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DR.T.V.RAO MD
Month
April May June July
DR.T.V.RAO MD
Births
312 294 268 250
Deaths
57 36 6 3
% Mortality
18.3 12.2 2.4 1.2
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HAND-BORNE MICROORGANISMS
Presence bacterial counts on hands range from 104 to 106 resident microorganisms-attached to deeper layers of the skin and are more resistant to removal; less likely to be associated with HAIs. transient microorganisms-colonize the superficial layers of skin and amenable to removable; acquired by direct contact with patients or contaminated environment surfaces; frequently associated with HAIs.
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In developing countries the risk of HCAI is 220 times higher than in developed countries and the proportion of patients affected by HCAI can exceed 25% In intensive care units, HCAI affects about 30% of patients and the attributable mortality may reach 44%
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5 sequential steps
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Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.
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Before:
Patient contact Donning gloves when inserting a CVC Inserting urinary catheters, peripheral vascular catheters, or other invasive devices that dont require surgery
After:
Contact with a patients skin Contact with body fluids or excretions, non-intact skin, wound dressings Removing gloves
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Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.
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Plain Soap
Antimicrobial soap
Alcohol-based handrub
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Handwashing
Wet hands with water, apply soap, rub hands together for at least 15 seconds
Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.
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Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.
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Contaminated hands transmit germs via direct contact with patient or patients immediate environment
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34%
13%
Inadequate antibiotic prophylaxis Incorrect surgical skin preparation Inappropriate wound care
Surgical intervention duration Type of wound Poor surgical asepsis Diabetes Nutritional state Immunodeficiency Lack of training and supervision
Most common sites of health careLACK OF associated infection HAND and the risk factors underlying the HYGIENE occurrence of infections
BLOOD INFECTIONS
17%
14%
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If hands are not visibly soiled, use an alcohol-based handrub for routinely decontaminating hands in all other clinical situations. IA. Alternatively, wash hands with antimicrobial soap and water. IB
Before having direct contact with patients. IB
Before donning sterile gloves when inserting a central intravascular catheter. IB
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long-term disability
excess deaths high additional financial burden high personal costs on patients and their families DR.T.V.RAO MD
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34%
13%
Inadequate antibiotic prophylaxis Incorrect surgical skin preparation Inappropriate wound care
Surgical intervention duration Type of wound Poor surgical asepsis Diabetes Nutritional state Immunodeficiency Lack of training and supervision
Most common sites of health careLACK OF associated infection HAND and the risk factors underlying the HYGIENE occurrence of infections
BLOOD INFECTIONS
17%
14%
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WHY NOT?
Skin irritation Inaccessible hand washing facilities Wearing gloves Too busy Lack of appropriate staff Being a physician
(Improving Compliance with Hand Hygiene in Hospitals Didier Pittet. Infection Control and Hospital Epidemiology. Vol. 21 No. 6 Page 381)
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WHY NOT?
Working in high-risk areas Lack of hand hygiene promotion Lack of role model Lack of institutional priority Lack of sanction of non-compliers Lack of rewarding of compliers
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SUCCESSFUL PROMOTION
Education
Location of hand basins Possible, easy & convenient Alcohol-based hand rubs available
Patient education
(Improving Compliance with Hand Hygiene in Hospitals. Didier Pittet. Infection Control and Hospital Epidemiology. Vol. 21 No. 6 Page 381)
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Monitoring hand hygiene practices, infrastructure, perceptions and knowledge, while providing results feedback to health-care workers
FOUR Reminders in the workplace
Creating an environment and the perceptions that facilitate awareness-raising about patient safety issues
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Validated and standardized prevention strategies have been shown to reduce HCAI At least 50% of HCAI could be prevented Most solutions are simple and not resource-demanding and can be implemented in developed, as well as in transitional and developing countries
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Old CDC, APIC-nonantimicrobial between most patient contacts, antimicrobial before invasive procedures or caring for high-risk patients New CDC-if hands are not visibly soiled, use an alcohol-based handrub for decontaminating hands in all clinical situations; alternatively, wash hands with antimicrobial soap and wat er
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Global compliance with the My 5 Moments for Hand Hygiene approach is universally sub-optimal
<insert name of facility> has implemented an Action Plan to improve hand hygiene and reduce infection Your support and compliance with the initiatives is essential to save lives in our facility
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Soap, Water and Common sense, are still the best Antiseptics.
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Visit the SAVE LIVES: Clean Your Hands website at: www.who.int/gpsc/5may/en/
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PROGRAMME CREATED BY DR.T.V.RAO MD FOR HEALTH CARE WORKERS IN THE DEVELOPING WORLD
Email
doctortvrao@gmail.com
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