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| − | '''Hand washing''' is the act of [[cleaning|cleansing]] the [[hand]]s with [[water]] or other [[liquid]], with the use of [[soap]] or other [[detergent]]s, for the purpose of removing [[soil]] or [[microorganism]]s. | + | '''Infection control and health care epidemiology''' |
| | + | is the discipline concerned with preventing the spread of infections within the health-care setting. |
| | + | As such, it is a practical (rather than an academic) sub-discipline of [[epidemiology]]. |
| | + | It is an essential (though often underrecognized and undersupported) part of the infrastructure of health care. |
| | + | Infection control and hospital epidemiology are akin to [[public health]] practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole. |
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| − | ==Purpose==
| + | Infection control concerns itself both with prevention (hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance) and with investigation and management of demonstrated or suspected spread of infection within a particular health-care setting (e.g. outbreak investigation). |
| − | The main purpose of washing hands is to cleanse the hands of [[pathogen]]s (including [[bacterium|bacteria]] or [[virus]]es) and chemicals which can cause disease. This is especially important for people who handle food or work in the medical field. With the emergence of infectious agents ("germs") that are [[antibiotic resistance|resistant to antibiotics]], hand washing is taking on new urgency, as the use of antibiotics and even hand washing with antibiotic soap have favored the [[natural selection]] of more resistant bacteria.
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| − | ==Personal hand washing== | + | ==Prevention of Infection in the Health Care setting== |
| − | {{Cleanup-verify}}
| + | ===Hand Hygiene=== |
| − | To maintain good [[hygiene]], hands should always be washed after using the toilet, changing a diaper or tending to someone who is sick; before eating; before handling or cooking food and after handling raw meat, fish or poultry. Conventionally, the use of soap and running water and the washing of all surfaces thoroughly, including under fingernails is seen as necessary. One should rub wet, soapy hands together outside the stream of running water for at least 20 seconds, before rinsing thoroughly and then drying with a clean or disposable towel. After drying a dry paper towel should be used to turn off water and open exit door. Moisturizing [[lotion]] is often recommended to keep the hands from drying out, should one's hands require washing more than a few times per day. [http://www.tufts.edu/med/apua/Patients/handwashing.html]
| + | Since the days of [[Ignaz Semmelweis]], hand washing has been known to decrease the transmission of infectious diseases. see [[Hand washing]] for additional details. |
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| − | Antibacterial soaps have been heavily promoted to a health-conscious public. To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature. <ref>Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. (Infect Control Hosp Epidemiol) 2006 Oct; 27(10): 1107-19
| + | ===Cleaning, [[disinfection]] and [[sterilization (microbiology)]]=== |
| − | </ref>. These soaps are quite different from the non-water-based hand hygiene agents referred to below, which do not promote [[antibiotic resistance]].
| + | ===Vaccination of health care workers=== |
| | + | ===Surveillance for emerging infections=== |
| | + | ==Outbreak investigation== |
| | + | Penicillin is a common treatment when an outbreak occurs. However, if the infection has built a resistance, then ''penicillin'' would have no effect whatsoever. This was the cause of people overusing ''penicillin''. |
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| − | ==Medical hand washing== | + | ==Training in infection control and health care epidemiology== |
| − | The purpose of hand washing in the health care setting is to remove or destroy (disinfect) [[pathogens|pathogenic microrganisms]] ("germs" in common parlance) to avoid transmitting them to a patient. Water alone is fairly effective, simply by removing many agents loosely adherent to the skin. Ordinary soap aids in removal and also helps to kill [[pathogens]]. Other "medicated" soaps or hand disinfectants are used in certain settings when higher levels of disinfection are required, e.g. surgery (see below).
| + | Practitioners can come from several different educational streams. Many begin as nurses, some as medical technologists (particularly in clinical microbiology), and some as physicians (typically infectious disease specialists). Specialized training in infection control and health care epidemiology are offered by the professional organizations described below. Physicians who desire to become infection control practitioners often are trained in the context of an infectious disease fellowship. |
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| − | The proper washing of hands in a [[medicine|medical]] setting generally consists of the use of generous amounts of soap and water to lather and rub each part of ones hands systematically. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush is often used to remove it. Finally, it is necessary to rinse well and wipe dry with a paper towel. After drying, a dry paper towel should be used to turn off water and open exit door.
| + | [http://www.cbic.org Certification Board of Infection Control and Epidemiology] is an organization that certifies infection control practitioners based on their educational background and professional experience, in conjunction with testing their knowledge base with standardized exams. The credential awarded is CIC, Certification in Infection Control and Epidemiology. |
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| − | To ''''scrub'''' one's hands for a [[surgery|surgical operation]], one requires a tap that can be turned on and off without touching with the hands, some [[chlorhexidine]] or [[iodine]] wash, sterile towels for drying the hands after washing, a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails. All jewellery should be removed. This procedure requires washing the hands and forearms up to the elbows, and one must in this situation ensure that all parts of the hands and forearms are well scrubbed several times. When rinsing, it is ensured at all times that one does not allow water to drip back from the elbow to your hands. When done hands are dried with the sterile cloth and the surgical gown is donned.
| + | A [http://www.shea-online.org/about/shea_courses.cfm course] in hospital epidemiology (infection control in the hospital setting) is offered jointly each year by the Centers for Disease Control and Prevention (CDC) and the Society for Healthcare Epidemiology of America. |
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| − | In the late 1990s and early part of the 21st century, non-water-based hand hygiene agents began to gain popularity. Most are based on [[isopropyl alcohol]] formulated into a gel or lotion for ease of use and to decrease the drying effect of the alcohol. The increasing use of these agents is based on speed and ease of use—it's easier to do a good job quickly with these agents than with soap and water. Used properly, soap and water are as good as the non-water-based agents.
| + | ==Professional organizations== |
| − | Of note: the non-water agents don't clean, they simply disinfect. If visible soiling of any sort is present on the hands, they need to be washed with soap and water. The alcohol-based disinfectants are not effective in the presence of large amounts (i.e. visible amounts) of extraneous material.
| + | [http://www.apic.org Association of Professionals in Infection Control and Epidemiology] is primarily composed of infection prevention and control professionals with nursing or medical technology backgrounds |
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| − | ==Hand washing as compensation==
| + | [http://shea-online.org The Society for Healthcare Epidemiology of America] is more heavily weighted towards practitioners who are physicians or doctoral-level epidemiologists. |
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| − | Excessive hand washing is commonly seen as a symptom of [[obsessive-compulsive disorder]] (OCD).
| + | [[Category:Epidemiology]] |
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| − | It has also been found that people, after having recalled or contemplated unethical acts, tend to wash hands more often than others, and tend to value hand washing equipment more. Furthermore, those who are allowed to wash their hands after such a contemplation are less likely to engage in other "cleansing" compensatory actions, such as volunteering.<ref>Benedict Carey. Lady Macbeth Not Alone in Her Quest for Spotlessness. ''[[The New York Times]]'', 12 September 2006</ref><ref>Chen-Bo Zhong and Katie Liljenquist. [http://www.sciencemag.org/cgi/content/abstract/313/5792/1451?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Liljenquist&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT Washing Away Your Sins: Threatened Morality and Physical Cleansing]. ''[[Science (journal)|Science]], 8 September 2006:
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| − | Vol. 313. no. 5792, pp. 1451 - 1452</ref>
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| − | ==Symbolic hand washing==
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| − | {{main|ablution}}
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| − | *[[Ablution]] in the [[Hebrew Bible]]
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| − | *[[Ablution in Judaism]]
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| − | *[[Wudu]] in [[Islam]]
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| − | *[[Ablution]] in the [[Bahá'í Faith]]
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| − | *[[Ablution]] in [[Hinduism]]
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| − | *[[Misogi]] in [[Shintoism]]
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| − | ==Idioms==
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| − | When someone "washes their hands of" something, this means that they are declaring their unwillingness to take responsibility for it or share complicity in it. [[Gospel of Matthew|Matthew]] 27:24 gives an account of [[Pontius Pilate]] washing his hands of the decision to crucify [[Jesus]]: "When Pilate saw that he could prevail nothing, but that rather a tumult was made, he took water, and washed his hands before the multitude, saying, I am innocent of the blood of this just person: see ye to it."
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| − | ==See also==
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| − | * [[Escherichia coli O157:H7|E. coli O157:H7]]
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| − | * [[Antibiotic resistance]]
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| − | * [[Ignaz Semmelweis]]
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| − | * [[Soap dispenser]]
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| − | ==References==
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| − | <references/>
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| − | ==External links==
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| − | * [http://www.tufts.edu/med/apua/Patients/handwashing.html Alliance for Prudent Use of Antibiotics on hand washing]
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| − | * [http://www.cdc.gov/handhygiene/ Centers for Disease Control on hand hygiene in healthcare settings]
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| − | * [http://www.publichealthgreybruce.on.ca/Communicable/Handwashing/ Hand Washing Video - Grey Bruce Health Unit, Canada ]
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| − | [[Category:Hygiene]] | |
| − | [[Category:Medical hygiene]]
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| − | [[de:Händedesinfektion]]
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| − | [[fr:Lavage des mains]]
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| − | [[simple:Hand washing]]
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Infection control and health care epidemiology
is the discipline concerned with preventing the spread of infections within the health-care setting.
As such, it is a practical (rather than an academic) sub-discipline of epidemiology.
It is an essential (though often underrecognized and undersupported) part of the infrastructure of health care.
Infection control and hospital epidemiology are akin to public health practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.
Infection control concerns itself both with prevention (hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance) and with investigation and management of demonstrated or suspected spread of infection within a particular health-care setting (e.g. outbreak investigation).
Prevention of Infection in the Health Care setting
Hand Hygiene
Since the days of Ignaz Semmelweis, hand washing has been known to decrease the transmission of infectious diseases. see Hand washing for additional details.
Vaccination of health care workers
Surveillance for emerging infections
Outbreak investigation
Penicillin is a common treatment when an outbreak occurs. However, if the infection has built a resistance, then penicillin would have no effect whatsoever. This was the cause of people overusing penicillin.
Training in infection control and health care epidemiology
Practitioners can come from several different educational streams. Many begin as nurses, some as medical technologists (particularly in clinical microbiology), and some as physicians (typically infectious disease specialists). Specialized training in infection control and health care epidemiology are offered by the professional organizations described below. Physicians who desire to become infection control practitioners often are trained in the context of an infectious disease fellowship.
Certification Board of Infection Control and Epidemiology is an organization that certifies infection control practitioners based on their educational background and professional experience, in conjunction with testing their knowledge base with standardized exams. The credential awarded is CIC, Certification in Infection Control and Epidemiology.
A course in hospital epidemiology (infection control in the hospital setting) is offered jointly each year by the Centers for Disease Control and Prevention (CDC) and the Society for Healthcare Epidemiology of America.
Professional organizations
Association of Professionals in Infection Control and Epidemiology is primarily composed of infection prevention and control professionals with nursing or medical technology backgrounds
The Society for Healthcare Epidemiology of America is more heavily weighted towards practitioners who are physicians or doctoral-level epidemiologists.
