Desinfektion behandschuhter Hände

Das Tragen von Handschuhen für mehrere Tätigkeiten am selben Patienten wie in der Anästhesie oder Notaufnahme führt oft dazu, dass Tätigkeiten einschließlich aseptischer Tätigkeiten mit kontaminierten Handschuhen durchgeführt werden. Die Desinfektion behandschuhter Hände kann das Risiko der Übertragung deutlich reduzieren, wenn Handschuhe für mehrere Tätigkeiten am selben Patienten getragen werden sollen.

Schlüsselwörter

Händedesinfektion - behandschuhte Hand - Wirksamkeit - Sicherheit - nosokomiale Infektionen

• Literatur

• 1 Kocher T. On some conditions of healing by first intention, with special reference to disinfection of hands. Trans Am Surg Assoc 1899; 17: 116-151
• 2 WHO. Glove use information leaflet: WHO. 2009 Im Internet: http://www.who.int/gpsc/5may/Glove_Use_Information_Leaflet.pdf Stand: 31.01.2018
• 3 Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V (AWMF). Leitlinie „Händedesinfektion und Händehygiene“ 2015; Registernummer 029-027.
• 4 National Institute for Health and Care Excellence (NICE). http://www.nice.org.uk/guidance/cg139/resources/healthcareassociated-infections-prevention-and-control-in-primary-and-community-care-pdf-35109518767045 Stand: 31.01.2018
• 5 WHO. WHO guidelines on hand hygiene in health care. First Global Patient Safety Challenge Clean Care is Safer Care. Geneva: WHO; 2009
• 6 Loveday HP, Wilson JA, Pratt RJ. et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect 2014; 86 (Suppl. 01) S1-S70
• 7 Loveday HP, Lynam S, Singleton J. et al. Clinical glove use: healthcare workersʼ actions and perceptions. J Hosp Infect 2014; 86: 110-116
• 8 Eveillard M, Rabjeau A, Pradelle MT. et al. Rates of adherence to hand hygiene and gloving practices in 2 French rehabilitation hospitals by differentiation between single contacts and series of successive contacts with patients or the environment. Infect Control Hosp Epidemiol 2010; 31: 878-879
• 9 el Mikatti N, Dillon P, Healy TE. Hygienic practices of consultant anaesthetists: a survey in the north-west region of the UK. Anaesthesia 1999; 54: 13-18
• 10 Katherason SG, Naing L, Jaalam K. et al. Hand decontamination practices and the appropriate use of gloves in two adult intensive care units in Malaysia. J Infect Dev Ctries 2010; 4: 118-123
• 11 Eveillard M, Joly-Guillou ML, Brunel P. Correlation between glove use practices and compliance with hand hygiene in a multicenter study with elderly patients. Am J Infect Control 2012; 40: 387-388
• 12 Bingham J, Abell G, Kienast L. et al. Health care worker hand contamination at critical moments in outpatient care settings. Am J Infect Control 2016; 44: 1198-1202
• 13 Lopaz MA, Amela C, Ordobas M. et al. First secondary case of Ebola outside Africa: epidemiological characteristics and contact monitoring, Spain, September to November 2014. Euro Surveill 2015; 20: pii:21003
• 14 McCarty CL, Basler C, Karwowski M. et al. Response to importation of a case of Ebola virus disease-Ohio, October 2014. MMWR Morb Mortal Wkly Rep 2014; 63: 1089-1091
• 15 Centers for Disease Control and Prevention (CDC). Guidance on Personal Protective Equipment To Be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing): Centers for Disease Control and Prevention; 2014. Im Internet: http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html Stand: 08.01.2018
• 16 Goudra B, Singh PM, Galvin E. Comparison of compliance of glove use among anesthesia providers: a prospective blinded observational study. AANA J 2014; 82: 363-367
• 17 Ben-David B, Gaitini L. Compliance with gloving in anesthesia: an observational study of gloving practice at induction of general anesthesia. J Clin Anesth 1997; 9: 527-531
• 18 Mills PJ. Glove-wearing by anaesthetists. Anaesthesia 1991; 46: 237-238
• 19 Harrison CA, Rogers DW, Rosen M. Blood contamination of anaesthetic and related staff. Anaesthesia 1990; 45: 831-833
• 20 Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) am Robert Koch-Institut. Empfehlungen zur Prävention der nosokomialen beatmungsassoziierten Pneumonie. Bundesgesundheitsbl 2013; 56: 1578-1590
• 21 Fukada T, Iwakiri H, Ozaki M. Anaesthetistsʼ role in computer keyboard contamination in an operating room. J Hosp Infect 2008; 70: 148-153
• 22 Steedman DJ. Protective clothing for accident and emergency personnel. J Accid Emerg Med 1994; 11: 17-19
• 23 Ross B, Spors J, Oberndörfer D. et al. Hygiene in Krankentransport und Rettungsdienst – Empfehlungen unter besonderer Berücksichtigung des Personalschutzes. Hyg Med 2013; 38: 8-15
• 24 Barr N, Holmes M, Roiko A. et al. Self-reported behaviors and perceptions of Australian paramedics in relation to hand hygiene and gloving practices in paramedic-led health care. Am J Infect Control 2017; 45: 771-778
• 25 Megeus V, Nilsson K, Karlsson J. et al. Hand hygiene and aseptic techniques during routine anesthetic care – observations in the operating room. Antimicrob Resist Infect Control 2015; 4: 5
• 26 Chau JP, Thompson DR, Twinn S. et al. An evaluation of hospital hand hygiene practice and glove use in Hong Kong. J Clin Nurs 2011; 20: 1319-1328
• 27 Husni RN, Goldstein LS, Arroliga AC. et al. Risk factors for an outbreak of multi-drug-resistant Acinetobacter nosocomial pneumonia among intubated patients. Chest 1999; 115: 1378-1382
• 28 Loftus RW, Koff MD, Birnbach DJ. The dynamics and implications of bacterial transmission events arising from the anesthesia work area. Anesth Analg 2015; 120: 853-860
• 29 Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) am Robert Koch-Institut. Empfehlungen zur Händehygiene in Einrichtungen des Gesundheitswesens. Bundesgesundheitsbl 2016; 59: 1189-1220
• 30 Bearman GM, Marra AR, Sessler CN. et al. A controlled trial of universal gloving versus contact precautions for preventing the transmission of multidrug-resistant organisms. Am J Infect Control 2007; 35: 650-655
• 31 Girou E, Chai SH, Oppein F. et al. Misuse of gloves: the foundation for poor compliance with hand hygiene and potential for microbial transmission?. J Hosp Infect 2004; 57: 162-169
• 32 Cusini A, Nydegger D, Kaspar T. et al. Improved hand hygiene compliance after eliminating mandatory glove use from contact precautions-Is less more?. Am J Infect Control 2015; 43: 922-927
• 33 Fuller C, Savage J, Besser S. et al. “The dirty hand in the latex glove”: a study of hand hygiene compliance when gloves are worn. Infect Control Hosp Epidemiol 2011; 32: 1194-1199
• 34 Calhoun AJ, Rodrick GE, Brown FH. Integrity of powdered and powder-free latex examination gloves. J Public Health Dent 2002; 62: 170-172
• 35 Fiehn NE, Westergaard J. Physical and microbiological quality of five different examination and surgical gloves before and after use in dental practice. Zentralbl Hyg Umweltmed 1993; 195: 27-36
• 36 Phalen RN, Wong WK. Integrity of disposable nitrile exam gloves exposed to simulated movement. J Occup Environ Hyg 2011; 8: 289-299
• 37 Baumann MA, Rath B, Fischer JH. et al. The permeability of dental procedure and examination gloves by an alcohol based disinfectant. Dent Mater 2000; 16: 139-144
• 38 Capron A, Destree J, Jacobs P. et al. Permeability of gloves to selected chemotherapeutic agents after treatment with alcohol or isopropyl alcohol. Am J Health Syst Pharm 2012; 69: 1665-1670
• 39 Gao P, Horvatin M, Niezgoda G. et al. Effect of multiple alcohol-based hand rub applications on the tensile properties of thirteen brands of medical exam nitrile and latex gloves. J Occup Environ Hyg 2016; 13: 905-914
• 40 Douglas CW, Millward TA, Clark A. The use of various handwashing agents to decontaminate gloved hands. Br Dent J 1989; 167: 62-65
• 41 Mehtar S, Tsakris A, Castro D. et al. The effect of disinfectants on perforated gloves. J Hosp Infect 1991; 18: 191-200
• 42 Davies JG, Babb JR, Bradley CR. et al. Preliminary study of test methods to assess the virucidal activity of skin disinfectants using poliovirus and bacteriophages. J Hosp Infect 1993; 25: 125-131
• 43 Tomas ME, Nerandzic MM, Cadnum JL. et al. A novel, sporicidal formulation of ethanol for glove decontamination to prevent clostridium difficile hand contamination during glove removal. Infect Control Hosp Epidemiol 2016; 37: 337-339
• 44 Ng PC, Wong HL, Lyon DJ. et al. Combined use of alcohol hand rub and gloves reduces the incidence of late onset infection in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 2004; 89: F336-F340
• 45 Gesetz über Medizinprodukte (Medizinproduktegesetz – MPG) in der Fassung der Bekanntmachung vom 07.08.2002, BGBL. I S. 3146.
• 46 Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen (NRZ), Aktionsbündnis Patientensicherheit e. V., Wissenschaftlicher Beirat der Aktion Saubere Hände. Positionspapier „Desinfizierbarkeit von medizinischen Untersuchungshandschuhen“ in Absprache mit der Abteilung Prävention der DGUV 2015. Im Internet: http://www.aktion-sauberehaende.de/fileadmin/ash/downloads/pdf/ergebnisse/Positionspapier_Handschuh_Desinfektion_Stand_06.07.2015.pdf Stand 8.1.2018
• 47 Pitten FA, Muller P, Heeg P. et al. The efficacy of repeated disinfection of disposable gloves during usage. Zentralbl Hyg Umweltmed 1999; 201: 555-562
• 48 Pitten F-A, Kramer A. Desinfizierbarkeit medizinischer Handschuhe. Hyg Med 2001; 26: 10-12
• 49 Scheithauer S, Hafner H, Seef R. et al. Disinfection of gloves: feasible, but pay attention to the disinfectant/glove combination. J Hosp Infect 2016; 94: 268-272