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Table 3 Observed indications for hand hygiene

From: Helping hands: A cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses

Indication

for hand hygiene

When

Transmission risk

Major targeted

negative infectious

outcome

Examples

Before an aseptic task

Directly before performing an aseptic task

Hand transmission of micro-organisms from any surface (including the patient skin) to a site that would facilitate invasion and infection

Endogenous or exogenous infection of the patient

Giving an injection. Insertion and care of intravenous catheters. Blood draws. Administering intravenous medication. Endotracheal suction

From contaminated body site to another body site

Directly after completing task (whether gloved or ungloved)

Hand exposure to patient's contaminated body sites and fluids potentially containing blood-borne or other pathogens

Infection of the HCW

by patient blood borne

pathogens

Drawing blood and then adjusting the infusion drop count. Handle wound, mucous membrane, and body fluids. After oral care

After touching the patient

Directly after leaving the patient when the patient was touched

Hand transmission of micro-organisms from the patient flora to other surfaces in the healthcare setting

Dissemination of patient flora to the rest of the healthcare

environment and

infection of other patients or HCWs

After skin contact with the patient. Bathing, change position or lifting a patient. Taking a pulse or blood pressure. Shaking hands

After taking care of an infected/colonized patient

Directly after leaving the patient's room

Hand transmission of micro-organisms from the patient flora to other surfaces in the healthcare setting

Dissemination of patient flora to the rest of the healthcare

environment and

infection of other patients or HCWs

Contact with any patient know to be infectious/isolated (eg. MRSA)

After use of gloves

Directly after removing gloves

Hand transmission of micro-organisms from the skin of the HCW 's to other surfaces in the healthcare setting

Dissemination of patient flora to the rest of the healthcare

environment and infection of other patients or HCWs

Wearing gloves high-risk contacts

After contact with patient surroundings

After completing the task and before contacting another patient

Hand transmission of micro-organisms from the patient flora to other surfaces in the healthcare setting

Dissemination of patient flora to the rest of the healthcare

environment and infection of other patient or HCWs

Touching the patient's environment like bed, table, blanket, clothes. After contact with medical equipment in the immediate vicinity of the patient