1- Before touching a patient
WHY? To protect the patient against colonization and, in some cases, against exogenous infection, by harmful germs carried on your hands
WHEN? Clean your hands before touching a patient when approaching him/her*
Situations when Moment 1 applies:
- Before shaking hands, before stroking a child’s forehead.
- Before assisting a patient in personal care activities: to move, to take a bath, to eat, to get dressed, etc.
- Before delivering care and other non-invasive treatment: applying oxygen mask, giving a massage.
- Before performing a physical non-invasive examination: taking pulse, blood pressure, chest auscultation, recording ECG.
2 – Before clean / aseptic procedure
WHY? To protect the patient against infection with harmful germs, including his/her own germs, entering his/her body
WHEN? Clean your hands immediately before accessing a critical site with infectious risk for the patient (e.g. a mucous membrane, non-intact skin, an invasive medical device)*
Situations when Moment 2 applies:
- Before brushing the patient’s teeth, instilling eye drops, performing a digital vaginal or rectal examination, examining mouth, nose, ear with or without
an instrument, inserting a suppository / pessary, suctioning mucous.
- Before dressing a wound with or without instrument, applying ointment on vesicle, making a percutaneous injection / puncture.
- Before inserting an invasive medical device (nasal cannula, nasogastric tube, endotracheal tube, urinary probe, percutaneous catheter, drainage),
disrupting / opening any circuit of an invasive medical device (for food, medication, draining, suctioning, monitoring purposes).
- Before preparing food, medications, pharmaceutical products, sterile material.
3- After body fluid exposure risk
WHY? To protect you from colonization or infection with patient’s harmful germs and to protect the health-care environment from germ spread
WHEN? Clean your hands as soon as the task involving an exposure risk to body fluids has ended (and aer glove removal)*
Situations when Moment 3 applies:
- When the contact with a mucous membrane and with non-intact skin ends.
- After a percutaneous injection or puncture; after inserting an invasive medical device (vascular access, catheter, tube, drain, etc); after disrupting and opening an invasive circuit.
- After removing an invasive medical device.
- After removing any form of material offering protection. (napkin, dressing, gauze, sanitary towel, etc)
- After handling a sample containing organic matter, after clearing excreta and any other body fluid, after cleaning any contaminated surface and soiled material (soiled bed linen, dentures, instruments, urinal, bedpan, lavatories, etc).
4-After touching a patient
WHY? To protect you from colonization with patient germs and to protect the health-care environment from germ spread.
WHEN? Clean your hands when leaving the patient’s side, after having touched the patient *
Situations when Moment 4 applies, if they correspond to the last contact with the patient before leaving him / her:
- After shaking hands, stroking a child’s forehead.
- After you have assisted the patient in personal care activities: to move, to bath, to eat, to dress, etc.
- After delivering care and other non-invasive treatment: changing bed linen as the patient is in, applying oxygen mask, giving a massage
- After performing a physical non-invasive examination: taking pulse, blood pressure, chest auscultation, recording ECG.
5- After touching patient surroundings.
WHY? To protect you from colonization with patient germs that may be present on surfaces / objects in patient surroundings and to protect the health-care environment against germ spread
WHEN? Clean your hands aer touching any object or furniture when living the patient surroundings, without having touched the patient*
This Moment 5 applies in the following situations if they correspond to the last contact with the patient surroundings, without having touched the patient:
- After an activity involving physical contact with the patients immediate environment: changing bed linen with the patient out of the bed,
holding a bed trail, clearing a bedside table.
- After a care activity: adjusting perfusion speed, clearing a monitoring alarm.
- After other contacts with surfaces or inanimate objects (note – ideally try to avoid these unnecessary activities): leaning against a bed, leaning against a night table / bedside table.
*NOTE: Hand hygiene must be performed in all indications described regardless of whether gloves are used or not.