"Hand Hygiene Guidelines for Irish Healthcare Settings (SARI 2015)"

Hand hygiene is a cornerstone of infection prevention and control in healthcare settings. The Healthcare Infection Society of Ireland (HISI) and the Health Protection Surveillance Centre (HPSC) collaborated to develop the Guidelines for Hand Hygiene in Irish Healthcare Settings in 2015, known as the SAFE HANDS initiative. These guidelines aim to standardize hand hygiene practices, reduce healthcare-associated infections, and improve patient safety. This article delves into the key aspects of these guidelines, ensuring Irish healthcare professionals maintain the highest standards of hand hygiene.

Understanding the Importance of Hand Hygiene

Hand hygiene is the most effective way to prevent the spread of healthcare-associated infections. It reduces the risk of transmitting microorganisms from healthcare workers' hands to patients, from patients to healthcare workers, and from one patient to another. The SAFE HANDS guidelines emphasize the critical role of hand hygiene in preventing healthcare-associated infections, which can lead to increased morbidity, mortality, and healthcare costs.

When to Perform Hand Hygiene

Hand hygiene should be performed at five key moments, as outlined by the World Health Organization (WHO) and reinforced in the SAFE HANDS guidelines:

• Before touching a patient
• After touching a patient
• Before a clean/aseptic procedure
• After a clean/aseptic procedure
• After exposure to body fluids

Additionally, hand hygiene should be performed after using the toilet, blowing your nose, coughing, sneezing, or eating, and whenever hands are visibly soiled.

Hand Hygiene Techniques

The SAFE HANDS guidelines recommend using either alcohol-based hand rub (ABHR) or soap and water for hand hygiene. The choice between the two depends on the clinical situation and local policies.

Alcohol-Based Hand Rub

ABHR is the preferred method for routine hand hygiene due to its rapid onset of action, broad-spectrum activity, and lower potential for skin irritation compared to soap and water. The guidelines recommend using an ABHR containing at least 60% alcohol. To use ABHR effectively, apply a palmful of product to the palm of one hand and rub hands together, covering all surfaces, until hands are dry.

Soap and Water

Soap and water should be used when hands are visibly soiled or contaminated with potentially infectious body fluids. The guidelines recommend using plain or antimicrobial soap. Wet hands thoroughly, apply soap, lather, and rub hands together for at least 20 seconds, ensuring all surfaces are covered. Rinse hands under clean, running water, and dry using a single-use towel or air dry.

Gloves: Use and Limitations

Gloves are not a substitute for hand hygiene but rather a supplement. They should be used when there is a risk of contact with blood, body fluids, or contaminated surfaces. Gloves should be put on after performing hand hygiene and changed as soon as they become contaminated or torn. It is essential to perform hand hygiene immediately after removing gloves to prevent cross-contamination.

Educating and Monitoring Hand Hygiene Compliance

Effective hand hygiene requires ongoing education and monitoring of healthcare workers' compliance. The SAFE HANDS guidelines recommend using a multimodal approach to education, including workshops, posters, and reminders. Monitoring compliance can be achieved through direct observation, patient feedback, and audit. Regular feedback on compliance rates and areas for improvement can help maintain high standards of hand hygiene.

The SAFE HANDS initiative has been instrumental in promoting and standardizing hand hygiene practices in Irish healthcare settings. By adhering to these guidelines, healthcare workers can significantly reduce healthcare-associated infections, improve patient safety, and enhance the quality of care provided. As the guidelines emphasize, "Clean hands save lives."