Hand hygiene is the simplest, most effective, most convenient and most economical way to control hospital infections. Through years of publicity and education, hospital staff basically understand the important role of hand hygiene in the control of hospital infections, but in practice do we really do hand hygiene? Is the hardware management of hand hygiene really scientific, effective and standardised? Is the monitoring of hand hygiene really well done?

First, the choice of hand hygiene hardware facilities (a) hand washing facilities in the faucet selection (1) long-handled, non-touch faucet is not a mandatory option for clinical departments to use the most common faucet for the induction, foot-operated, long-handled. Choose long handle type more, the initial intention is long handle type can use the elbow to turn off the tap to avoid pollution after washing hands. However, the actual situation is that only a few people will use the elbow to turn off the tap, most still use their hands to turn off the tap. Environmental sampling of tap handles showed that multi-drug resistant Acinetobacter baumannii was found to be >1000 cfu/cm2, so long-handled taps are not necessarily the best choice.
(2) Hand hygiene hardware settings need to be scientifically regulated WHO hand hygiene norms do not prohibit the use of manual taps, but there is a very subtle action when turning off the tap after hand washing, requiring that a paper towel be held to turn it off. During the epidemic we put forward the concept of dirt-avoiding paper, and many people took the paper to open doors, do a variety of operations, etc. It is the same concept. When turning off the tap, you can hold the paper to turn it off, thus avoiding hand contamination, so it is not necessarily necessary to use non-contact taps.
(B) the environmental pollution of the sink needs to cause enough concern (1) pay attention to the location of the sink to avoid possible contamination of some hospitals in the intensive care medicine ward in accordance with the Health Office of the medical government issued [2009] No. 23, ‘Critical Care Medicine Construction and Management Guidelines (Trial)’ requirements ‘with sufficient non-contact hand washing facilities and hand disinfection devices, a single room per bed, 1 set, open beds at least every 2 beds, and the hand disinfection device. Open beds at least 1 set for every 2 beds.’ Set up a very large number of sinks, but sinks are prone to cause more follow-up problems: ① humidity is relatively large, the environment of microorganisms, including filamentous fungi, Aspergillus, Legionella, etc. a large increase in infection risk. ②The tap will splash, the water in the sink will splash to the surrounding distance of nearly 1m. Now according to the whole genome sequencing can be traced back to the origin of the bacteria, clearly distinguish the offspring, the parent generation, can be clear because of the splash caused by the contamination of the sink will be passed on to the patient.
The United States, which previously proposed that there should be at least one tap in an intensive care unit, now proposes that sinks should be moved outside the single room and can be placed in the doorway. Sinks in intensive care units should be located far enough away from patients.
(2) Concerns about contamination from sinks During the epidemic, there was talk that water sealing of sewers would prevent the spread of aerosols, but this ignored the problem that biofilm can easily form where there is water, and once biofilm is formed it will climb up the pipe to the mouth of the sink. Water seal can indeed avoid the spread of aerosols, but in the end to avoid how much need to play a question mark, but the water will inevitably form a biofilm after the accumulation of more.
New sink faucet nozzles should not flow directly into the sewer; the bottom area of the sink should be restricted and the use of counter space around existing sinks for patient care supplies or storage should be prohibited; sinks should be strategically located in the patient care area as there is a 1-metre droplet dispersion zone around the sink; handwashing sinks should be limited to handwashing only, and disposal of nutrients or contaminated wastes into the sink should be prohibited.
(C) quick-drying hand sanitiser open after the expiry date according to the product manual to determine the quick-drying hand sanitiser can be used after opening 30 days or 60 days of the problem, the previous national standard is open after 30 days, write the specification of the teacher said it is a pat on the head to think of it. Through the West China Hospital of Sichuan University Qiao Fu, Zong Zhiyong Professor's research found that quick-drying hand disinfectant in the opening 65 days of the concentration of disinfectant, disinfection effect, bacterial contamination are no difference, and now the specification has been changed to quick-drying hand disinfectant after opening the expiry date according to the product specification to determine.
(D) dry hand way preferred dry hand paper towels (1) do not choose to dry the hands of the drying phone dry hand abroad in 2015 published an article comparing the dry hand paper, drying mobile phone on the issue of environmental pollution, found that the hand drying machine will cause a lot of environmental pollution. China's disease control department research found that the air around the drying mobile phone there is a large amount of bacterial pollution, because the drying mobile phone does not have a filtering device, usually placed in the bathroom, the surrounding air conditions are poor, the temperature of the wind sprayed out of the temperature of 20-30 ° C, is the most prone to a large number of bacterial breeding temperature. Therefore, it is recommended to use dry hand tissue to dry hands.
(2) Surgical hand washing can choose non-sterile hand drying paper first of all surgical hand disinfection is divided into surgical rinse hand disinfection method and surgical non-rinse hand disinfection method, the first step is surgical hand washing, surgical hand disinfection is through the application of hand disinfectant to achieve the purpose of bacterial inhibition. Therefore, no sterile hand dryer is needed in the surgical handwashing process. In the second step of applying hand disinfectant, surgical rinse hand disinfection method is applied after the disinfectant also need to flow water rinse, this step of the rinse water quality and hand drying requirements, the need to use sterilised dry hand towels or cloth towels to dry thoroughly. Surgical no-rinse hand disinfection does not require rinsing after the application of disinfectant and does not require drying with dry paper or cloth towels.
Surgical hand washing in the choice of dry hand paper box, because the dry environment above is not easy to have bacterial growth, in order to prevent the dry hand paper contamination, there is a kind of dry hand paper box on the market, you can dry the hand paper sterilised and sealed within the use of a piece of paper and have a length of the length of the length of the adjustment and automatic length of the cut, the exit of ultraviolet light disinfection to avoid contamination, it is a better method of drying the hands.