Hand hygiene (eg, hand washing, hand antisepsis or surgical hand antisepsis) substantially reduces potential pathogens on the hands and is considered the single most critical measure for reducing the the risk of transmitting organisms to patiets and DHCP.
Transient and resident flora can colonize the skin. Transient flora are usually acquired during contact with patients and contaminated environmental surfaces. These are usually the cause of healthcare associated infections. Being superficial, they are easier to remove by routine handwashing. Resident flora are attached to deeper layers of the skin and are more difficult to remove. They are however, less likely to be associated with such infections.
The preferred method of hand hygiene will depend on:
1. The type of procedure to be done (invasive or non-invasive).
2. The degree of contamination.
3. Substantivity of the antimicrobial agent.
For routine dental examinations and nonsurgigal procedures, handwashing and hand antisepsis is achieved by using either plain or antimicrobial soap and water. If the hands are no visibly soiled, an alcohol based hand rub is adequate.
For surgical procedures, antisepsis is directed toward elimination of transient flora and reduction of resident flora to prevent introduction of the organisms into the operative site.
The soap used should be antimicrobial. Skin bacteria can rapidly multiply under surgical gloves if hands are washed with soap that is not antimicrobial.