The Importance of Hand Hygiene for Infection Prevention

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Have you ever thought about how much work your hands actually do during the day, what they touch or even what they pick up along the way?
"Cover your mouth when you cough"! "Wash your hands before you eat"! No one would argue that hand hygiene is important. Keeping our hands clean is one of the most important steps we can take to avoid getting sick and spreading germs, such as norovirus onto others. 
The glove is a protective barrier between pathogens on the hands of glove wearers and the patient. But is a medical grade disposable glove enough?


TO PUT IT SIMPLY...NO.

Medical safety demands a dual approach that includes both proper hand hygiene and correct disposable glove use. Hand Hygiene plays one of the most important roles in Infection Prevention. Infection Prevention and Control measures aim to ensure the protection of those who might be vulnerable to acquiring an infection both in the general community and while receiving care due to health problems, in a range of settings.1


LET'S TALK HAND HYGIENE

Eagle Protect has partnered with the “Guru of Hand Hygiene,” Barry Michaels, who brings over 50 years’ experience in the field of infectious disease investigation to push the research of disposable gloves farther than anyone ever has. What he has discovered is:

  • GLOVE JUICE

To oversimplify a complex topic, hand hygiene is essential because of the environment created within the disposable glove. Hands contain over 400 sweat glands per square centimetre. The nail region, the most difficult to get pristinely clean, contains the richest microbial flora. Any medical grade glove, whether it is nitrile or latex, will create an environment where oxygen levels decrease and skin maceration creates high microbial counts. Read Barry’s article from the Deb Group’s Hand Hygiene, Infection Prevention Blog, Protective Gloves Get Used and Abused, for a detailed breakdown.

  • LIQUID BRIDGE

As explained by Barry Michaels in the Glove Hazard Analysis & Mitigation Strategies Research Study, the real problem occurs when, due to poor skin health and poor hand hygiene, organisms become resident on the hands. When this occurs, combined with a glove puncture what has been described as a “liquid bridge” of microbial contamination can flow to contact surfaces (Cole & Bernard 1964, Fox 1971). Studies have shown that up to 18,000 Staphylococci can pass through a single glove hole during a 20-minute period, even though the hands had been scrubbed for 10 minutes prior to gloving (Guzewich & Ross 1999). 

MEDICAL GRADE GLOVES AND HAND HYGIENE GO HAND-IN-HAND; NO PUN INTENDED!

The hazards outlined above are just a few of the reasons why hand hygiene plays an essential role in infection prevention. The microbe promoting environment created inside gloves is inevitable, but there are ways to prevent the spread of disease. A combination of these interventions can be effective in the prevention of the transmission of viruses and bacteria in patients.

THREE SIMPLE WAYS QUALITY GLOVES HELP INFECTION PREVENTION

  1. Correct Hand-washing Procedures
    Follow correct hand-washing procedures, including washing around and under fingernails, to limit microbes exposed to the damp inner glove environment.

    Since a lot of infections are spread by touch, washing your hands & then using an alcohol-based hand rub before touching another person is one of the best ways to help stop the spread of these infections. For procedures, PPE equipment should be worn once the following Hand Hygiene steps have been completed.

    Wash your hands with a liquid soap at the following times:

    • When your hands are visibly dirty or contaminated with proteinaceous material, blood or other body fluids.
    • At the beginning and end of each session.
    • When washing your hands, use sinks dedicated for hand washing purposes that are fitted with non-touch tap ware, or employ a non-touch technique. After hand washing, dry your hands using single-use linen or disposable paper towels (not using an air dryer).
    • And of course, after a toilet break. 2

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    Did you know that hand washing alone can prevent about 30% of diarrhoea-related sicknesses and about 20% of respiratory infections (e.g., colds)? 3 4

    When your hands are visibly and clinically clean use an Anti-Bacterial Hand Rub (ABHR) at the following times:

    • Before and after every physical contact.
    • Before gloves are put on and after they are taken off.
    • On entering and leaving the instrument reprocessing areas.
    • After hands inadvertently touch contaminated environmental surfaces, instruments or other equipment.

    Apply the volume of ABHR specified by the manufacturer. Leave your hands to dry naturally; do not dry them with linen or paper towels.

    Follow the measures below to prevent transmission of infection. Damaged skin harbours higher numbers of micro-organisms than intact skin, consequently the risk of skin infection and transmission of infection to others increases:

    • Cover superficial cuts or open skin lesions with a waterproof dressing, even if gloves are worn over the affected area/s.
    • Refrain from direct physical contact if you have an exudative lesion or weeping dermatitis on the lower arms, hands or face that cannot effectively be dressed to prevent transmission until the condition is resolved.
    • Use an aqueous based hand moisturiser regularly to maintain skin health; compatible with the hand hygiene products used. 2

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    Wear appropriate PPE for any procedure or activity associated with a risk of contamination. When gloves are required for procedures, they should:

    • Fit properly for your hand size, not too tight & not too loose.
    • Fingernails should be kept short and clean.
    • Refrain from wearing nail polish, nail jewellery, artificial nails, and jewellery on the hands or arms.
    • A new pair of gloves for each session.
    • Replace gloves as soon as possible if they become soiled or damaged, do not wash gloves as this may damage glove integrity.
    • For general procedures, wear non-sterile examination gloves that comply with AS/NZS 4011; or, when a sterile field is required, wear sterile gloves that comply with AS/NZS 4179.

    By following all these steps above you will help prevent the spread of infection. Do your bit to control what you spread via your hands.

  2. Review of the Type of Glove Touching Your Patient
    Unlike Nitrile gloves and Latex gloves, vinyl glove molecules are not cross-linked leading to more holes in the glove film and higher levels of bacteria and virus permeation. Small holes and breaches to form in vinyl gloves during use will often go unnoticed and can result in measurements of 20,000 bacteria escaping within seconds.

  3. Purchase a Good Quality Glove
    Glove manufacturers can reduce costs by using cheap raw materials which lower glove strength, flexibility, and durability, increasing the rate of glove failure both from the box and during food handling. Glove studies have shown that 50% - 96% of glove punctures go undetected by wearers, and because a single glove hole can release tens of thousands of bacteria from overly moist internal glove surfaces, this becomes an infection risk.   

Choose only disposable gloves that are medical grade, with an AQL 2.5 or less (2.5 glove failures per 100 gloves). Read more about AQL and how it affects food safety here.

Contact our food safety experts to answer all your questions about improving your hand hygiene procedures through the correct use of disposable gloves and clothing. Eagle supplies medical grade disposable gloves and clothing to protect your business, your staff and your customers. 

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References:

  1. World Health Organization. Infection Control. 2016.
  2. Infection Prevention & Control Practice Standards. New Zealand Dental Council. May 2016.
  3. Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev. 2008;(1):CD004265.
  4. Rabie T, Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic review.Trop Med Int Health. 2006;11(3):258-67.