General
According to studies, 75 to 90% of nosocomial infections are manuportees.
The simple application of rules of hygiene contributes to the reduction of the source of infection and mortality costs for society.
Washing hands is the 43 th recommendation for monitoring and prevention of nosocomial infections.

Our Hands
Skin flora
It contains 2 families:

• Flora transitional variable according to the contacts,
• Commensal flora or residual that is stable and renewed regularly.

hands who care
Areas of contamination are:

• The ends of the fingers,
• Nails and nail beds,
• The interdigital spaces,
• The grooves, palm
• The outer edges.

Recommendations and basic principles
Wearing jewelry is prohibited.
Keep nails short.
Any nail polish is prohibited.
The holding should be preferably short sleeves or sleeves must be identified.

The means available:

• Points of water must meet standards (avoid splashing must be clean, preferably running order at the elbow or foot, …)
• Dispensers for liquid soap,
• Dispensers towels disposable,
• The garbage containers made closed and equipped with foot control, easy to open.

What is prohibited:

• The collective towels, tea towels,
• The furnaces,
• The soaps,
• The towels that are out of the sink.

Different handwashes

Washing simple
The antiseptic wash or toilet,
The surgical scrub
The wash solution of water and ethanol.

Simple washing
These objectives are:
Remove transient flora, dirt, dander, …
Manuportee prevent transmission.
The washing is a simple mechanical action.
The product used is typically a mild soap.
The time of simple hand washing is at least 30 seconds.
The water points nearest the care will be used.
Its indications are:

• During the hygiene, comfort to the patient
• Before and after each care activity,
• When a nurse care non-invasive (eg therapeutic administrations)
• At the service plug and left him,
• After all gestures of everyday life (before / after meals, have been the toilet, blowing your nose, coughing, wearing …)

Technical:
Wet hands and wrists,
Collect a dose of soap,
lather hands and wrists for 30 seconds minimum
Do not forget to lather the hands and back of the board sagittal
Do not forget also the interdigital spaces,
the backs of the fingers,
‘Flush,
Wipe dabbing with towels disposable,
In case of manual control, close the faucet with the towel.

The antiseptic wash or toilet
These objectives are
Eliminate the transient flora acquired
Reduce the commensal flora.
This washing is a mechanical action associated with a chemical action.
The time of the wash water is less than 1 minute.
The product used is an antiseptic soap broad spectrum soap solution.
Its indications are:

• Before and after any invasive procedure (urinary catheter, catheterization, …)
• Before and after any aseptic task: manipulation of central venous,
• Before and after contact with a patient in isolation,
• Before contact with an immunocompromised patient,
• action tank, contaminating or after handling contaminated objects,
• Before donning sterile gloves.

Technique:
The technique is the same as washing except that it takes just a minute.

The surgical scrub
Its indications are:

• Before any surgery
• Before any action at high risk of infection in the service of care requiring a surgical procedure (lumbar puncture, …)

Equipment used:

• Soap antiseptic broad spectrum
• From bacteriologically pure water (micro-filtered)
• A disposable brush impregnated or not impregnated with antiseptic
• The towels disposable,
• A valve released.

Technique:
There is a washing 3 times lasting 6 minutes in all.
1 time:

• Port mask and cap,
• Hygienic washing of hands by massaging the fingertips to elbow for a minute
• Always keep hands above the elbows throughout the operation,
• Flush hands, wrists and forearms.

2nd time:

• Repeat the previous operation,
• Use the brush sterile
• Brush your nails and count 30 seconds per hand.

3rd time:

• Acquire a dose of soap, rub and rinse;
• Dry thoroughly by dabbing with a sterile towel per member, always keep hands up,
• Maintain this position during the wrapping.

The hydro-alcoholic solution
Is the removal of transient flora.
To use an antiseptic for disinfection and rapid drying hands.
It does not remove the stains on both the nature of the product used.
This process is being carried out on clean hands.
The product used is a solution with alcohol.
Its indications:

• In addition to handwashing,
• Palliative washing hygienically clean hands by care.
• Substitutive simple washing of hands not soiled in the absence of water point.
• Recommended in the operating room during a change of gloves.

Technique:
Palm palm cons
Palm of his right hand on the back of his left hand and vice versa
Palm cons palm with fingers interlaced
Back of fingers against the opposite palm with fingers interlocked
Friction in rotation of the thumb right enshrined in the left palm and vice versa
Friction and rotational movement back and forth with the finger joints

Recommendation:

• Each step must be repeated at least 5 times,
• The friction must be at least 30 seconds,
• No rinsing
• Lavage simple it is dirty and maximum after 5 applications of the solution,
• Do not use on damaged hands or with cuts,
• Dry hands before applying the solution,
• Do not use pre-powdered gloves.

Wearing disposable gloves
These objectives are:

• Fight against nosocomial infections and protections treated vis-a-vis these infections.
• Caregiver protections vis-a-vis the treated face of exposure to blood.
• Gloves Disposable Non-sterile come in dispenser box, are either latex or vinyl, come in different sizes to meet standards.

There may be minor inconveniences:
Latex allergy in the form of eczema, hives or respiratory allergy,
Hands more easily damaged due to a hand washing and glove use non-optimal.
The gloves do not provide the washing of hands.
Recommendations to avoid irrational use are:

• Wash hands before and after wearing gloves,
• Respect indications: for any gesture at risk
• Use only between 2 patients,
• Compulsory when hands are of pleasure,
• Use appropriate,
• Respect the time of shipping

The gloves are a defensive line that can be broken by:
Perforation,
Porosity.