| Hand washing A Tribute to Semmelweis Legacy | | | | Soap/ liquid detergent used with warm water. |
| Dr.T.V.Rao MD | | | | Washing extends up to elbow apart from washing |
| Ignaz Philip Semmelweis (1818-1867) championed the | | | | fingers and palms. |
| importance of hand washing among the medical | | | | Practical Tips in Hand Washing |
| professional. Yet there is no other procedure which is | | | | Use soap and water (if possible mild warm water) |
| simple and cost effective in preventing the spread of | | | | Vigorously rub your hands together until you have |
| infections in hospital environment. It is utmost | | | | generated lather. |
| important duty of every medical, paramedical and | | | | Scrub your wrist between your fingers, under our |
| nursing staff to educate, promote and monitor hand | | | | nails, around the tips and palms of the hands, practice |
| washing. Inspite of more than a century of | | | | this for 15-20 seconds and rinse and dry your hands |
| knowledge many times, this simple procedure is | | | | with clean towel. |
| ignored by the many senior staff. The simple | | | | In view of configuration of hands certain areas of |
| procedure of hand washing is the best prayer in | | | | the hands are relatively less cleared of microbes than |
| prevention of infections in a hospital, continues to be | | | | other surrounding areas. |
| the best remedy in reducing the hospital acquired | | | | Common infections spread by unclean hands: |
| infections. | | | | 1. Drug Resistant Staphylococci |
| The basis of spread of infections in hospital is that | | | | 2. Clostridium spp. |
| microbes are commonly exchanged from patients to | | | | 3. Salmonella, E.coli, Shigella, Hepatitis A&E. |
| patients, patients to medical staff and medical staff | | | | 4. When you are working in ICU and ICCU the |
| to patients. | | | | patients are invariably on broad spectrum antibiotics |
| In the above methods of spread our hands play a | | | | and colonized with multi drug resistant bacteria. Your |
| great role in transmission of infections. By simple | | | | dedicated effort in hand washing will save the lives of |
| procedure of hand washing the chain of events in | | | | serious patients, from infection. |
| spread can be minimised. | | | | 5. In the era of AIDS and Hepatitis B infection all the |
| Methods of hand washing | | | | blood and body secretions are identified as health risk |
| 1. Social hand washing | | | | to all medical/paramedical staff. Hand washing is |
| 2. Hygienic hand washing or disinfection | | | | included as primary importance in the universal |
| 3. Surgical hand washing | | | | precautions. |
| 1. Social hand washing | | | | 6. Wearing a glove is not a total protection in handling |
| Most commonly practiced procedure involves | | | | infectious cases. Even the new gloves contain micro |
| vigorous mechanical friction applied to all surfaces of | | | | holes. Washing is equally important after you remove |
| hand using simple plain (toilet) soap and water for | | | | gloves. |
| 15-20 seconds. If no running water is available store | | | | 7. Your children can be effectively protected from |
| water in a clean container, close lid and only | | | | infection if you teach simple hand washing, even in |
| necessary amount drawn to the needs with a clean | | | | school after attending a toilet or before taking food. |
| mug. After washing, dry hands with tissue paper or a | | | | It is observed that in schools with good washing |
| clean towel. Never use a common towel as the very | | | | facilities the children are less likely to be sick with |
| purpose of washing is lost when you do a clean | | | | infection from communicable diseases. |
| procedure on the patients. | | | | Our goals in hand washing promotion Experience has |
| 2. Hygienic hand washing and disinfection | | | | shown that most effective way to increase hand |
| Hand washing using a disinfectant as 4% | | | | washing is to have physicians, surgeons, senior |
| chlorhexidine gluconate- detergent or Povidone- | | | | paramedical staff and other respected individuals as |
| Iodine detergent solution (containing 0.75% available | | | | role models to consistently wash their hands and |
| Iodine and alcohol) is preferred. | | | | encourage others to do so. |
| The following types of alcohols can be added such as | | | | Social hand washing is also an important procedure to |
| Ethanol- 70% or Isopropanol-70% to 0.5% | | | | be explained to all the patient attendants. As even |
| chlorhexidine or povidone. | | | | attendants get infected while serving and may take |
| 3. Surgical hand washing | | | | home the infection or bring some infections from |
| Hand washing practiced more intensely, usually done | | | | outside when they attend the patients. |
| before surgical procedures or any interventions. | | | | Email tvraodoctor2000@yahoo.co. |