Hand hygiene technique. How to properly wash hands in medicine: modern requirements for hand hygiene of medical personnel
Washing hands at a social, hygienic, surgical level
Hand washing is the most effective method of preventing nosocomial infections in healthcare facilities.
1) social (routine handwashing);
2) hygienic (disinfection of hands);
3) surgical (sterility of the hands of surgeons is achieved for a certain time).
Conditions for achieving effective hand washing and disinfection, their preparation: short cut nails, no nail polish, no artificial nails, no rings, rings, etc. jewelry. Before processing the hands of surgeons, it is also necessary to remove watches, bracelets, etc.
Regular hand washing. It is carried out before the start of any work.
Target: remove dirt and temporary (transient) microflora from the skin of the hands by washing twice with water and soap.
Indications: when hands are dirty, before medical procedure and after its performance, with and without gloves, when caring for the patient (if the hands are not contaminated with the patient's body fluids), before eating, feeding the patient, and after visiting the toilet.
Equipment: liquid soap, neutral, odorless, soap dispenser (dispenser), watch with second hand, warm running water. To dry hands, use napkins 15x15 single use, a napkin for a tap.
| Stage | Rationale |
| Preparation for the procedure | |
| 1. Fulfill the prerequisites for effective hand washing and disinfection, check the integrity of the skin of the fingers | There may be skin maceration (damage to the epidermis), which prevents hand decontamination |
| 2. Roll up the sleeves of the robe | Draining water should not get on the sleeves of the bathrobe. |
| 3. Open the tap, adjust the water temperature (35-40 0 С) | Optimum water temperature for hand decontamination |
| Performing a procedure | |
| 1. Lather your hands and wash the faucet with soap (the elbow faucet is not washed) | Faucet decontamination in progress |
| 2. Soap your hands for 30 seconds, washing off the soap with water and paying attention to the phalanges and interdigital spaces of the hands, then wash the back and palm of each hand and wash the bases of the thumbs with rotational movements | Uniform decontamination of the hands is ensured if the surface is lathered thoroughly and evenly. At the first soaping, the bulk of the microflora is washed off, then after exposure warm water and self-massage the pores are opened and washed away. It must be remembered that hot water removes the protective fatty layer of the skin |
| 3. Rinse your hands under running water to remove suds by holding your hands so that water runs into the sink from your forearms or elbows (do not touch the sink). Repeat steps 2 and 3 of the procedure | The phalanges of the fingers should remain the cleanest. |
| Completion of the procedure | |
| 1. Close the faucet using a napkin (close the elbow faucet with the movement of the elbow) | |
| 2. Dry your hands with a dry, clean individual towel or with a dryer | According to the principle “from clean to dirty”, i.e. from the fingertips (they should be as clean as possible) to the elbow |
Hygienic level of hand washing
There are two processing methods:
1) Hygienic hand washing with soap and water to remove contaminants and reduce the number of microorganisms;
2) Hygiene treatment of hands with a skin antiseptic to reduce the number of microorganisms to a safe level.
Hand hygiene should be carried out in the following cases:
- before direct contact with the patient;
- after contact with the patient's intact skin (for example, when measuring pulse or blood pressure);
- after contact with secrets or excretions of the body, mucous membranes, dressings;
- before performing various manipulations to care for the patient;
- after contact with medical equipment and other objects in the immediate vicinity of the patient;
- after treatment of patients with purulent inflammatory processes, after each contact with contaminated surfaces and equipment.
Target: remove or completely destroy transient microflora from hands.
Equipment: liquid soap, soap and skin antiseptic dispensers, a watch with a second hand, warm running water (30-40 0 C), sterile tweezers, cotton balls, wipes, skin antiseptic, a waste disposal container with a disinfectant solution.
Run mandatory conditions - the same as for social processing of hands. To dry hands, clean cloth towels or disposable paper towels are used; when treating the hands of surgeons, only sterile cloth ones are used.
It is important to observe the exposure time: hands must be wet from the use of an antiseptic for at least 15 s.
Hand treatment rules medical staff And skin patients.
1. In order to prevent nosocomial infections, the hands of medical workers (hygienic treatment of hands, treatment of the hands of surgeons) and the skin of patients (treatment of the operating and injection fields, elbow folds of donors, sanitization of the skin) are subject to disinfection.
Depending on the medical manipulation being performed and the required level of reduction of microbial contamination of the skin of the hands, medical personnel carry out hygienic processing of hands or processing of hands of surgeons. The administration organizes training and monitoring of compliance with hand hygiene requirements by medical personnel.
2. To achieve effective washing and disinfection of hands, the following conditions must be observed: short-cut nails, no nail polish, no artificial nails, no rings, rings and other jewelry on the hands. Before processing the hands of surgeons, it is also necessary to remove watches, bracelets, etc. To dry hands, use clean cloth towels or single-use paper napkins; when treating the hands of surgeons, only sterile cloth ones are used.
3. Medical staff must be provided in sufficient numbers effective means for washing and disinfecting hands, as well as hand skin care products (creams, lotions, balms, etc.) to reduce the risk of contact dermatitis. When choosing skin antiseptics, detergents and hand care products, individual tolerance should be taken into account.
Hygienic processing of hands.
Hand hygiene should be carried out in the following cases:
Before direct contact with the patient;
After contact with the patient's intact skin (for example, when measuring the pulse or blood pressure);
After contact with body secrets or excretions, mucous membranes, dressings;
Before performing various manipulations to care for the patient;
After contact with medical equipment and other objects in the immediate vicinity of the patient.
After treatment of patients with purulent inflammatory processes, after each contact with contaminated surfaces and equipment;
Hand hygiene is carried out in two ways:
Hygienic hand washing with soap and water to remove contaminants and reduce microbial counts;
Hand sanitizing to reduce microbial counts to safe levels.
1. Hand washing apply liquid soap using a dispenser. Dry hands with an individual towel (napkin), preferably disposable.
2. Hygienic treatment of hands with an alcohol-containing or other approved antiseptic (without prior washing) is carried out by rubbing it into the skin of the hands in the amount recommended by the instructions for use, paying attention Special attention on the treatment of the fingertips, the skin around the nails, between the fingers.
3. When using the dispenser, a new portion of the antiseptic (or soap) is poured into the dispenser after it has been disinfected, rinsed with water and dried. Preference should be given to elbow dispensers and dispensers on photocells.
4. Skin antiseptics for hand treatment should be readily available at all stages of the diagnostic and treatment process. In units with a high intensity of patient care and a high workload on staff (intensive care units, etc.), dispensers with skin antiseptics for hand treatment should be placed in places convenient for use by staff (at the entrance to the ward, at the bedside of the patient and etc.). It should also provide for the possibility of providing medical workers with individual containers (vials) of small volumes (up to 200 ml) with skin antiseptic.
1. Remove rings, rings and other jewelry, because. they make it difficult effective removal microorganisms.
2. Under a moderate stream of comfortable warm water, hands should be vigorously lathered and rubbed against each other for at least 10 seconds the following methodology:
Rub hands palm to palm;
Right palm over the back of the left palm and vice versa;
Palm to palm, fingers crossed;
Fold your fingers "in the lock", rub your fingers against each other;
Friction with the rotational movements of the thumb right hand, clamped in the left palm and vice versa;
Friction with rotational movements back and forth with the fingers of the right hand compressed into a pinch on the left palm and vice versa.
3. Rinse your hands under running water.
4. Dry your hands with a paper towel, then turn off the tap.
Use of gloves.
1. Gloves must be worn in all cases where contact with blood or other biological substrates, potentially or obviously contaminated microorganisms, mucous membranes, damaged skin is possible.
2. It is not allowed to use the same pair of gloves when in contact (for care) with two or more patients, when moving from one patient to another or from a contaminated area of the body to a clean one. After removing gloves, hand hygiene is carried out.
3. When gloves are contaminated with secretions, blood, etc. in order to avoid contamination of hands in the process of removing them, a swab (napkin) moistened with a solution of a disinfectant (or antiseptic) should be removed to remove visible contamination. Remove gloves, immerse them in the product solution, then discard. Treat hands with an antiseptic.
In order to prevent blood-borne infections, gloves must be worn before any parenteral manipulation in the patient. After removing gloves, hand hygiene is carried out.
Change of work clothes in the hospital.
4. Personnel provided with funds personal protection in the required quantity and appropriate sizes (gloves, masks, shields, respirators, aprons, etc.) depending on the profile of the department and the nature of the work performed.
5. Medical personnel must be provided with sets of change of clothes: gowns, caps, change of shoes in accordance with the equipment sheet, but not less than 3 sets of overalls per worker.
In the operating unit, doctors and other persons involved in the operation must work in sterile gowns, gloves and masks. Changeable shoes must be nonwoven fabric.
6. Washing of clothes of the staff should be carried out centrally and separately from the linen of patients.
7. Change of clothes in the units of the surgical and obstetric profile is carried out daily and as it gets dirty. In institutions of a therapeutic profile - 2 times a week and as it gets dirty. Replaceable shoes for personnel working in aseptic rooms should be made of non-woven material available for disinfection. Change of clothes and shoes should also be provided for medical personnel of other units providing advisory and other assistance, as well as for engineering and technical workers.
8. During the manipulation of the patient, the staff should not keep records, touch the handset, and the like.
Eating is prohibited in the workplace.
It is not allowed to be in medical clothes and shoes outside the medical facility.
Surgical treatment hands
The processing of the hands of surgeons is carried out by everyone involved in surgical interventions, childbirth, catheterization of the main vessels. Processing is carried out in two stages:
Stage I - washing hands with soap and water for two minutes, and then drying with a sterile towel (napkin);
Stage II - antiseptic treatment of the hands, wrists and forearms.
The amount of antiseptic required for processing, the frequency of processing and its duration are determined by the recommendations set forth in the guidelines / instructions for the use of a particular agent. An indispensable condition for effective hand disinfection is keeping them moist for the recommended treatment time.
Sterile gloves are put on immediately after the antiseptic has completely dried on the skin of the hands.
Classical methods of processing the surgeon's hands:
For the treatment of hands, the following solutions of antiseptics are used:
a) Pervomur S-4 (2.4% or 4.8%)
Pervomur is used during the day. Before use, mix 17.1 ml of 33% hydrogen peroxide and 6.9 ml of 100% formic acid. The reagent is placed in the refrigerator for 1 hour, shaking alternately. Before use, the mixture is poured into a basin with water up to 10 liters. Wash hands in a basin with the prepared solution for 1 minute. Dry hands and put on gloves.
b) cerigel
4 ml of cerigel is applied to the hands. It is rubbed for 10-15 seconds. A film forms on the hands.
c) chlorhexidine bigluconate (gibitan) - 0.5% alcohol solution.
Hands are treated with two napkins plentifully moistened in cerigel for 2 minutes each.
Disinfection of the skin of patients (injection and surgical fields)
Treatment of the surgical field of the patient before surgery and other manipulations associated with a violation of the integrity of the skin (punctures, biopsies), it is preferable to carry out an antiseptic containing a dye.
Treatment of the injection field provides for skin disinfection with an alcohol-containing antiseptic at the injection site (subcutaneous, intramuscular, intravenous) and blood sampling.
To treat the elbow bends of donors, the same antiseptics are used as for the treatment of the surgical field.
For sanitizing the skin patients (general or partial) use antiseptics that do not contain alcohols, which have disinfecting and washing properties. Sanitary treatment is carried out on the eve of surgery or when caring for a patient.
1. Remove all rings from your hands (depressions on the surface of jewelry are a breeding ground for microorganisms).
2. Move the watch above the wrist or take it off.
3. Clean the areas under the nails with a nail cleaner under running water.
4. Apply 3-5 ml of liquid soap to your hands or lather your hands thoroughly with bar soap.
5. Wash your hands using the following technique:
Vigorous mechanical friction of the palms (repeat 5 times);
The right palm washes the back of the left hand with rubbing movements, then left palm washes the rear of the right hand (repeat 5 times);
Palm to palm, fingers of one hand in the interdigital spaces of the other (repeat 5 times);
The back of the fingers to the palm of the other hand (fingers interlaced - repeat 5 times);
Alternating rotational friction of the thumbs of one hand with the palms of the other, palms clenched (repeat 5 times);
Variable friction of the palm of one hand with the closed fingers of the other hand (repeat)
fig.6. Hand washing.
6. Rinse your hands under running water, hold them so that the wrists and hands are below the level of the elbows and to avoid contamination from touching the sink, bathrobe and other objects.
7. Close the tap, grasping it only through paper towel as it can be a source of pollution.
8. Dry hands with sterile gauze.
8. Carefully treat the skin of the hands for 2-3 minutes with 2 swabs moistened with 70% alcohol or an alcohol-containing skin antiseptic with a virucidal effect (at least one minute on each hand) or apply 5-8 ml of 70% on the palmar surfaces ethyl alcohol or an alcohol-containing skin antiseptic that has a virucidal effect and rub into the skin for 2 minutes.
9. Throw away the used balls into a container for disinfection.
10. Put on gloves according to the algorithm of actions.
Use of protective clothing.
Bathrobes.
With the exception of operating rooms or dressing rooms, where sterile gowns are worn to protect the patient, the main purpose of gowns is to prevent the entry of infectious agents on the clothes and skin of personnel.
Beanies.
Medical caps securely cover the hair, preventing it from acting as a source of pollution.
Aprons.
Rubber and polyethylene aprons are necessary to protect the overalls and skin of personnel in case of the threat of splashing of blood and other and other biological fluids and secretions.
Masks.
Masks are necessary to avoid airborne transmission of microorganisms, as well as in cases where there is a possibility of liquid substances of the human body entering the nose or mouth. They are especially important when personnel work directly on a large wound surface, such as open surgical wounds or burns, or in procedures with infectious patients from whom the infection can be easily transmitted by airborne droplets.
Masks should be replaced every 3-4 hours (depending on the type of work performed) or when they are moistened during work. Masks must not be lowered around the neck, reused. All masks must completely cover the nose and mouth.
The question of the need for hand hygiene by medical personnel was first raised only in the middle of the 19th century. At that time, due to unsanitary conditions in Europe, almost 30% of women in childbirth died in hospitals. The main cause of death was the so-called puerperal fever. It often happened that doctors went to women in labor after dissecting corpses. At the same time, they did not treat their hands with anything, but simply wiped them with a handkerchief.
Types of processing
Keeping hands clean is prerequisite for all medical personnel. Hygienic treatment of the hands of medical staff can be carried out in two ways:
- removing impurities and reducing the number of microorganisms on the skin of the hands with soap and water;
- the use of special alcohol-containing skin antiseptics, which can reduce the number of bacteria on the skin to a minimum level.
Only the second method can be called hygienic processing of hands. The first is only hygienic washing. Hands should be washed with liquid soap with a dispenser and dried with an individual disposable towel. But disinfection is carried out using skin antiseptics.
According to the rules, medical personnel must always have hand sanitizers available. In addition, they must be provided with creams, balms, and lotions intended for skin care. After all, with constant hygienic treatment, the risk of developing contact dermatitis increases. Also, the selection of detergents and antiseptics should be carried out taking into account individual intolerance.
Important conditions
Each hospital employee should know when hygienic treatment of the hands of medical staff should be carried out. This is required in the following situations:
- before and after contact with each patient;
- before and after putting on gloves that are used during medical procedures, contact with excreta or body secrets, dressings, mucous surfaces;
- after contact with intact skin, for example, after measuring blood pressure, pulse, shifting the patient;
- after working with equipment that is located in the immediate vicinity of the patient;
- after treatment of patients with various pyoinflammatory processes.
If there is a clear contamination of the skin of the hand with blood or secretions of the patient, then first they must be thoroughly washed with soap and water and dried. After that, they must be treated twice with an antiseptic.
Hand washing technique
Do not forget the importance of cleansing the skin, not only in hospitals, but also in other places. Hand processing technique remains the same everywhere. Before proceeding with the procedure, it is necessary to remove all rings, watches and bracelets. Any foreign objects make it difficult to remove pathogens. It is advisable to wash your hands with moderately warm water.
To increase the effectiveness of the procedure, you must first moisten your hands and squeeze them onto them. The hand treatment algorithm looks like this:
- Lather the soap by intensively rubbing the palms together.
- Rub one palm against the other in a reciprocating motion.
- Rub the back surface of the right hand with the left palm and vice versa.
- Connect the fingers of the right hand and the interdigital spaces of the left, carefully process them.
- It is necessary to go through the inner surface of the fingers.
- Cross your outstretched fingers and rub your palms together.
- Fasten and walk the back of your fingers across the palm of your hand.
- Rub thoroughly in circular motions thumb, for this its base must be covered by a large and index fingers other hand.
- The wrist is processed in a similar way.
- Rub your palms with your fingertips in a circular motion.
Each movement should be repeated at least 5 times, and the total duration of such a wash should be about a minute.
Rules for medical personnel
Every employee of hospitals and clinics should know how the hands of medical staff should be treated. SanPiN (scheme proper washing above) establishes the procedure for not only cleaning the skin, but also disinfecting them. Health care providers should also be aware of the following:
- short cut nails without varnish;
- the absence of rings, rings and other similar jewelry.
Nail polish can cause unwanted dermatological reactions that can lead to secondary infection. In addition, dark varnish does not allow assessing the degree of cleanliness of the subungual space. This may result in poor processing. Cracked varnish is considered the most dangerous. Indeed, in this case, it becomes more difficult to remove microorganisms from the surface of the hands.
The very performance of a manicure is associated with microtraumas that are easy to infect. This is one of the reasons why medical professionals are not allowed to wear false nails.
Any jewelry or costume jewelry can cause the hygienic treatment of the hands of medical staff to become less effective. In addition, because of them, gloves can be damaged, and the process of donning them is complicated.
Nuances for surgeons
The processing of the hands of people involved in surgical interventions is carried out according to a slightly modified scheme. So, for example, the washing time for them is extended and is 2 minutes. The further hand processing algorithm is as follows. After mechanical cleaning, it is necessary to dry the skin with a sterile tissue or disposable paper towel.
In addition to washing, antiseptic treatment is also important. Attention must be paid not only to the hands, but also to the wrists and forearms. During the prescribed treatment time, the skin should remain moist. You can not wipe your hands, you must wait until the antiseptic is completely dry. Only then can surgeons put on gloves.
Selection of hygiene products
Many people now opt for antibacterial soap. But it is important to follow the technique of cleaning the skin. If done right, washing your hands with regular soap will be just as effective. In surgical practice, they use special means for antiseptic hand treatment. The soap contains chlorhexidine gluconate or povidone-iodine. These substances are able to reduce the number of bacteria by 70-80% at the first application and by 99% at the second application. At the same time, when using povidone-iodine, the microflora grows faster than when in contact with chlorhexidine.
To be in full compliance regulatory requirements hygienic treatment of the hands of the medical staff took place, it is desirable to equip medical institutions. They are controlled without the participation of the hands.
Also in surgical practice, brushes can be used to clean hands, but this is not considered mandatory. They must be either sterile, disposable, or capable of withstanding autoclaving.
Time periods
In surgical practice, special rules for cleaning the skin are established. After the usual thorough washing according to the established protocol, they should be disinfected.
It is imperative that the hands of the medical staff be processed. SanPin (the washing scheme remains the same) provides that skin cleaning before surgical procedures can be carried out using the same means as hygienic.
It is important to remember that throughout the entire period of disinfection of hands, they must remain moist. For the procedure, as a rule, it is necessary to use more than 6 ml of antiseptic. As a result of research, it was found that for the qualitative destruction of bacteria, a five-minute treatment of the skin is sufficient. It has also been confirmed that performing this procedure for three minutes reduces the number of microorganisms to an acceptable level.
Hand sanitizer rules
After thoroughly washing the skin of the hands, wrists and forearms, it is necessary to dry them. After that, the established standard for the processing of hands for workers in operating units provides for the need to use special disinfectants.
Before this, if necessary, it is necessary to process the nail beds and periungual ridges. For these purposes, sterile disposable wooden sticks are used, which must be additionally moistened with an antiseptic.
The disinfectant is applied in 2.5 ml to the hands and forearms. About 10 ml of disinfectant liquid should be spent on one treatment of two hands. The antiseptic must be rubbed into the skin in the same way that hand washing is carried out, observing the correct sequence of movements.
Only after complete absorption / evaporation of the product, you can wear gloves. If it lasts more than 3 hours, then the treatment is repeated. After all, pathogens can begin to multiply under gloves again.
Final stage
But this is not all levels of hand processing. It is important to remove gloves after working and wash your hands with soap and water. In this case, it is no longer necessary to use a disinfectant solution. Washing with liquid soap is enough, it is desirable that its pH is neutral.
After cleaning the skin, they must be moisturized. For these purposes, various creams and lotions are used. Their main purpose is to prevent the drying effect of alcohol-containing disinfectants.
Separately, it should be noted that the hygienic treatment of hands in the absence of visible contamination can be performed without washing. In most cases, it is enough to use antiseptic solutions for 30-60 seconds.
Possible Complications
It should be noted that the regular use of disinfectants is not the most in the best way affects the skin of healthcare workers. There are two main types of reactions experienced by hospital staff. Most often they complain of itching, dryness, irritation, the appearance of cracks with bleeding. These symptoms can be both minor and significantly affect general state workers.
There is also another type of complications - allergic dermatitis. They occur with intolerance to any components of products intended for hand disinfection. Allergic dermatitis can manifest itself both in mild localized and in severe generalized form. In the most advanced cases, they can be combined with respiratory distress syndrome or other manifestations of anaphylaxis.
The prevalence of complications and their prevention
You can understand the significance of the problem if you know that such methods of hand washing lead to the fact that 25% of nurses present with signs of dermatitis, and 85% reported that they had a history of skin problems.
You can slightly reduce the irritating effect of antiseptics if you add emollients to them. This is one way to reduce the prevalence of contact dermatitis. Also, the risk of their occurrence can be minimized by using moisturizers that are designed for hand skin care after each wash.
To prevent the development of complications, do not wash your hands every time before treating them with an antiseptic. In addition, it is important to ensure that gloves are put on only when the skin is completely dry.
Do not neglect the use of moisturizers. On the market you can find special protective creams designed to prevent the onset of contact dermatitis. However, as a result of studies, it was not possible to confirm their unambiguous effectiveness. Stops many high price for these creams.
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There are 3 levels of decontamination (disinfection) of hands:
1. Social.
2. Hygienic (disinfection).
3. Surgical.
SOCIAL PROCESSING LEVEL
Washing lightly soiled hands twice with soap and water. Allows you to remove most transient microorganisms from the skin.
Social processing of hands is carried out:
Before eating
After going to the toilet
Before and after patient care
When hands are dirty
Before putting on gloves After taking off gloves
EQUIPMENT: soap, liquid soap, wipes, sterile towel.
When using soap, it must be kept dry (by hanging or stored in a special soap dish) to prevent contamination by some microorganisms that grow in such an environment.
ALGORITHM
2. Lather your palms, wash your hands by vigorously rubbing soapy palms for 10 seconds, rinse off the soap under running water, hold your hands so that your wrists and hands are above elbow level.
NOTE: In this position, water flows from the clean area to the dirty area.
ATTENTION: DO NOT USE A WET TOWEL!!!
Given the number of microorganisms transmitted through the hands, it is important to understand that hand washing is a serious prevention of nosocomial infections and viral hepatitis.
HYGIENIC LEVEL OF HAND PROCESSING
A certain washing technique, including the use of antiseptics. It's over effective method removal and destruction of microorganisms.
Hygienic treatment of hands is carried out:
Before performing invasive procedures
Before caring for an immunosuppressed patient
Before and after wound care, urinary catheter
Before putting on and after removing gloves
After contact with body fluids
Before working with a sterile table
EQUIPMENT: soap, liquid soap, skin antiseptic, sterile wipes or disposable towels.
ALGORITHM
1. Remove all rings from your hands, remove your watch, turn on the faucet using a disposable cloth, adjust the water temperature.
2. Soap your palms, wash your hands by vigorous mechanical friction of soapy palms for 10 seconds:
1) rubbing the palms
2) palm to palm: friction between the interdigital spaces
3) washing the back of the fingers with the opposite palm
4) alternate rubbing the thumbs
5) carry out alternating friction of the palms with the fingers of the other hand. Wash off the soap under running water.
3. Turn off the tap using a paper towel and dry your hands with a disposable towel.
4. Apply 3-5 ml of antiseptic.
PROCESSING OF HANDS AND MUCOUS IN CONTACT WITH BIOLOGICAL FLUIDS.
1. When the skin of the hands is contaminated with secretions, blood, etc. wash hands with soap and water; dry hands thoroughly with a disposable towel; treat twice with an antiseptic.
2. Treat gloved hands with a napkin moistened with a disinfectant, then wash with running water, remove gloves, wash hands and treat with a skin antiseptic.
3. If the biological fluid gets on the mucous membranes of the oropharynx, immediately rinse the mouth and throat with 70% alcohol or 0.05% potassium permanganate solution.
4. If biological fluids get into the eyes, rinse them with a solution of potassium permanganate in water at a ratio of 1:10000.
5. In case of injections and cuts, wash hands without removing gloves with running water and soap, remove gloves, squeeze blood out of the wound, wash hands with soap and treat the wound 5% alcohol tincture iodine. If there are microtraumas, scratches, abrasions on the hands, seal the damaged areas with adhesive tape.
6. According to indications, emergency prevention of hepatitis and HIV infection is carried out.
7. In case of injuries, including microtraumas (shots, cuts), dangerous in terms of infection, the person responsible for the prevention of parenteral infections in the health facility organizes registration in the injury register and draws up an act in accordance with the legislation of the Russian Federation.
8. For hand skin care, softening and protective creams are used to ensure skin elasticity and strength.
Disinfection
Disinfection is a system of measures aimed at the complete destruction of pathogenic microorganisms and the destruction of conditionally pathogenic organisms to a safe level in environmental objects.
When disinfecting high level(TLD) only certain types of spores of microorganisms remain viable (used for the final processing of flexible endoscopes).
Types of disinfection
1. Preventive - before the appearance of cases of infectious diseases (chlorination tap water cleaning of premises with disinfectant solutions).
2. Focal - when a focus of the disease appears (in an apartment, hospital, etc.) It is divided into:
1) current - from the moment of detection infectious disease before removing the patient from the focus;
2) final - after removal of the patient from epid. hearth.
Disinfection methods
Wet cleaning of premises and furnishings;
Freeing the premises from dust using a vacuum cleaner, whitewashing, painting the premises;
Hand washing.
2. Physical means and methods (thermal):
Irradiation ultraviolet radiation;
Ironing with a hot iron;
Burning garbage and items of no value;
Treatment with boiling water or heating to a boil;
Pasteurization;
Boiling.
3. Chemical Methods (Chemical substance that destroys microorganisms):
Irrigation;
Rubbing;
Full immersion;
Spraying (use aqueous solutions, emulsions, powders).
Disinfection control methods:
1. Visual (st. m/s, ch. m/s, epidemiologist);
2. Chemical (indicator strips - determine the percentage concentration of the active substance in the working solution).
3. Bacteriological (washouts).
Documentation for working with disinfectants:
1. "Journal of receipt and expenditure of disinfectants";
2. "Working Instructions for Cooking disinfectant solution»;
3. "Folder with the results of chemical control of the percentage concentration of the active substance in the working solution."
PRECAUTIONS FOR HANDLING DISINFECTANTS
1. Used for disinfection, pre-sterilization treatment, sterilization, disinfection chemicals have varying degrees of local and general toxic effects.
2. Persons at least 18 years of age who have undergone appropriate instruction on duties, safety precautions, precautions and prevention of accidental poisoning, as set out in the "Rules for labor protection of employees of disinfection departments, preventive disinfection departments of sanitary and epidemic stations, individual disinfection plants, approved by the Ministry health care of the USSR 09.02.1979 No. 1963-79. Responsible for the briefing is the head physician of the institution or a specially designated person.
3. Persons with hypersensitivity to the chemicals used and allergic diseases are excluded from working with them.
4. When carrying out work, it is necessary to observe the rules of personal hygiene. It is forbidden to smoke, drink, eat food. After work open areas body (face, hands) wash with soap and water.
5. Soaking linen, dishes and other items in solutions of disinfectants, pre-sterilization treatment and sterilization of medical devices with chemicals is carried out in special rooms equipped with supply and exhaust ventilation.
6. Preparation of working solutions of disinfectants is carried out in well-ventilated areas. Store solutions and keep processed objects in them in tightly closed containers. Stocks of drugs are stored in places inaccessible to common use, V dark dishes, in a dry, dark and cool room. All disinfectants and solutions must be labeled with the name, concentration, date of manufacture and expiration date. In departments, disinfectants and their solutions are kept under lock and key in places inaccessible to children and persons not engaged in disinfection, separately from medicinal preparations.
7. The sequence is strictly observed, and the stages of washing and disinfection are precisely carried out, ensuring the maximum removal of residues of detergents and disinfectants from the processed objects.
8. All work with disinfectants, chemicals is carried out in accordance with the instructions.
9. When cleaning up a spilled concentrate, the product must be used protective clothing, boots and personal protective equipment: respiratory organs with universal respirators of the RPG-67 or RU-60M type with a brand B cartridge; eye - sealed glasses; skin of hands - rubber gloves. The spilled concentrated agent should be adsorbed with a moisture-retaining substance (sand, sawdust) or rags and sent for disposal. It is forbidden to drain the concentrated agent into the sewer.
First aid for accidental poisoning with disinfectants.
1. In case of violation of the operating mode, non-observance of precautionary measures and in emergency situations, the personnel may experience general poisoning or local irritation with disinfectants. characteristic of most used chemicals disinfection and sterilization is an irritating effect on the skin, mucous membranes of the eyes, respiratory tract.
2. If the drug gets on the skin, immediately wash off this area clean water. Lubricate the skin with a softening cream.
3. If signs of irritation of the respiratory system appear, stop working with the product. Remove the victim from the premises immediately Fresh air or in a well-ventilated area, rinse mouth and nasopharynx with water, seek medical advice if necessary.
4. If the drug gets into the eyes, immediately rinse them under running water for 10-15 minutes, drip with a 30% solution of sodium sulfacyl. Urgently consult a doctor.
5. If the product enters the stomach, give the victim several glasses of water with 10-20 crushed tablets activated carbon. Do not wash the stomach. Seek medical attention if necessary.
Read the instructions and precautions carefully before using any new disinfectant.
TECHNIQUE FOR PREPARING DISINFECTANTS PURPOSE: use for disinfection, according to the order for compliance with the sanitary and epidemiological regime.
EQUIPMENT:
Overalls:
Long robe
Beanie
Oilcloth apron
Medical gloves
Respirator (4 ply gauze mask)
Protective glasses
Indoor shoes
Des. means
- containers:
For labeled water with caps
For disinfectant solution labeled with lids
For detergents labeled with lids.
ATTENTION: See instructions for preparation and use
| STAGES | RATIONALE |
| PREPARATION FOR THE PROCEDURE | |
| 1. Put on overalls. | Ensuring the safety of m / s in the workplace |
| 2. Prepare equipment | Clarity in work |
| 3. check the labeling (name of disinfectant, concentration, purpose, date of preparation) | Ensuring Personal Responsibility |
| PERFORMING THE PROCEDURE | |
| 1.Pour water into the container up to the mark | |
| 2,Put the disinfectant into the water container | Compliance with the methodology for preparing a solution of percentage concentration |
| 3. Stir the solution wooden spatula | |
| 4. Close the lid | |
| 5. On the tag, put the date of preparation of the solution and the signature of the m / s. | Ensuring continuity in work with des. solutions, personal responsibility. |
