How to wash your hands correctly. Hand washing at the social, hygienic, surgical level Methods of hand washing in medicine

• subungual space
• periungual ridges
• fingertips

• interdigital spaces
• thumb notch

Hand hygiene of medical personnel - presentation:

Problems

Allergist Alexey Semenovich Dolgin believes that many problems can be avoided. In almost half of the cases, medical staff do not comply with all WHO recommendations.

“The main mistake is that doctors do not wait until their hands are completely dry after washing. The antiseptic is rubbed into damp skin. And this will definitely lead to irritation.”

Constant hand disinfection inevitably leads to rashes, dermatitis and skin irritation. Most often, allergies are caused by substances that are added to ethyl alcohol: iodine, triclosan, and some ammonium compounds. Experienced surgeons claim that when cleansing with pure ethyl alcohol allergic reactions was many times less, and the disinfection effect remained high.

Medical personnel are advised not to wash their hands vigorously hot water, use alkaline soap and hard brushes to wash your nails. If you have excessive dryness, you should moisturize your skin. protective equipment(usually before bedtime), avoid aggressive substances. This will help minimize allergic skin reactions.

The issue of the need for hand hygiene by medical personnel was first raised only in the middle of the 19th century. At that time, due to unsanitary conditions in Europe, almost 30% of women giving birth died in hospitals. The main cause of death was the so-called puerperal fever. It often happened that doctors went to women giving birth after dissecting corpses. At the same time, they did not treat their hands with anything, but simply wiped them with a handkerchief.

Types of processing

Keeping hands clean is mandatory for all healthcare personnel. Hygiene treatment of medical staff’s hands can be carried out in two ways:

• removing contaminants and reducing the number of microorganisms on the skin of the hands using soap and water;
• the use of special alcohol-containing skin antiseptics, which reduce the number of bacteria on the skin to a minimum level.

Only the second method can be called hand hygiene. The first is just hygienic washing. Hands should be washed with liquid soap with a dispenser and dried with an individual disposable towel. But disinfection is carried out using skin antiseptics.

According to the rules, medical personnel must always have hand sanitizer available. In addition, they must be provided with creams, balms, and lotions intended for skin care. Indeed, with constant hygienic treatment, the risk of developing contact dermatitis increases. Also selection detergents and antiseptics should be carried out taking into account individual intolerance.

Important Terms

Every hospital employee should know when the hands of medical staff should be sanitized. This is necessary in the following situations:

• before and after contact with each patient;
• before and after putting on gloves that are used during medical procedures, contact with excreta or body secretions, dressings, mucous surfaces;
• after contact with intact skin, for example, after measuring blood pressure, pulse, or shifting the patient;
• after working with equipment that is located in close proximity to the patient;
• after treating patients with various purulent-inflammatory processes.

If there is obvious contamination of the skin of the hand with the patient’s blood or secretions, they must first be thoroughly washed with soap and water and dried. After this, they must be treated twice with an antiseptic.

Hand washing technique

Do not forget about the importance of cleansing the skin not only in hospitals, but also in other places. The hand treatment technique remains the same everywhere. Before starting the procedure, you must remove all rings, watches and bracelets. Any foreign objects make it difficult to remove pathogenic microorganisms. It is advisable to wash your hands with moderately warm water.

To increase the effectiveness of the procedure, you must first wet your hands and squeeze liquid soap onto them. The hand processing algorithm looks like this:

1. Lather the soap by vigorously rubbing your palms together.
2. Rub one palm against the other in a back-and-forth motion.
3. Rub the back of your right hand with your left palm and vice versa.
4. Connect the fingers of the right hand and the interdigital spaces of the left, carefully process them.
5. It is also necessary to go through the inner surface of the fingers.
6. Cross your outstretched fingers and rub your palms together.
7. Clasp your hands and walk the backs of your fingers across your palm.
8. Thoroughly rub your thumb in a circular motion; to do this, you need to cover its base with the thumb and forefinger of your other hand.
9. The wrist is treated in a similar way.
10. Rub your palm with your fingertips in a circular motion.

Each movement should be repeated at least 5 times, and the total duration of this wash should be about a minute.

Rules for medical personnel

Every hospital and clinic worker should know how to clean the hands of medical staff. SanPiN (the proper washing diagram is given above) establishes the procedure for not only cleaning the skin, but also disinfecting it. Healthcare workers should also remember the following requirements:

• short-cut nails without varnish;
• absence of rings, signet rings and other similar jewelry.

Nail polish can cause unwanted dermatological reactions that can lead to secondary infection. In addition, dark varnish does not allow assessing the degree of cleanliness of the subungual space. This may cause poor processing. Cracked varnish is considered the most dangerous. Indeed, in this case, it becomes more difficult to remove microorganisms from the surface of the hands.

Performing a manicure itself is associated with microtraumas that can easily become infected. This is one of the reasons why medical professionals are prohibited from wearing false nails.

Any jewelry or costume jewelry can cause the hand hygiene of medical staff to become less effective. In addition, they can damage gloves and make putting them on more difficult.

Nuances for surgeons

The treatment of the hands of people participating in surgical interventions is carried out according to a slightly modified scheme. For example, the washing time for them is extended and amounts to 2 minutes. The further algorithm for processing hands is as follows. After mechanical cleaning, it is necessary to dry the skin using a sterile fabric or disposable paper towel.

In addition to washing, treatment with an antiseptic is also important. Attention must be paid not only to the hands, but also to the wrists and forearms. The skin should remain moist during the specified treatment time. You cannot wipe your hands; you must wait until the antiseptic has completely dried. Only after this can surgeons put on gloves.

Selection of hygiene products

Many people are now opting for antibacterial soap. But it is important to follow the skin cleansing technique. If done correctly, washing your hands with regular soap will be just as effective. In surgical practice, special means are used for antiseptic hand treatment. The soap contains chlorhexidine gluconate or povidone iodine. These substances can reduce the number of bacteria by 70-80% upon first use and by 99% upon repeated use. Moreover, when using povidone-iodine, the microflora grows faster than when in contact with chlorhexidine.

To be in full compliance regulatory requirements The hands of medical staff were sanitized; it is advisable to equip medical institutions with elbow dispensers. They are controlled without the use of hands.

Also in surgical practice, brushes can be used to clean hands, but this is not considered necessary. They must be either sterile for single use or capable of withstanding autoclaving.

Time periods

In surgical practice, special rules for cleaning the skin have been established. After the usual thorough washing according to the established protocol, they must be disinfected.

It is mandatory to sanitize the hands of medical staff. SanPin (the washing scheme remains the same) stipulates that skin cleansing before surgical procedures can be carried out using the same means as hygiene.

It is important to remember that throughout the entire period of hand disinfection, they must remain wet. To carry out the procedure, as a rule, it is necessary to use more than 6 ml of antiseptic. As a result of research, it was found that for high-quality destruction of bacteria, a five-minute treatment of the skin is sufficient. It has also been confirmed that performing this procedure for three minutes reduces the number of microorganisms to an acceptable level.

Rules for treating hands with antiseptic

After thoroughly washing the skin of your hands, wrists and forearms, you need to dry them. After this, the established standard for hand treatment for workers in operating rooms requires the use of special disinfectants.

Before this, if necessary, you need to treat the nail beds and periungual folds. For these purposes, use sterile disposable wooden sticks, which must be additionally moistened with an antiseptic.

The disinfectant is applied 2.5 ml to the hands and forearms. One treatment of two hands should require about 10 ml of disinfectant liquid. The antiseptic must be rubbed into the skin according to the same scheme as hand washing, observing correct sequence movements.

Only after complete absorption/evaporation of the product can you put on gloves. If surgery lasts more than 3 hours, then the treatment is repeated. After all, pathogenic microorganisms can begin to multiply again under gloves.

Final stage

But this is not all levels of hand treatment. It is important to remove gloves after working with gloves and wash your hands with soap. In this case, there is no longer any need to use a disinfectant solution. Washing with liquid soap is sufficient, preferably with a neutral pH.

After cleaning the skin, it is necessary to moisturize it. Various creams and lotions are used for these purposes. Their main purpose is to prevent the drying effect of alcohol-containing disinfectants.

It is also worth noting that hand hygiene in the absence of visible contamination can be performed without washing. In most cases, it is enough to use antiseptic solutions for 30-60 seconds.

Possible complications

It is worth noting that regular use of disinfectants does not have the best effect on the skin of medical workers. There are two main types of reactions that hospital employees encounter. Most often they complain of itching, dryness, irritation, cracks with bleeding. These symptoms can be either minor or significantly affect general state workers.

There is also another type of complications - allergic dermatitis. They occur when there is intolerance to any components of products intended for hand disinfection. Allergic dermatitis can manifest itself in both mild localized and severe generalized forms. In the most advanced cases, they can be combined with respiratory distress syndrome or other manifestations of anaphylaxis.

Prevalence of complications and their prevention

The significance of the problem can be understood by knowing that such hand cleaning practices result in 25% of nurses presenting with signs of dermatitis, and 85% report a history of skin problems.

The irritating effect of antiseptics can be slightly reduced by adding emollients to them. This is one way to reduce the incidence of contact dermatitis. The risk of their occurrence can also be minimized if you use moisturizers that are designed to care for the skin of your hands after each wash.

To prevent the development of complications, do not wash your hands every time before treating them with an antiseptic. It is also important to ensure that gloves are only put on when the skin is completely dry.

Do not neglect the use of moisturizers. On the market you can find special protective creams designed to prevent the occurrence of contact dermatitis. However, research has failed to confirm their unambiguous effectiveness. Many are stopped by the high price of these creams.

Hygienic treatment of the hands of medical staff: methods, algorithm and preparations

Hygienic treatment of the hands of medical staff is a mandatory procedure before performing any action with the patient. Various means and preparations are used for processing, which do not require a lot of time and are approved by the Pharmacology Committee Russian Federation.

Why is disinfection needed?

Hand hygiene is a disinfecting procedure that prevents hospital-acquired infections, protecting not only the staff themselves, but also the patients. The purpose of the treatment is to neutralize microbes that are on human skin after contact with an infected object or are part of the natural flora of the skin.

There are two types of procedures: hygienic and surgical hand treatment. The first is mandatory before contacting the patient, especially if he must undergo surgery. Hygienic treatment of personnel's hands must be carried out after contact with saliva and blood. Disinfection must be carried out before sterile gloves are put on. You can wash your hands with a special soap that has an antiseptic effect or wipe your skin with a product containing alcohol.

When to perform hygienic treatment

Hygienic treatment of the hands of medical staff is mandatory in the following situations:

1. After therapy for patients diagnosed with an inflammatory process with the release of pus.
2. After contact with devices and any other object located near the patient.
3. After each contact with contaminated surfaces.
4. After contact with human mucous membranes, human excreta and gauze dressings.
5. After contact with the patient's skin.
6. Before performing casualty care procedures.
7. Before each contact with the patient.

Correctly carried out hygienic treatment involves washing with soap and running water in order to get rid of contaminants and reduce the number of microorganisms. In addition, hand cleaning in a hygienic way also includes procedures for treating the skin with antiseptic agents, which help reduce the number of bacteria to a minimum safe level.

What is used for processing

Liquid soap, which is dispensed using a dispensary, is ideal for washing the hands of medical staff. It is not recommended to use hot water due to the increased risk of dermatitis. Be sure to use a towel to close a faucet that is not equipped with an elbow drive. In order to dry clean hands, you should use disposable paper towels (or individual fabric ones).

Hygienic hand treatment, the algorithm of which includes several simple steps, can be carried out using a skin antiseptic. In this case, pre-washing with soap is not necessary. The product is rubbed into the skin of the hands in the amount indicated on the antiseptic packaging. Particular attention is paid to the fingers, the skin between them and the areas around the nails. A prerequisite for achieving the desired effect is keeping your hands wet for a certain time (usually indicated on the product). After hand hygiene has been carried out, there is no need to dry them with a towel.

Equipment for hygiene procedures

In order for the hygiene procedure to be carried out in accordance with all rules and requirements, the following is necessary:

• Running water.
• Liquid soap with a neutral pH level.
• Washbasin with mixer, operated without the touch of the palms (elbow method).
• Alcohol-based antiseptic.
• Disposable towels, both sterile and non-sterile.
• Detergent with antimicrobial action.
• Disposable rubber gloves (sterile or non-sterile).
• Hand skin care product.
• Household rubber gloves.
• Bin for used supplies.

Mandatory requirements

In the room where antimicrobial hand treatment is planned, the washbasin should be located in an accessible place. It is equipped with a tap through which hot and cold water, a special mixer. The faucet must be designed in such a way that water splashing is minimal. Hygienic level Hand treatment involves the maximum reduction in the number of microorganisms on the skin, so it is advisable to install several dispensers with products next to the washbasin. One contains liquid soap, the other contains an antimicrobial drug, and another should be filled with a product that cares for the skin of the hands.

It is not recommended to dry your hands using electric dryers, as they will still remain wet, and the device causes air turbulence, where contaminated particles may be located. All containers with products must be disposable. Hospitals should always have several hand antiseptics on hand, some of which are intended for workers with sensitive skin.

Algorithm

Hand hygiene is mandatory for all healthcare workers. The algorithm for cleansing with soap is as follows:

1. Squeezing out of the dispenser required quantity liquid soap.
2. Rubbing in palm-to-palm mode.
3. Rubbing one palm of the hand on the back of the other.
4. Rubbing the inner surfaces of the fingers vertically.
5. Rubbing the back of the fingers of the hand folded into a fist onto the palm of the other (do the same with the other hand).
6. Rubbing all fingers in a circular motion.
7. Rubbing each palm with your fingertips.

Surgical disinfection

Surgical hand disinfection is required to completely remove flora from the hands: resistant, as well as transistor. This is done to prevent the infection from being transmitted through hands. Like hand hygiene, surgical disinfection is performed by washing and wiping. The use of alcohol solutions is widespread due to the rapid and targeted action, optimal skin perception of the product, long period of action, and the effect of complete removal of microorganisms.

The process of surgical disinfection includes almost the same steps that involve hand cleaning at a hygienic level. Algorithm for surgical antisepsis:

1. Wash your hands with water and soap for at least two minutes.
2. Dry your hands using a disposable napkin or towel.
3. Treat your hands, forearms, and wrists with an antiseptic, without wiping your hands afterward.
4. Wait for the product to dry completely and put on sterile gloves.

Time of exposure to a specific antiseptic drug, its dosage and others important parameters can be read on the product label or in its instructions. The first hand treatment of each work shift should include the stage of cleaning the areas around each nail using a special soft brush - sterile and disposable (or one that has been sterilized by autoclaving).

Antiseptic treatment

An antiseptic solution is one of the main means of combating microorganisms, which includes hand hygiene. The algorithm is as follows:

1. Washing hands in water room temperature with liquid soap, dry with a disposable towel.
2. Apply the disinfectant using rubbing movements, which disinfects the hands.
3. With interlaced fingers, massage the backs of your hands.
4. With crossed fingers, widely spaced, rub your palms.
5. Rub the product into your thumbs with clenched palms one at a time.
6. Rubbing the forearms for at least 2 minutes, maximum 3 minutes, treating the nails and subungual area.

Each stage must be repeated 4-5 times. Throughout the entire procedure, you must ensure that your hands do not dry out. If necessary, apply another portion of the disinfectant.

Hand hygiene is a mandatory disinfection process for all medical personnel who come into contact with patients or various contaminated hospital facilities. For processing, chlorhexidine bigluconate (alcohol solution) in ethyl alcohol (70%) is used. In addition, the following drugs are used:

• "Octenisept."
• Ethyl alcohol with additives that effectively soften the skin.
• "Octeniderm".
• "Chemisept."
• "Higenix."
• “Isopropanol” – 60%.
• "Octenman."
• "Dekosept+".
• "Veltosept".

Before carrying out hygienic treatment, be sure to remove all wrist accessories and jewelry. Don't forget to clean your hands with a sterile brush, paying special attention to the nail area. The procedure is carried out once at the beginning of the working day.

Requirements for hygiene products

If antiseptic and soap containers are not disposable, then refilling should only be done after they have been thoroughly disinfected, rinsed under running water and completely dried. It is recommended to use dispensers that operate on photocells or those from which the product is squeezed out using the elbow.

All used antiseptics intended for skin treatment should be readily available at all stages of the treatment process. If the unit is aimed at intensive patient care, then containers with antiseptics should be placed in places that are most convenient for medical personnel, for example, at the patient’s bedside or near the entrance to the hospital. hospital ward. It is recommended to provide each employee with an individual small container of antiseptic.

Rules for antiseptic hand treatment drawing

2. HANDS TREATMENT OF MEDICAL STAFF

Hand treatment - this one is simple, but very important method prevention of HAIs. P Correct and timely hand washing is the key to the safety of medical personnel and patients .

Rules for preparing for hand treatment:

1. Remove rings and watches.

2. Nails must be cut short; polish is not allowed.

3. Fold the long sleeves of the robe over 2/3 of your forearms.

All jewelry and watches are removed from hands, as they make it difficult to remove microorganisms. Hands are soaped and then rinsed warm running water and everything repeats itself from the beginning. It is believed that the first time you soap and rinse with warm water, germs are washed off from the skin of your hands. Under the influence of warm water and self-massage during mechanical treatment, the pores of the skin open, so when repeated soaping and rinsing, germs are washed away from the opened pores. Warm water makes the antiseptic or soap work more effectively, while hot water removes the protective fat layer from the surface of the hands. In this regard, you should avoid consuming too much hot water for washing hands.

When entering and exiting the intensive care unit or intensive care unit, personnel must treat their hands with a skin antiseptic.

There are three levels of hand treatment:

1. Household level (mechanical hand treatment);

2. Hygienic level (hand treatment using skin antiseptics);

3. Surgical level (special sequence of actions when treating hands, increasing treatment time, treatment area, followed by putting on sterile gloves).

1. Mechanical treatment of hands

The purpose of household hand treatment is to mechanically remove most of the transient microflora from the skin (antiseptics are not used).

· after visiting the toilet;

· before eating or working with food;

· before and after physical contact with the patient;

· for any contamination of hands.

Required equipment:

1. Liquid dosed neutral soap. It is desirable that the soap does not have a strong odor. Open liquid soap quickly becomes infected with microbes, so you need to use closed dispensers, and after finishing the contents, process the dispenser, and only fill it with new contents after processing.

2. Disposable, clean, 15x15 cm napkins for drying hands. Using a towel (even an individual one) is not advisable, because it does not have time to dry and, moreover, is easily contaminated with germs.

Hand treatment - the necessary sequence of movements:

1. Rub one palm against the other palm in a back-and-forth motion.

2. Use your right palm to rub the back surface of your left hand, switch hands.

3. Connect the fingers of one hand in the interdigital spaces of the other, rub the inner surfaces of the fingers with up and down movements.

4. Connect your fingers into a “lock” and rub the palm of your other hand with the back of your bent fingers.

5. Cover the base of the thumb of the left hand between the thumb and index finger of the right hand, rotational friction. Repeat on the wrist. Change hands.

6. Rub the palm of your left hand in a circular motion with the fingertips of your right hand, switch hands.

HAND HYGIENIC RULES

European standard E N -1500

Palm to palm, including wrists

Right palm on the left back of the hand and left palm on the right back of the hand

Palm to palm of hands with fingers crossed

Outer side of fingers on opposite palm with fingers crossed

Circular rubbing of the left thumb in the closed palm of the right hand and vice versa

Circular rubbing of the closed fingertips of the right hand on the left palm and vice versa

2. Hand hygiene

The purpose of hygienic treatment is to destroy resident microflora from the surface of the skin of the hands using antiseptics.

A similar hand treatment is carried out:

· before putting on gloves and after taking them off;

· before caring for a patient with a weakened immune system or during ward rounds (when it is not possible to wash hands after examining each patient);

· before and after performing invasive procedures, minor surgical procedures, wound care or catheter care;

· after contact with biological fluids (for example, emergency situations with blood).

Required equipment:

2. Napkins measuring 15x15 cm, disposable, clean (paper or fabric).

3. Skin antiseptic. It is advisable to use alcohol-containing skin antiseptics (70% ethyl alcohol solution; 0.5% solution of chlorhexidine digluconate in 70% ethyl alcohol, AHD-2000 special, Sterillium, Sterimax, etc.).

Hand hygiene consists of two stages:

1 - mechanical cleaning of hands followed by drying with disposable napkins;

2 - disinfection of hands with a skin antiseptic.

3. Surgical treatment of hands

The purpose of the surgical level of hand cleaning is to minimize the risk of disruption of surgical sterility in the event of glove damage.

A similar hand treatment is carried out:

· before surgical interventions;

· before serious invasive procedures (for example, puncture of large vessels).

Required equipment:

1. Liquid dosed pH-neutral soap.

2. Wipes measuring 15x15 cm are disposable, sterile.

3. Skin antiseptic.

4. Disposable sterile surgical gloves.

Hand treatment rules:

Surgical treatment of hands consists of three stages:

1 - mechanical cleaning of hands followed by drying,

2 - hand disinfection with skin antiseptic twice,

3 - covering hands with sterile disposable gloves.

In contrast to the above-described method of mechanical cleaning at the surgical level, the forearms are included in the treatment; sterile wipes, and itself hand washing lasts at least 2 minutes. After drying, the nail beds and periungual folds are additionally treated with disposable sterile wooden sticks soaked in an antiseptic solution.

It is not necessary to use brushes. If brushes are used, sterile, soft, single-use or autoclave-resistant brushes should be used only for periungual areas and only for the first brush of a work shift.

At the end of the mechanical cleaning stage, an antiseptic is applied to the hands in 3 ml portions and, without allowing drying, rubbed into the skin, strictly observing the sequence of movements. The procedure for applying skin antiseptic is repeated at least twice, the total consumption of antiseptic is 10 ml, the total procedure time is 5 minutes.

Sterile gloves are worn only on dry hands. If you work with gloves for more than 3 hours, hand treatment is repeated with a change of gloves.

After removing the gloves, hands are wiped again with a cloth moistened with a skin antiseptic, then washed with soap and moisturized with an emollient cream.

Bacteriological control of the effectiveness of personnel hand treatment.

Washings from the hands of personnel are carried out using sterile gauze wipes measuring 5x5 cm, soaked in a neutralizer. Using a gauze napkin, thoroughly wipe the palms, periungual and interdigital spaces of both hands. After sampling, the gauze pad is placed in wide-necked test tubes or flasks with saline solution and glass beads and shaken for 10 minutes. The liquid is inoculated and incubated for 48 hours at a temperature of + 37 0 C. Recording of results: absence of pathogenic and opportunistic bacteria (Guidelines 4.2.2942-11).

Dermatitis associated with frequent hand cleaning

Repeated hand cleaning may cause skin dryness, cracking and dermatitis in sensitive subjects. A healthcare worker suffering from dermatitis increases the risk of infection for patients due to:

· the possibility of colonization of damaged skin by pathogenic microorganisms;

Difficulties in adequately reducing the number of microorganisms when washing hands;

Tendency to avoid hand-handling.

Measures to reduce the likelihood of developing dermatitis:

Thorough rinsing and drying of hands;

· use an adequate amount of antiseptic (avoid excess);

· usage modern and various antiseptics;

· mandatory use of moisturizing and softening creams.

Skin microflora

The superficial layer of the epidermis ( upper layer skin) is completely replaced every 2 weeks. Every day, up to 100 million skin flakes are shed from healthy skin, of which 10% contain viable bacteria. Skin microflora can be divided into two large groups:

1. Resident flora

2. Transitory flora

1. Resident microflora- these are those microorganisms that constantly live and multiply on the skin without causing any diseases. That is, this is normal flora. The number of resident flora is approximately 10 2 -10 3 per 1 cm 2. The resident flora is represented predominantly by coagulase-negative cocci (primarily Staphylococcus epidermidis) and diphtheroids (Corinebacterium spp.). Although Staphylococcus aureus is found in the nose in approximately 20% healthy people, it rarely colonizes the skin of the hands (if it is not damaged), however, in hospital conditions it can be found on the skin of the hands of medical personnel with no less frequency than in the nose.

Resident microflora cannot be destroyed by regular hand washing or even antiseptic procedures, although its numbers are significantly reduced. Sterilization of the skin of the hands is not only impossible, but also undesirable: because normal microflora prevents the colonization of the skin by other, much more dangerous microorganisms, primarily gram-negative bacteria.

2. Transient microflora are those microorganisms that are acquired by medical personnel as a result of contact with infected patients or contaminated environmental objects. Transient flora can be represented by much more epidemiologically dangerous microorganisms (E.coli, Klebsiella spp., Pseudomonas spp., Salmonella spp. and other gram-negative bacteria, S.aureus, C. albicans, rotaviruses, etc.), including hospital strains of pathogens of nosocomial infections. Transient microorganisms remain on the skin of the hands for a short time (rarely more than 24 hours). They can be easily removed by regular hand washing or destroyed by using antiseptics. While these microbes remain on the skin, they can be transmitted to patients through contact and contaminate various objects. This circumstance makes the hands of personnel the most important factor in the transmission of infection.

If the integrity of the skin is compromised, then transient microflora can cause an infectious disease (for example, whitlow or erysipelas). You should be aware that in this case, the use of antiseptics does not make your hands safe from the point of view of transmission of infection. Microorganisms (most often staphylococci and beta-hemolytic streptococci) remain on the skin during the disease until recovery occurs.

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The purpose of household hand treatment is to mechanically remove most of the transient microflora from the skin (antiseptics are not used).

A similar hand treatment is carried out:

• after visiting the toilet;
• before eating or working with food;
• before and after physical contact with the patient;
• for any contamination of hands.

Required equipment:

1. Liquid dosed neutral soap or individual disposable soap in pieces. It is desirable that the soap does not have a strong odor. Opened liquid or bar reusable non-individual soap quickly becomes infected with germs.
2. Napkins measuring 15x15 cm are disposable, clean for blotting hands. Using a towel (even an individual one) is not advisable, because it does not have time to dry and, moreover, is easily contaminated with germs.

Hand treatment rules:

All jewelry and watches are removed from hands, as they make it difficult to remove microorganisms. Hands are soaped, then rinsed with warm running water and everything is repeated all over again. It is believed that the first time you soap and rinse with warm water, germs are washed off from the skin of your hands. Under the influence of warm water and self-massage, the pores of the skin open, so when repeated soaping and rinsing, germs are washed away from the opened pores.

Warm water makes the antiseptic or soap work more effectively, while hot water removes the protective fat layer from the surface of the hands. Therefore, you should avoid using too hot water to wash your hands.

Hand treatment - the necessary sequence of movements

1. Rub one palm against the other palm in a back-and-forth motion.

1. Rub the back of your left hand with your right palm and switch hands.
2. Connect the fingers of one hand in the interdigital spaces of the other, rub the inner surfaces of the fingers with up and down movements.
3. Place your fingers in a “lock” and rub the palm of your other hand with the back of your bent fingers.
4. Cover the base of the thumb of the left hand between the thumb and index finger of the right hand, rotational friction. Repeat on the wrist. Change hands.
5. Rub the palm of your left hand in a circular motion with the fingertips of your right hand, switch hands.

Each movement is repeated at least 5 times. Hand treatment is carried out for 30 seconds - 1 minute.

It is very important to follow the described hand washing technique, since special studies have shown that during routine hand washing, certain areas of the skin (fingertips and their inner surfaces) remain contaminated.

After the last rinse, wipe your hands dry with a napkin (15x15 cm). The same napkin is used to close the water taps. The napkin is dumped into a container with a disinfectant solution for disposal.

In the absence of disposable napkins, it is possible to use pieces of clean cloth, which after each use are thrown into special containers and, after disinfection, sent to the laundry. Replacing disposable napkins with electric dryers is impractical, because... with them there is no rubbing of the skin, which means there is no removal of detergent residues and desquamation of the epithelium.