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Hand hygiene in Long-Term Care

Long-term care homes have diverse groups of people performing equally varied roles.  This can make it hard to ensure that everyone is aware of how and when to use hand hygiene properly since one person may have very different opportunities than another person.  The key for all staff is to pause for a second and consider what contamination potentials exist with each interaction and each task that they perform in the home.

Nurses, PSWs, and RAs spend a lot of time in direct contact with residents which makes determining some of their hand hygiene opportunities relatively easy.  If you are helping someone in the washroom, everyone knows that hand washing should follow.  But what if you are an Activities Coordinator trying to help a resident make a call to their loved ones, a housekeeper who is seeing to a spilled drink, or a volunteer helping to move equipment before the day’s big bingo event?  Whatever role you are in, there are a few questions you can ask yourself based on the 4 Moments for Hand Hygiene:

• Am I going to be touching a resident or their environment? All of us have bacteria on our skin which can easily spread to the people and surfaces we touch. Although the majority of these organisms are harmless, even beneficial, other more harmful organisms may also be present. Susceptible individuals can become ill from these organisms, and hand hygiene can help prevent their spread from your skin to residents or their belongings.
• Am I going to be doing something that should be clean or aseptic?  Assisting with feeding, brushing a resident’s teeth, or disinfecting surfaces are examples of clean tasks where the risks of invading organisms are important considerations. Caring for wounds, inserting catheters, or giving injections are examples of aseptic procedures where the risk posed by invading organisms is very high. These tasks should be approached with thought to reducing the potential introduction of contamination, with hand hygiene playing a key role.
• Am I going to be coming in contact with body fluids? Items such as tissues, waste bins, dishes, bandages, and personal items could all contain various bodily fluids which are well known to be vectors for disease transmission.  Not only could the organisms on these items make you sick, they are very easy to spread to others if proper hand hygiene procedures are not observed after handling them.
• Have I touched a resident or their environment? In contrast to the first point, after you have performed a task you have to ask yourself whether you may have come into contact with anything.  If you moved a wheelchair, closed a privacy curtain, helped a resident with a puzzle, or held a resident’s hand while they walked down the hall, you have been exposed to another person’s environment and need to perform hand hygiene.

The best thing about hand hygiene is that there is no bad time, so if you are ever in doubt, just do it!  Hand sanitizers only take a few seconds and using them could help save someone’s life!