Infection prevention and control guidelines
2. Hand hygiene
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- Infection prevention and control guidelines
- Table of contents
- About these guidelines
- Transmission of infection in health care
- 1. Principles
- Overview – Principles
- Risk assessment and planning
- Education and training
- Clinical handover
- Antimicrobial stewardship to reduce opportunities for antimicrobial resistance
- Managing risk in special circumstances
- Resources and references
- 2. Hand hygiene
- Overview – Hand hygiene
- Role of hand hygiene in infection prevention and control
- When hands must be cleansed
- Facilities for hand hygiene
- Hand-hygiene products
- Hand hygiene technique
- Hand care
- Jewellery, nail polish and artificial nails
- Hand hygiene with glove use
- Hand hygiene when specific pathogenic microorganisms are present or suspected
- Other factors affecting practice hygiene
- Hand hygiene for patients
- Resources and references
- 3. Personal protective equipment
- Overview – Personal protective equipment
- General principles of personal protective equipment use
- When to use personal protective equipment
- Applying, removing, and disposing of personal protective equipment
- Extended use of personal protective equipment
- Case study
- Resources and references
- 4. Aseptic technique
- Overview – Aseptic technique
- Principles and terminology
- Standard aseptic technique
- Surgical aseptic technique
- Skin disinfection (asepsis)
- Resources and references
- 5. Levels of precaution
- Overview – Levels of precaution
- Standard precautions
- Transmission-based precautions
- Contact tracing
- Case study
- Resources
- 6. Staff screening immunisation and infection management
- Overview – Staff screening
- Principles for managing staff immune status
- Screening
- Staff immunisation policy and procedures
- Vaccinations for health professionals
- Health professionals with a blood borne virus
- Staff disease surveillance
- Resources and references
- 7. Sharps
- Overview – Sharps
- Responsibilities for sharps management
- Safe sharps handling practices
- Safety-engineered medical devices
- Reducing risk of infection after a sharps injury
- Resources
- 8. Exposure to blood and other body substances
- Overview – Exposure to blood and other body substances
- Blood-borne viral infection risk
- Strategies for preventing exposure to blood and body substances
- Responsibilities for managing exposure to blood and body substances
- Summary of steps for managing an exposure incident involving a staff member or patient
- Documentation of the exposure
- Resources and references
- 9. Cleaning, laundry and waste management
- Overview – Cleaning, laundry and waste management
- Policy and responsibilities
- Work health and safety issues
- Scheduled cleaning
- Cleaning agents and methods
- Cleaning reprocessing area
- Cleaning after contamination by blood or other body substances (spills)
- Cleaning tools
- Monitoring of cleaning
- Laundry
- Waste management
- Toilets
- Case study
- Resources and references
- 10. Reprocessing reusable medical devices
- Overview – Reprocessing reusable medical devices
- Choosing whether to reprocess or use disposables
- Policies and procedures
- Risk assessment
- Summary of steps in reprocessing medical devices that require sterilisation
- Staff education, training and competency assessment
- Initial treatment at point of use
- Managing the area for reprocessing for reusable medical devices
- Cleaning processes before sterilisation
- Rinsing and drying (after manual cleaning)
- Sterilisers
- Disposable materials used in the sterilisation process
- Preparing the load for sterilising
- Loading the steriliser
- Running the sterilisation cycle
- Unloading the steriliser
- Documenting reprocessing including steriliser cycles
- Documenting performance data for other equipment
- Storing sterilised reusable medical devices
- Monitoring each sterilisation cycle
- Record keeping
- Checking steriliser function
- Steriliser maintenance
- Step-by-step guide: simple first validation
- Step-by-step guide: complex validation
- Validating reprocessing procedures
- Tracking reusable medical devices for patient tracing
- Offsite sterilisation services
- Reusable medical devices on loan
- Reprocessing of reusable medical devices used off-site
- Reprocessing of specific categories of medical devices
- Resources and references
- 11. Disease surveillance and outbreak response
- Overview – Disease surveillance and outbreak response
- Response procedure
- Staff education
- Monitoring for threats
- Notifying relevant authorities
- Contact tracing
- Practice response to threats
- Patient-specific precautions
- Receptionists’ infection prevention and control kit
- Critical infection prevention and control incidents
- Resources
- 12. Planning a practice: design, fit-out, equipment and consumables
- Overview – Planning a practice: design, fit-out, equipment and consumables
- Building design and fit-out
- Equipment
- Choosing consumables and reusable equipment
- Resources and references
- Figures
- Glossary
- Links
- Relevant standards
- Acknowledgements
- Disclaimer
- Search
Last revised: 17 Jun 2024
Note: Guidance on jewellery, nail polish and artificial nails is principally intended for procedural general practice.
Health professionals should not wear rings at work because they interfere with hand-hygiene techniques and the skin under rings may be more heavily colonised by microorganisms than comparable skin without rings.
Freshly applied nail polish on natural nails does not increase the microbial load if fingernails are short. However, it should be removed before rough edges or chipping develop.
False fingernails may harbour microorganisms, especially Gram-negative bacilli and yeasts, even after handwashing.
Health professionals when providing direct patient care should adhere to a ‘bare below the elbow’ policy, including short sleeves, to ensure hands (and, if necessary, wrists and forearms) can be decontaminated effectively. This is particularly important for treatment room procedures.
Each practice could develop policies on jewellery, artificial nails and nail polish for other situations, based on risk assessment (see also: Clothing and other wearable items).