Healthcare and Medicine Reference
Universal Precautions and
Critical Care Unit, Heart of England NHS Foundation Trust, Good Hope Hospital, Birmingham, UK
Apply one shot of liquid soap to wet hands and wash using a 6- or
8-point technique (see Figure 3.1).
Rinse in warm water.
By the end of this chapter you will:
understand the importance of infection control
Dry thoroughly by patting with paper towels to prevent chafi ng.
be able to describe the various levels of hand hygiene
understand the term 'universal precautions'
Level 2: Intermediate or disinfection
An alcohol hand rub is used to kill any surface skin organisms.
The hand rub should be available at all washbasins, in all clinical
areas and outside any isolation areas. In areas where wall-mounted
dispensers are not practical, dispensers may be attached to trolleys
or smaller dispensers may be clipped to staff uniform. Alcohol
gel can be used as an alternative to soap and water (only if hands
are physically clean), or to disinfect the hands before an aseptic
Hands must be physically clean before application.
be able to set up a sterile fi eld
understand the various methods of achieving asepsis
know what to do if a needlestick or sharps injury occurs.
Infection prevention and control procedures are processes or
techniques that we can use to ensure that we safeguard the patient
from infection. It is essential that these techniques are followed in
all patient contact situations.
Apply alcohol hand rub to clean hands and massage using a 6- or
8-point technique (follow manufacturer's recommendations for
the amount to be used) (see Figure 3.2).
Allow to dry before beginning your next task.
Handwashing and decontamination
Good hand hygiene by healthcare workers has been shown to be the
single most important preventative measure to reduce the incidence
of healthcare-associated infection. It is a simple, important action
that helps prevent and control cross-infection.
Every practitioner is personally responsible for their hand
hygiene, and must actively seek to promote and safeguard the inter-
ests and wellbeing of patients.
Before handwashing, rings, watches and bracelets must be
removed (most hospitals will allow the wearing of a plain band
wedding ring only; ensure that you are aware of local policy).
There are three levels of hand hygiene.
Alcohol hand gel will not kill Clostridium diffi cile spores -
soap and water is necessary
Level 3: Surgical scrub
This involves the use of a chemical disinfection and prolonged
washing to physically remove and kill surface organisms in the
deeper layers of the epidermis. This should be done before any
invasive or surgical procedure.
Apply a bactericidal, detergent, surgical scrub solution to wet
Level 1: Socially clean
This involves the use of liquid soap and running water to remove
any visible soiling of the skin. It should be used before and after
each task and every patient contact. This is suffi cient to prevent
hands and massage in using an 8-point technique, extending the
wash to include the forearms.
Ensure the hands are positioned so as to prevent soap and water
running onto and contaminating the hands from unwashed areas
of the arms (high hands, low elbows technique).
Rinse in warm water.
Dry thoroughly by patting with sterile paper towels.
Don sterile gown and gloves.
Figure 3.3 shows areas that are commonly missed during hand
Table 3.1 shows a summary of the three techniques.