Infection Controls Update
David Vidra
This is the first in a series of articles which
will deal with infection control issues in the modification industry i.e.,
tattooing and piercing.
Infection “control” is the process of preventing
infection from occurring, not only to our clients but to ourselves, as
practitioners. It is not enough to practice the learned routines of
protection. You must know why you do what you do. Only then are you
able to understand the process of infection control and practice it safely.
HAND WASHING: THE CRITICAL
LINE OF DEFENSE
The Centers for Disease Control and Prevention
(CDC) has just published a report on hand washing. Here are those items most
important to our industry. Gloves - The use of gloves does not
eliminate the need for hand hygiene. Likewise, the use of good hand hygiene
does not eliminate the need for gloves. Gloves reduce hand contamination by
70 to 80 percent, prevent cross-contamination and protect your clients and
yourself from infection.
Hand Hygiene
- One of the most important
tools and protective devices we have is our skin. It is the largest organ of
the body. If we do not provide it with proper care, it can have reactions to
soaps we use and the gloves we wear.
Water should be tepid or lukewarm. Hot water will dry out the
skin. Cold water will also cause damage and make the pores close, therefore
not getting down where we need to be with hand washing.
Soaps -
Antibacterial soaps are
highly overused and can cause severe irritation to the skin. Presumed
allergy or sensitivity to gloves may be from irritated skin due to over
washing with antibacterial soap. Consider how many procedures you do in a
day. Keep in mind rest room use and interruptions during the procedures.
Chances are if you exclusively use antibacterial soap, you are using it in
excess. There are resident and transient bacteria on the hands. With hand
hygiene, you must realize the purpose of the soap is to suspend the
bacteria. The friction from washing removes them, and the chemicals will
reduce the number of bacteria present. If you are removing or killing off
too many resident bacteria, you are using the product in excess.
Nails -
Nails are a huge
consideration. The majority of hand bacteria can be found under and around
the fingernails. No artificial nails should be worn and natural nails
should be kept less than one quarter of an inch long. Nail polish chips and
can harbor bacteria. Rings also trap bacteria underneath them. If you must
wear one put it on a chain around your neck, not on your hands with gloves.
Warm, moist, and dark places are perfect breeding grounds for bacterial
growth.
Gels
are just now being accepted in the health care community but only with good
hand hygiene. They do not have any place in our industry. We have the time,
and the proper environment for sound hand washing techniques. We don’t
generally have so many procedures to do to that it warrants their use.
Skin care -
Use a cream to help
condition the skin. It will minimize the occurrence of irritant contact
dermatitis associated with hand washing and hand antiseptics. Protect your
hands from the elements. Select your soaps wisely. Know when and how much
of them to use. They all come with instructions, follow them.
How to wash your hands -
You must get between the fingers (digits) and scrub,
this is called inter digital washing. Clean under the nails top and wrists
of the hands. Rinse in a downward manner. The length of time necessary is
about 15-20 seconds. If you sing Happy Birthday to yourself, that is
about the time needed.
Hand drying -
When drying, pat the hands
dry, don’t rub them. The rubbing causes friction which causes minor
abrasions, and then we put on gloves. Now you see how the chemicals irritate
us from the gloves.
The last step is the
training. Have a
complete training program so everyone in the studio will follow the same
procedures.
Here is a sample written protocol for hand washing that can
be adjusted for your specific needs:
Hand Washing Protocol
Hand washing is the first step in any infection control
program. The surface of the hands and nails must be clean before any
contact is made with clients. Abrasions, cuts, or lesions should be covered
by a waterproof dressing. Consistency in hand-washing procedures is
essential in reducing the risk of cross-contamination and the spread of
infectious diseases.
When to wash hands:
·
Upon arrival
in the studio
·
After working
at the counter and/or handling money
·
After using
the toilet
·
Before and
after each procedure
·
Before and
after daily room set-up
·
Before and
after eating
·
Whenever
hands are dirty
·
After smoking
·
Before
leaving the building
·
Whenever
there is doubt about cleanliness of hands
What to Wash Hands With:
Hands should be washed using the liquid, antibacterial soap
provided in each of the procedure rooms, the sterilization areas and the
restroom. Soap for hand washing should always come from a wall-mounted, pump
dispenser. Bar soaps are unacceptable, as they can harbor different forms of
bacteria and other microorganisms.
How to Wash Hands:
Turn on water if using hand
operated paper towels. Turn on and off so as to prevent cross
contamination.
Always wet hands with water
then apply soap (follow manufacturers instructions).
Using soap provided for hand washing:
Rub hands vigorously during the washing process. Both the
chemical action of the soap as well as the friction from the physical act of
hand washing results in appropriate cleaning.
Hand washing should include the following actions:
a) Washing
palm-to-palm
b) Washing palm
over dorsum (top of hand)
c) Washing
palm-to-palm with fingers interlaced
d) Washing tops
of fingers and nail area
e) Washing
forearms to an area above where the cuffs of gloves stop
f) Thoroughly
rinse hands, with hands pointed downwards
Your hands are your most important tools and are the greatest
at risk for you to contract a disease and to cause one.
