NICE highlights how hand washing can save lives

Behind the Headlines

Thursday April 17 2014

Hospital acquired infections can be dangerous for vulnerable patients

Hand washing can help prevent the spread of infection

“Doctors and nurses should do more to stop hospital patients developing infections, an NHS watchdog says,” BBC News reports.

The National Institute for Health and Care Excellence (NICE) has highlighted how basic hygiene protocols, such as hand washing, may be overlooked by some health professionals, which may threaten patient safety.

NICE points out that one in 16 people being treated on the NHS picks up a hospital acquired infection such as methicillin-resistant Staphylococcus aureus (MRSA).

 “It is unacceptable that infection rates are still so high within the NHS” said Professor Gillian Leng, director of Health and Social Care at NICE. “Infections are a costly and avoidable burden. They hinder a patient's recovery, can make underlying conditions worse, and reduce quality of life.”

The measures to reduce infection are laid out by NICE in a “Quality Standard” on “Infection prevention and control” and are outlined below.

 

Now wash your hands

Washing your hands, aside from vaccination, is probably the most effective contribution you can make to public health. Regularly washing your hands, especially after going to the toilet or if you have the cold or the flu, will help prevent the spread of infection.

 

Experts have determined that washing your hands with hot water and soap for the time it takes to sing a verse of “Happy Birthday” should ensure any germs on your hands are destroyed.

What has NICE said?

This NICE Quality Standard lays out six specific statements for NHS staff on preventing and controlling infections. They are based on previous more detailed guidance and are listed below:

  • People should be offered antibiotics according to local guidance about which ones are most suitable. They should only be prescribed antibiotics when they are needed and not for self limiting, mild infections such as colds and coughs, earache and sore throats. This measure is aimed at reducing the problem of antibiotic resistance, which is when an infection no longer responds to treatment with one or more types of antibiotic and so is more likely to spread and can become serious.
  • NHS organisations should aim to continually improve their approach to preventing infection (for example, by sharing information with other organisations and monitoring rates of infection).
  • All health care staff should always clean their hands thoroughly, both immediately before and immediately after coming into contact with a patient or carrying out care, and even after wearing gloves. Hands can usually be cleaned with either soap and water or an alcohol-based handrub; but soap and water must be used when the hands are obviously soiled or contaminated with bodily fluids, or when caring for people with diarrhoea or vomiting. All care providers should be trained in effective hand cleaning techniques. Hand hygiene in hospitals has improved in recent years says NICE, but good practice is still not universal.
  • Staff involved in the care of patients with urinary catheters should minimise the risk of infection by carrying out procedures to make sure that the catheter is inserted, looked after and removed correctly and safely. These procedures include cleaning hands, using a lubricant when inserting the catheter, emptying the drainage bag when necessary, and removing the catheter as soon as it is no longer needed. (A urinary catheter is a thin flexible tube used to drain urine from the bladder).
  • Staff involved in the care of patients who need a vascular access device should minimise their risk of infection by making sure that the device is inserted, looked after and removed correctly and safely. These procedures include using sterile procedures when inserting the device, using the correct antiseptics and dressings, and removing the device as soon as it is no longer needed. A vascular access device is a tube that is inserted into a main vein or artery and used to administer fluids and medication, monitor blood pressure and collect blood samples.
  • Health care staff should give people who have a urinary catheter, a vascular access device or an enteral feeding tube, and any family members or carers who help them, information and advice about how to look after the equipment, including advice about how to prevent infection. Enteral feeding is a type of feeding used for people who cannot eat normally or safely (for example they may have trouble swallowing) in which liquid food is given through a tube directly into the stomach or upper parts of the digestive system.

 

What are the dangers of not washing hands?

Bugs (microbes) such as bacteria and viruses can easily be spread by touch. They may be picked up from contaminated surfaces, objects or people, then passed on to others. 

Effective hand decontamination – either by washing with soap and water or with an alcohol-based handrub – is recognised as crucial in the reducing avoidable infection.

 

What hygiene procedures should visitors to hospitals follow?

When visiting someone in hospital, always clean your hands using soap and water or alcohol handrubs. Do this when you enter or leave a patient’s room or other areas of the hospital. Effective hand decontamination relies on an effective technique, which includes:

  • wetting hands with warm water
  • applying an adequate amount of (preferably liquid) soap
  • rubbing this thoroughly onto all hand surfaces (for at least 10 to 15 seconds)
  • rinsing thoroughly
  • drying thoroughly, preferably with disposable paper towel
  • taps should be then turned off with the paper towel to avoid recontaminating the hands

Alcohol handrub can only be used if hands are free from soling. The handrub needs to be thoroughly rubbed into all hand surfaces until hands are completely dry.

If you are concerned about the hand hygiene of doctors, nurses or anyone else who comes into contact with the patient you are visiting, you are encouraged to ask them whether they have cleaned their hands.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.

Analysis by Bazian

Edited by NHS Choices

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