Infection control: Hand hygiene for direct patient care


Healthcare associated infections (HAIs) are the most common complication for patients in health care settings. They are caused by infectious microorganisms and can be prevented using standardised infection control procedures adhered to by all healthcare workers.

Whilst the risk of transmission of healthcare associated infections in primary healthcare is lower than for the hospital setting, there is none the less a growing body of evidence that suggests that HAIs can and do occur in primary healthcare.

Numerous studies point to HAIs being associated with microorganism transmission via intact skin. Many microorganisms are present as part of a person’s flora, present long term under the superficial cells of the d ermis. However, many also form part of transient flora and are transmitted from the skin surface.

These include bacteria, viruses, and fungi and are acquired via any direct contact – with patients, family and community members, colleagues, or any other contaminated environment, such as equipment, chairs, desks in consultation rooms and drinking cups.

Not surprisingly, these microorganisms are easily transmitted, and the hands of a healthcare worker are one common source of transmission.

Nationally and globally there is a persistent theme pressed by health advisors, governments (for Australia, via the Australian Commission on Quality and Safety in Healthcare and Hand Hygiene Australia), and the World Health Organization. That is – that if healthcare workers were to adhere to the basic principles of hand hygiene, HAIs would be significantly reduced.

The National Safety and Quality Health Service (NSQHS) Standards incorporate hand hygiene, Hand Hygiene Australia and the NHMRC Infection control guidelines all encourage regular updates and reinforcement of hand hygiene messages, and auditing of hand hygiene is an element of compliance.

In the hospital setting there are 5 moments of hand hygiene. Within the primary healthcare setting, the World Health Organization and Hand Hygiene Australia have identified using either 4 or 5 moments of hand hygiene.

This module focuses squarely on hand hygiene in primary healthcare. It is a reminder to every healthcare worker of the importance of diligent hand hygiene.

  • Learning how to properly do hand hygiene
  • Learning when to properly do hand hygiene
  • Doing hand hygiene every time it is required

This module is about hand hygiene.

Learning Objectives

At the end of this module participants will be able to:

  • Know the three main forms of transmission of healthcare associated infections.
  • Understand standard precautions as they relate to hand hygiene.
  • Identify the moments of hand hygiene for primary healthcare.
  • Identify common barriers to hand hygiene.
  • Be able to support improvement in hand hygiene.

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