Συμπεράσματα
Το απλό πλύσιμο των χεριών με κοινό σαπούνι και νερό έχει περιορισμένες ενδείξεις σε ένα νοσοκομειακό περιβάλλον όπως για τον καθαρισμό των χεριών όταν είναι εμφανώς λερωμένα με αίμα ή άλλα βιολογικά υγρά, πριν το φαγητό, μετά τη χρήση W.C. και όταν υπάρχει υποψία για μόλυνση των χεριών με βακτηριακούς σπόρους. Σε αυτές τις κλινικές καταστάσεις, το απλό πλύσιμο έχει τα καλύτερα αποτελέσματα σε σύγκριση με άλλες πιθανές μεθόδους (24).
Για την αντισηψία των χεριών στην Οδηγία του CDC προτείνεται η χρήση αλκοολούχου αντισηπτικού ως διαδικασία επιλογής πριν και μετά τη διενέργεια εργασιών φροντίδας ασθενών που μπορούν να οδηγήσουν σε επιμόλυνση των χεριών του ιατρονοσηλευτικού προσωπικού και διάδοση μικροβίων, π.χ. μετά την επαφή με το άθικτο δέρμα ασθενών, με σωματικά υγρά ή εκκρίσεις, με βλεννώδεις μεμβράνες, με τραύματα και με επιθέματα τραυμάτων, μετά την επαφή με μολυσμένη περιοχή σώματος και πριν την μετακίνηση σε καθαρή περιοχή σώματος, μετά την επαφή με επιφάνειες κοντά σε ασθενείς και μετά την αφαίρεση γαντιών. Τα χέρια θα πρέπει επίσης να απολυμαίνονται πριν την επαφή με τους ασθενείς, πριν την χρήση γαντιών, πριν την φλεβοκέντηση, πριν την εισαγωγή ουροκαθετήρα ή αρτηριακής γραμμής. Επίσης, η υγιεινή των χεριών με ένα αλκοολούχο αντισηπτικό ενδείκνυται μετά τη χρήση W.C. σε περίπτωση διάρροιας και μετά το φύσημα της μύτης σε περίπτωση λοίμωξης του ανώτερου αναπνευστικού συστήματος (2).
Η συμμόρφωση σε πρακτικές υγιεινής χεριών μπορεί να αυξηθεί σημαντικά με την επιλογή των κατάλληλων αλκοολούχων αντισηπτικών και με την εντατική και συνεχή εκπαίδευση και προώθηση της υγιεινής των χεριών στο προσωπικό του νοσοκομείου (97).
Η παραπάνω εργασία αποτελεί περίληψη των βασικών στοιχείων της Οδηγίας του CDC για την υγιεινή των χεριών (έκδοση 2002) καθώς και της εργασίας των G. Kampf and Axel Kramer: Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs: Clinical Microbiology Reviews: Oct. 2004, p. 863-893.
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