Elements of Hand Washing

Rationale for Hand Hygiene

• Risks of transmission of microorganisms to patients

• Risks of health care worker colonization or infection caused by organisms acquired from the patient

• Morbidity, mortality and costs associated with health care-associated infections

Indications for Hand Washing

• Contact with a patient's skin (i.e., taking a pulse or blood pressure, performing physical examinations, lifting the patient in bed)

• Contact with environmental surfaces in the immediate vicinity of patients

• After glove removal

Indications for, and Limitations of, Glove Use

• Hand contamination may occur as a result of small, undetected holes in examination gloves

• Contamination may occur during glove removal

• Wearing gloves does not replace the need for hand washing

• Failure to remove gloves after caring for a patient may lead to transmission of microorganisms from one patient to another

Adapted from CDC. Guideline for hand hygiene in health-care settings. MMWR. 2002; 51(RR16):1-44.

General Steps for Cleaning Ice Machines, Dispensers, Storage Chests

1. Disconnect unit from power supply

2. Remove and discard ice from bin/storage chest

3. Allow unit to warm to room temperature

4. Disassemble removable parts of machine that make contact with water to make ice

5. Thoroughly clean machine and parts with water and detergent

6. Dry external surfaces of removable parts before reassembling

7. Check for any needed repair

8. Replace feeder lines as appropriate (i.e., damaged, old, difficult to clean)

9. Ensure presence of an air space in tubing leading from water inlet into water distribution system of machine

10. Inspect for rodent/insect infestations under the unit and treat as needed

11. Check door gaskets for evidence of leakage/dripping into storage chest

12. Clean the ice/storage chest or bin with fresh water and detergent, then rinse with fresh tap water

13. Sanitize machine by circulating a 50-100 parts per million (ppm) solution of sodium hypochlorite* through the icemaking and storage systems for two hours (100 ppm solution) or four hours (50 ppm solution)

14. Drain sodium hypochlorite solution and flush with fresh tap water; allow all surfaces of equipment to dry before returning to service

Adapted from: CDC. Guidelines for environmental infection control in health care facilities. MMWR. 2003; 52(RR10):1-42.

* Sodium hypochlorite is a solution containing 10% bleach. To make a 50-100 ppm sodium hypochlorite solution, mix 0.5cc regular bleach with 25 gallons of water, which is the approximate amount needed to clean one ice machine.