This standard stipulates the management and basic requirements for hand hygiene of medical staff, hand hygiene facilities, hand washing and sanitation hand disinfection, surgical hand disinfection, and hand hygiene monitoring.
This standard applies to all types of medical institutions at all levels.
This standard applies to all types of medical institutions at all levels.
2 Normative references
The terms in the following documents become the terms of this standard by reference to this standard. For dated references, all subsequent amendments (excluding errata content) or revisions do not apply to this standard. However, parties to agreements based on this standard are encouraged to study whether the latest versions of these documents are available. For undated references, the latest edition applies to this standard.
GB 5749 Sanitary Standard for Drinking Water
3 Terms and definitions
The following terms and definitions apply to this standard.
3.1 hand hygiene
A general term for hand washing, hand sanitization, and surgical hand disinfection for medical personnel.
3.2 Washing hands
Medical staff wash their hands with soap (soap) and running water to remove dirt, debris and some pathogenic bacteria from the skin of the hands.
3.3 Hygiene hand disinfection
Medical staff use quick-drying hand sanitizer to rub their hands to reduce the process of temporary hand-dwelling bacteria.
3.4 Surgical hand disinfection
Before the operation, the medical staff washes the hands with soap (soap) and running water, and then removes or kills the temporary bacteria and reduces the resident bacteria by hand disinfectant. The hand sanitizer used can have sustained antibacterial activity.
3.5 Resident bacteria
Microorganisms that can be separated from most human skin are persistent colonies on the skin that are not easily removed by mechanical friction. Such as coagulase-negative staphylococci, coryneform bacteria, propionic acid bacteria, Acinetobacter and the like. Under normal circumstances, it does not cause illness.
3.6 Temporary bacteria
A microorganism that colonizes the surface of the skin and is easily washed away by routine hand washing. It is available when directly in contact with the surface of a patient or contaminated object, and can be spread by hand at any time, which is closely related to nosocomial infection.
3.7 hand disinfectant
Disinfectant for hand skin disinfection to reduce bacteria in the hands and skin, such as ethanol, isopropanol, chlorhexidine, iodophor, etc.
3.7.1 Quick-drying hand disinfectant
Hand sanitizers containing alcohols and skin care ingredients, including water, gel and foam.
3.7.2 Free rinse hand disinfectant
It is mainly used for disinfecting surgical hands and disinfecting hands without disinfection with water. Includes water, gel and foam.
3.8 hand hygiene facilities
Facilities for hand washing and hand sanitizing, including sinks, faucets, running water, detergents, dry hand products, hand sanitizers, etc.
4 Hand hygiene management and basic requirements
4.1 Medical institutions should develop and implement a hand hygiene management system with effective and convenient hand hygiene facilities.
4.2 Medical institutions should regularly carry out all-person training for hand hygiene. Medical personnel should master hand hygiene knowledge and correct hand hygiene methods to ensure the effect of hand washing and hand disinfection.
4.3 Medical institutions should strengthen the guidance and supervision of the work of medical staff, and improve the compliance of medical staff’s hand hygiene.
4.4 Hand disinfection effect should meet the following requirements:
a) Sanitary hand disinfection, the total number of bacterial colonies monitored should be ≤10cfu/cm2
b) Surgical hand disinfection, the total number of bacterial colonies monitored should be ≤ 5cfu/cm2
5 hand hygiene facilities
5.1 Hand washing and sanitation hand disinfection facilities
5.1.1 Set up a mobile water hand washing facility.
5.1.2 Operating room, delivery room, cath lab, laminar flow clean ward, bone marrow transplant ward, organ transplant ward, intensive care unit, neonatal room, maternal and child room, hemodialysis ward, burn ward, infectious disease department, oral cavity Key departments such as department and disinfection supply center should be equipped with non-hand touch faucets. Conditional medical institutions should be equipped with non-hand touch faucets in the treatment area.
5.1.3 A cleaning agent should be provided. The soap should be kept clean and dry. The container containing the soap should be disposable and the reused container should be cleaned and disinfected weekly. When the soap liquid is cloudy or discolored, it should be replaced in time, and the container should be cleaned and disinfected.
5.1.4 Dry hand items or facilities should be provided to avoid secondary pollution.
5.1.5 Eligible quick-drying hand sanitizer should be provided.
5.1.6 The setting of hand hygiene facilities should be convenient for medical personnel.
5.1.7 Sanitary hand disinfectants should meet the following requirements:
a) It should comply with relevant national regulations.
b) One-time packaging should be used.
c) The medical staff should have good acceptance of the selected hand disinfectant, and the hand disinfectant has no odor and no irritation.
5.2 Surgical hand disinfection facility
5.2.1 The sink should be configured. The sink is located near the operating room. The size and height of the sink are suitable to prevent the hand washing water from splashing. The pool surface should be smooth and free of dead spots. The sink should be cleaned and disinfected daily.
5.2.2 The number of sinks and faucets should be set according to the number of operating rooms. The number of faucets should be no less than the number of operating rooms. The faucet switch should be non-hand touch.
5.2.3 Cleaners should be provided and meet the requirements of 5.1.3.
5.2.4 Should be equipped with clean nail supplies; can be equipped with hand hygiene products. If equipped with a hand brush, the brush should be soft and regularly checked to remove the unqualified hand brush in time.
5.2.5 Hand disinfectant should obtain the health permit approval from the Ministry of Health and use it within the validity period.
5.2.6 Hand dispensers for hand sanitizers should be non-hand touch. Disinfectants should be used in disposable packaging, and reusable disinfectant containers should be cleaned and disinfected weekly.
5.2.7 Dry hand items should be provided. Dry hand towels should be used by each person, cleaned and sterilized after use; containers containing disinfectant towels should be cleaned and sterilized each time.
5.2.8 Timing devices, hand washing procedures and explanatory drawings should be provided.
6 hand washing and sanitation hand disinfection
6.1 Hand washing and sanitation hand disinfection should follow the following principles:
a) Wash hands with soap (soap) and running water when there is visible contamination of the hands such as blood or other body fluids.
b) When there is no visible contamination of the hand, it is advisable to use a quick-drying hand disinfectant to disinfect the hands instead of washing hands.
6.2 Medical staff should choose to wash their hands or use quick-drying hand sanitizer according to the principles of 6.1 under the following circumstances:
a) Before and after direct contact with each patient, when moving from the contaminated part of the same patient’s body to the cleaned area.
b) After contact with the patient’s mucous membrane, damaged skin or wound, after contact with the patient’s blood, body fluids, secretions, excretions, wound dressings, etc.
c) Before and after wearing the detachment, after picking up the gloves.
d) Before performing aseptic processing, contact cleaning, and sterile items.
e) After contact with the patient’s surroundings and items.
f) Before handling the drug or before serving.
6.3 Medical staff should wash their hands first in the following situations, then hand sanitization:
a) After contact with the patient’s blood, body fluids and secretions, and items contaminated with infectious pathogenic microorganisms.
b) After directly inspecting, treating, caring for or treating the infected patient’s dirt.
6.4 Medical staff washing methods, see Appendix A
6.5 Disinfection should follow the following methods:
a) Take an appropriate amount of quick-drying hand sanitizer on the palm.
b) Strictly follow Appendix A for medical staff washing methods A. The steps of hand rub are carried out.
c) Ensure that the hand sanitizer completely covers the skin of the hands until the hands are dry.
7 surgical hand disinfection
7.1 Surgical hand disinfection should follow the following principles:
a) Wash hands first, then disinfect.
b) Surgical hand disinfection should be performed again between different patients during surgery, when the gloves are damaged or when the hands are contaminated.
7.2 Hand washing methods and requirements
7.2.1 Remove the hand accessories and trim the nails before washing your hands. The length should not exceed the fingertips.
7.2.2 Take an appropriate amount of detergent to clean the hands, forearms and upper arm 1/3, and carefully rub. When cleaning your hands, be careful to clean the dirt under your nails and the wrinkles on your hands.
7.2.3 Rinse your hands, forearms and upper and lower arms by 1/3 of flowing water.
7.2.4 Dry your hands, forearms and upper arm 1/3 with dry hand items.
7.3 surgical hand disinfection method
7.3.1 Rinse hand disinfection method Apply appropriate amount of hand disinfectant to each part of the hands, the forearm and the upper arm 1/3, and carefully lick for 2min~6min, flush the hands with the running water, the forearms and the upper arm 1 /3, the sterile towel is thoroughly dried. The flowing water should meet the requirements of GB 5749. In special cases, when the water quality is not up to the requirement, the surgeon will use alcohol hand disinfectant before disinfecting the hands and wearing gloves before wearing gloves. The amount of hand disinfectant taken, the time of sputum and the method of use follow the instructions for use of the product.
7.3.2 Disinfecting hand disinfection method Apply an appropriate amount of hands-free disinfectant to each part of the hands, the forearm and the lower arm of the upper arm 1/3, and carefully rub until the disinfectant is dry. The amount of hand disinfectant taken, the time of use and the method of use follow the instructions for use of the product.
7.4.1 Do not wear fake nails to keep the tissues around the nails and nails clean.
7.4.2 Keep hands on the chest and above the elbows during the entire hand disinfection process so that water flows from the hands to the elbows.
7.4.3 Hand washing and disinfection can be done by using sponges, other toiletries or hands.
7.4.4 After removing the surgical gloves after surgery, use soap (soap) to clean your hands.
7.4.5 After use, clean nail tools, such as sponges, hand brushes, etc., should be placed in the designated container; the products should be disinfected or used once after each use; cleaning nail supplies should be cleaned daily. disinfection.