A) When there is visible pollution, such as blood or other body fluids, wash your hands with soap (soap liquid) and running water.

B) When there is no visible pollution on hands, it is advisable to disinfect hands with quick-drying hand disinfectant instead of washing hands.

6.2 Under the following circumstances, medical personnel should choose to wash their hands or use quick-drying hand disinfectant according to the principle of 6. 1:

A) Before and after direct contact with each patient, when moving from a contaminated part of the same patient's body to a clean part.

B) Before and after contact with the patient's mucosa, damaged skin or wound, after contact with the patient's blood, body fluids, secretions, excreta, wound dressing, etc.

C) Before and after wearing isolation gown, after taking off gloves.

D) After contact with patients' surroundings and objects.

E) After contact with patients' surroundings and objects.

F) Before handling drugs or meals.

6.3 Medical personnel should wash their hands before hand hygiene disinfection in the following cases:

A) After contact with blood, body fluids and secretions of patients and articles contaminated by infectious pathogenic microorganisms.

B) After direct examination, treatment, care or treatment of the pollutants infecting patients.

6.4 See Appendix A for the method of hand washing for medical staff.

6.5 disinfection should follow the following methods:

A) Apply a proper amount of quick-drying hand sanitizer to the palm of your hand.

B) Scrubbing shall be carried out in strict accordance with Appendix A, Methods of Washing Hands for Medical Personnel and scrubbing steps.

C) When scrubbing, ensure that the hand disinfectant completely covers the skin of the hand until the hand is dry.

7 surgical hand disinfection

7. 1 surgical hand disinfection should follow the following principles:

A) Wash your hands first, and then disinfect them.

B) Between operations of different patients, when the gloves are damaged or the hands are contaminated, the operating hands should be disinfected again.

7.2 hand washing methods and requirements

7.2. 1 Before washing your hands, you should take off your jewelry and trim your nails, and the length should not exceed your fingertips.

7.2.2 Take a proper amount of detergent to clean hands, forearms and under upper arms 1/3, and knead carefully. When washing your hands, you should pay attention to cleaning the dirt under your nails and wrinkles on your hands.

7.2.3 Wash hands with running water, under forearms and upper and lower arms 1/3.

7.2.4 Dry hands, dry forearms and forearm.

7.3 surgical hand disinfection method

7.3. 1 hand washing disinfection method Apply a proper amount of hand disinfectant to the hands, forearms and upper arms, and knead carefully for 2-6 min. Rinse hands, forearms and upper arms with running water, and thoroughly dry sterile towels. The flowing water shall meet the requirements of gb 5749. Under special circumstances, when the water quality can't meet the requirements, the surgeon should disinfect his hands with alcohol hand disinfectant before wearing gloves. The amount of liquid taken, rubbing time and usage of hand disinfectant shall be carried out according to the product instructions.

7.3.2 Hand-free disinfection method: Apply a proper amount of hand-free disinfectant to hands, forearms and upper arms, and carefully knead until the disinfectant is dry. The amount of liquid taken, rubbing time and usage of hand disinfectant should follow the product instructions.

7.4 Preventive measures

7.4. 1 Don't wear fake nails, and keep your nails and surrounding tissues clean.

7.4.2 During the whole hand disinfection process, keep your hands on your chest and above your elbows, so that water can flow from your hands to your elbows.

7.4.3 When washing hands for disinfection, sponges, other rubbing objects or hands can be used to rub against each other.

7.4.4 After removing surgical gloves after operation, wash hands with soap (soap solution).

7.4.5 After use, nail cleaning appliances, sponges, hand brushes and other wiping products should be put into the designated container; Rubbing supplies should be disinfected or used once per person; Nail cleaning products should be cleaned and disinfected every day.

Monitoring of hand hygiene effect

8. 1 monitoring requirements

Medical institutions should monitor the disinfection effect of the hands of medical staff working in operating rooms, delivery rooms, catheter rooms, laminar flow clean wards, bone marrow transplant wards, organ transplant wards, intensive care units, neonatal rooms, maternal and child rooms, hemodialysis wards, burn wards, infectious diseases departments, stomatology departments and other departments every quarter; When it is suspected that the outbreak of nosocomial infection is related to the hand hygiene of medical staff, it should be monitored in time and the corresponding pathogenic microorganisms should be detected.

8.2 Monitoring method

According to appendix B.

8.3 Criteria for judging qualified hand hygiene

The total number of bacterial colonies meets the requirements of 4.4.

Appendix a

(normative appendix)

Hand washing methods of medical staff

A. 1 Under running water, let your hands be fully wet.

A.2 Take a proper amount of soap (soap solution) and evenly spread it on the whole palm, back of hand, fingers and fingertips.

A.3 Rub your hands carefully for at least 15 seconds, and pay attention to cleaning all the skin of your hands, including the back of your fingers, fingertips and fingers. The specific kneading steps are as follows:

A.3. 1 palms are opposite, fingers are close together, and they rub against each other, as shown in figure A. 1.

A.3.2 palms are facing each other, and fingers with hands crossed rub and exchange with each other, as shown in Figure A.2. ..

A.3.3 palms facing each other, hands crossed and fingers rubbed, as shown in Figure A.3. ..

A.3.4 Bend your fingers, make the joints rotate, and rub them in the palm of the other hand for exchange, as shown in Figure A.4. ..

A.3.5 Hold the left thumb with the right hand to rotate, rub and exchange, as shown in Figure A.5. ..

A.3.6 Put five fingertips together in the palm of the other hand, rotate, knead and exchange, as shown in Figure A.6. ..

A.4 Wash your hands thoroughly under running water, dry them, and take a proper amount of hand cream for skin care.

Appendix b

(normative appendix)

Monitoring method of hand hygiene effect

B. 1 sampling time: sample before contact with patients and medical activities.

B.2 Sampling method: put the five fingers of the examinee together, and rub the cotton swab from heel to fingertips twice, with the area of one hand about 30cm2 ~ 2, and rotate the cotton swab at the same time during the rubbing process; Cut off the part of the cotton swab that contacts the operator, put it into a 10ml sterile eluent test tube with corresponding neutralizer, and send it for inspection in time.

B.3 Detection method: Shake the sampling tube on the mixer for 20 seconds or shake it violently for 80 times, suck 65438±0.0ml of the same sample with a sterile straw and inoculate it into a sterilization plate, inoculate 2 plates for each sample, add 65,438 05 ml ~ 65,438 ml of nutrient agar dissolved at 45℃ ~ 48℃ to the plate, and shake it evenly while pouring.

Calculation method of total bacterial colonies;