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Hand hygiene: the “before” momentMar042016

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In January, we promoted the 4 Moments for Hand Hygiene – a simple and effective way to ensure safe, quality care and prevent infections in health care settings.

This month, we’re focusing in on the first moment: before initial patient / patient environment contact.

In a nutshell, here’s what you need to remember:

AmbulatoryWhen? Clean your hands when entering a room:

  • before touching client/patient/resident
  • before touching any object or furniture in the client/patient/resident’s environment
    Some examples of patient / patient environment contact may be:
  • shaking hands or stroking an arm
  • taking pulse, blood pressure, chest auscultation, or abdominal palpation
  • helping a patient to move around or get washed, or giving a massage
  • adjusting an IV rate

Why? To protect the client/patient/resident and their environment from harmful germs carried on your hands.

Remember: ambulatory patient areas count, too!

Share your thoughts, enter to win

There’s an interesting statistical trend when it comes to the “before” moment. In provincial hand cleaning compliance audits, hand hygiene rates before contact are consistently lower than after contact (see the graph below). PICNet is interested in hearing why you think this is happening. 


Update March 21: the contest is now closed, but you are still welcome to add comments at any time. (If the comments aren’t displaying, click the More button, below right.)


5 Responses to “Hand hygiene: the “before” moment”

  1. Toren

    Hand Hygiene rates before patient contact are often lower that after patient contact because it is harder to realize that our hands aren’t clean. After patient contact, we have usually made contact with a sick patient and we know now that we must clean our hands to rid us of any germs we came in contact with. Before patient contact, we have simply been touching our charts and computers, which are contaminated, but sometimes we forget this. It is important to remind healthcare workers that nursing stations and IMIT equipment is indeed contaminated. To keep our patients safe, we must perform hand hygiene before contacting their own environment.

    • Name: Toren
    • Display with Comment: NO
    • Email: toren.huntley@viha.ca
    • Health Authority: Island Health
  2. Kathy Bromley

    I suspect that this is an attitude issue. HCW attitude may be to protect themselves from acquiring microbes/illness from patients (who they know to be ill), and HH helps protect them after patient contact because they believe that they may have picked up germs. This would not be the case for HH before patient contact. As well, HCW may not see themselves as being ill (unlike the patient), and they do not think it necessary to perform HH before patient contact.

    • Name: Kathy Bromley
    • Display with Comment: NO
    • Email: KBromley@regionofwaterloo.ca
    • Health Authority: Outside BC
  3. Stephanie Cardinal

    I agree with the above comment- that we as health care workers often find ourselves too busy worrying about protecting ourselves after having patient or client contact that we neglect to remember the importance of protecting them. I don’t think it’s necessarily deliberate, because we wouldn’t be in this profession if we didn’t want to care or improve the lives of those in need of medical care. On the other hand, because caring for patients is also our ‘job’, it can cause us to maybe overlook or take for granted that these people have a live outside their current ‘role’ as a patient; it could just as easily be us or a family member in their place instead! Knowing what I know about secondary and nosocomial infections, I for one would really want my care provider coming to me with freshly washed hands.

    In Northern Health, all our soap and sanitizer dispensers display this message:
    “You will touch someone’s life today … Do it with clean hands”.

    I believe that making this or similar ‘personalized’ messaging more widely (but tastefully) displayed, may serve as a ‘close-to-home’ reminder for staff that caring for a patient, someone else’s loved one, deserves the same that we would wish for our own family or friends, and it starts with clean hands.

    • Name: Stephanie Cardinal
    • Display with Comment: NO
    • Email: Stephanie.Cardinal@northernhealth.ca
    • Health Authority: Northern Health
  4. Kim Leslie

    I was an ICP and I have returned to the bedside. The reason for the lower rates “after” can be multiple fold – but for me, your mindset “before” vs what can be classed as an “after” plays a part. I am preparing to see my patient “before”, touching clean items to bring to bedside and hand hygiene is part of that. “After” may involve several returns to the bedside – in and out of the room for items forgotten and a mindset of “I’m not quite done” – the hand hygiene products at the bedside helps with this immensely! My thought is that HCWs have entered the chaos of patient care with multiple demands, priorities and actions after contact with a patient and without the solidification of hand hygiene as part of our habits we may miss the opportunity. :)

    • Name: Kim Leslie
    • Display with Comment: YES
    • Email: kleslie3@telus.net
    • Health Authority: Interior Health
  5. Jordie Laidlaw

    Good article.

    • Name: Jordie Laidlaw
    • Display with Comment: YES
    • Email: jordie.laidlaw@northernhealth.ca
    • Health Authority: Northern Health

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