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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