of the water quality does not meet the requirements, the surgeon in the gloves before the application of alcohol-based hand disinfectant and then disinfect the hands after wearing gloves. Hand sanitizer take the amount of liquid, rubbing time and the use of methods to follow the instructions for use of the product.
7.3.2 Non-rinse hand sanitizer Apply an appropriate amount of non-rinse hand sanitizer to each part of the hands, forearms, and the lower 1/3 of the upper arms and rub carefully until the sanitizer dries. The amount of hand sanitizer to be taken, the rubbing time and the method of use follow the instructions for use of the product.
7.4 Precautions
7.4.1 Do not wear false nails and keep the nails and tissues around the nails clean.
7.4.2 Keep your hands in front of your chest and above your elbows throughout the hand sanitizing process so that water flows from your hands to your elbows.
7.4.3 Handwashing and sanitizing can be done with a sponge, other rubbing supplies, or by rubbing the hands against each other.
7.4.4 After removing the surgical gloves after surgery, the hands should be cleaned with soap (suds).
7.4.5 Nail-cleaning appliances and rubbing materials such as sponges and hand brushes should be placed in designated containers after use; rubbing materials should be sterilized after use by each person or be disposable; and nail-cleaning materials should be cleaned and sterilized daily.
8 Monitoring of hand hygiene effect
8.1 Monitoring requirements
Medical institutions should be quarterly on the operating room, delivery room, catheterization room, laminar flow clean wards, bone marrow transplantation wards, transplantation wards, intensive care wards, neonatal room, mother and baby room, hemodialysis wards, burns wards, infectious diseases, stomatology and other departments of the work of the medical staff hand disinfection effect monitoring; when suspected of hospital-acquired infections, the hospital should monitor the effectiveness of hand hygiene. The effect of monitoring; when suspected of hospital infection outbreaks and medical staff hand hygiene related, should be timely monitoring, and the corresponding pathogenic microbial detection.
8.2 Monitoring methods
According to Appendix b.
8.3 Hand hygiene standards
The total number of bacterial colonies in accordance with the requirements of 4.4.
Appendix a
(normative appendix)
Methods of hand washing for medical personnel
a．1 Under running water, make the hands fully wet.
a.2 Take an appropriate amount of soap (soap) and apply it evenly to the entire palm, back of the hand, fingers, and fingertips.
a. 3 carefully rub hands at least 15 seconds, should pay attention to cleaning all the skin of the hands, including the back of the fingers, fingertips and finger cracks, the specific rubbing steps as follows:
a. 3. 1 palm hand opposite, fingers together, rub each other, see Figure a. 1.
a. 3. 2 palm opposite, hands cross finger cracks and rub each other, exchange, see Figure a. 2.
a. 3. 3. 3. 3. 3. 3. 3. 3. 3. 3. 2 palm hands opposite, hands cross finger cracks, exchange each other.
a.3.3 Palms facing each other, hands crossed fingers rubbing each other, see Figure a.3.
a.3.4 Bend the fingers so that the knuckles rotate in the palm of the other hand and rub, and exchange, see Figure a.4.
a.3.5 Hold the left thumb in the right hand and rotate, and exchange, see Figure a.5.
a.3.6 Put the tips of the fingers of the five fingers together on the palm of the other hand and rotate and rub, see Figure a.5.
a.3.6 Put the tips of the fingers in the palm of the other hand and rotate and rub. The other hand palm rotation rubbing, exchange, see Figure a. 6.
a. 4 under running water to rinse hands thoroughly, dry, take the appropriate amount of hand lotion skin care.
Appendix b
(normative appendix)
Methods for monitoring the effectiveness of hand hygiene
b.1 Sampling time Sampling before contacting patients and carrying out diagnostic and therapeutic activities.
b.2 Sampling method The examinee's five fingers together, with a cotton swab moistened with a sterile eluent containing the corresponding neutralizing agent on the surface of the fingers of both hands from the heel of the finger to the end of the finger back and forth to rub 2 times, a hand rubbing an area of about 30cm2, rubbing the process of simultaneous rotation of the cotton swab; cotton swabs in contact with the operator's part of the cut off into the 10 ml of the sterile eluent containing the corresponding neutralizing agent in a test tube in time to send for testing. Send for inspection.
b.3 Detection method Vibrate the sampling tube on the mixer for 20 seconds or forcefully vibrate 80 times, use a sterile pipette to suck up 1.0 ml of equal samples to be inoculated in sterilized petri dishes, each sample is inoculated with 2 petri dishes, petri dishes with dissolved nutritional agar at 45 ℃ ~ 48 ℃ of 15 ml ~ 18 ml, pouring and shaking, to be agar solidification, placed in the incubator 36 ℃ ± 1 ℃ incubation 48h, counting the number of colonies. Count the number of colonies.
The total number of bacterial colonies is calculated as follows: