HAND HYGIENE THE 5 MOMENTS

CAC 11-10-15

Nothing’s Changed: Hand Hygiene is Still Important!

• It protects the patient, yourself and the health-care environment from harmful germs carried on your hands

Hand hygiene is the #1 way to prevent the spread of infections!

Overview• The Five Moments

• Patient Zone

• Observations

• Accountability

• Immediate Feedback

The World Health Organization’s 5 Moments of Hand Hygiene

Background

• Why 5 Moments?• Focus on moments when pathogen transmission occurs• Best practice, best for patients• Build awareness• Regulatory citations

Moment 1*:• When: Clean your hands before touching a patient or their immediate surroundings• Immediate surroundings

• Bedside table• Chair• Bed rails• Linens & etc

• Activities• Physical exam• Device manipulation• Assisting with patient movement

*In accordance with patient zone

Moment 2:

• When: Clean your hands immediately before performing any clean/aseptic procedures

• inserting/removing IV• wound care (ex: dressing change)• drawing labs• inserting/removing foley• before meds• before accessing any line

Moment 3:

• When: Clean your hands immediately after exposure to blood or bodily fluids

• obtaining specimens• manipulating lines in any way [including insertion and removal]• wound care• invasive procedures

Moment 4*:

• When: Clean your hands after touching a patient

• physical exam• handshake• moves• blood pressure• ambulation• clinical patient care

*In accordance with patient zone

Moment 5*:

• When: Clean your hands after touching the patient’s immediate surroundings

• bed rails• over-bed table• chair• linens• door handles• light switches, chairs, etc.

*In accordance with patient zone

Understanding the Patient Zone• Perform hand hygiene prior to touching the patient or their

environment (ie: something located within the patient zone)

• Move freely between the patient and their environment• i.e. May touch immediate surroundings and then touch patient

without performing hand hygiene, or vice versa

• Hand hygiene should still be performed:• Before clean/aseptic tasks• After exposure to blood

• Perform hand hygiene prior to exiting the space• i.e. After touching the patient or their surroundings

Patient Zone• The patient zone includes the patient and their immediate

surroundings• Private room/bay = anything with the room/bay• Shared spaces = anything which is currently dedicated to that

specific patient• Overbed tables, bed rails, WOWs, PCAs, chair, etc.

• What is not in the patient zone?• Items/areas that are likely to be contaminated w/ more than just

that patient’s germs• Ex: Computers shared between multiple patients at the same time or

located in common areas; door handles; curtains

Understanding the Patient Zone

A Tricky Component: Gloves• Hand hygiene should be performed before donning gloves to

complete “before” moments• Includes prior to entering the room

• Glove changes require hand hygiene if one of the 5 moments are encountered

AND• Hand hygiene is still required upon removal of gloves to

complete the “after” moment

Hand hygiene is always required prior to donning sterile gloves

Observations- what has changed?• Direct observations of hand hygiene practices

• Observers will observe in patient rooms, during patient care activities

• Immediate feedback provided to HCW• Observers will give feedback on what they observed to the HCW

whenever possible.• Feed back will be provided outside of the patient room, not in the

presence of patients or visitors

• When feed back is delivered from an observer, the appropriate response is “Thank you”

• Any questions or concerns should be directed to Infection Prevention

..but of course, how we perform hand hygiene is also important..

The first step is getting everyone to do hand hygiene..

THANK YOU for your commitment to patient safety!

#wuCares #accountability #everyhandeverytime