SARI Infection Control - Subcommittee

Executive Summary

Hand hygiene is the responsibility of all individuals involved in the provision of healthcare. As part of the Strategy for the control of Antimicrobial Resistance in Ireland (SARI), the Infection Control Subcommittee has drafted a set of guidelines on hand hygiene for implementation in all healthcare facilities. These are based on the best available evidence and follow an extensive consultation exercise.

Corporate responsibility for implementation of these guidelines lies with the Chief Executive Officer or the Director of each healthcare institution but the individual has an obligation to comply with best practice.

Hand hygiene is the single most important intervention to prevent transmission of infection and should be a quality standard in all healthcare institutions. Senior healthcare workers such as medical consultants, nurse managers and others must act as role models to actively promote hand hygiene and to ensure better compliance.

Social hand hygiene may be achieved with plain soap and warm water or an alcohol hand rub, but antiseptic hand hygiene, such as before patient contact in critical care areas, requires an antiseptic hand wash agent.

Careful consideration needs to be given to choosing a suitable hand hygiene product which has appropriate antimicrobial properties but which also is well tolerated by the user and does not cause adverse effects on the skin.

Social Hand Hygiene

The aim of social hand washing with plain soap and warm water is to remove dirt and organic material, dead skin and most transient organisms On visibly clean hands social hand hygiene may be undertaken using an alcohol hand rub product, and this will effectively remove transient organisms.

Social hand wash involves washing hands with ordinary soap and warm running water for at least 15 seconds, then drying with a disposable paper towel4, 5, 7, 8, 34. A good quality liquid soap rather than bar soap is recommended as it difficult to store bar soap dry at a sink4, 33. A hand wash technique has been described by Ayliffe and Lobury to ensure coverage of all surfaces of the hand33 . Prior to the introduction of this technique it was recognised that certain parts of the hands were often missed such as parts of the thumb, back of the hand, back of fingers, under the nails.