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Significance of hand washing


Ignaz Philipp Semmelweis, an official with the obstetrical clinics of the Vienna General Hospital (1847), noticed that surgeons and medical students frequently travelled directly from autopsy rooms to medical wards where they assisted women during childbirth. After studying hospital records, he concluded that materials transferred from cadavers were directly related to the incidence of puerperal or childbirth fever, a common cause of patient mortality. Semmelweis then instituted a policy requiring all medical students to wash their hands using a solution of chlorinated lime before attending to patients. Infection rates within the obstetrical clinics were significantly reduced while this practice was required, but Semmelweis was ridiculed for his policy, and ultimately resigned his position.

Handwashing is now recognised as the single most important procedure for preventing nosocomial infections. Handwashing with soap and water helps particularly in the control of methicillin-resistant strains of Staphylococcus aureus (MRSA). Washing with soap helps to remove a layer of oil and some of the microbes associated with the epithelial surfaces of dry skin. Prior to surgery, medical doctors use a complete surgical scrub to remove transient microorganisms as well as some normal flora by scrubbing with soap (or a halogen such as chlorine or iodine) for 10 minutes.

Common inhabitants such as Staphylococcus epidermidis and Staphylococcus lugdunensis help to inhibit the growth of potential pathogens such as MRSA, so help prevent infection.

It is very important and critical that, as you usually do, you wear gloves for these experiments

Procedure 1

1. Obtain a plate of nutrient agar and divide the base of the agar plate into four equal parts. Label one quadrant of the plate "before", one quadrant "glove1", one quadrant "transient", and the last quadrant "sanitise". Be sure to write your name and the date on the base of the plate also.

2. The first person (designated as Person 1) should remove their glove and press gently the forefinger of one hand onto “before” section of the nutrient agar plate...

3. Person 1 should now wear gloves and repeat step 2 by pressing the forefinger gently onto the section labelled “glove 1”.

3. Swab gloves worn by Person 1 with broth containing “Staphylococcus epidermidis”. A second student, designated as Person 2, wearing fresh gloves should now shake hands with Person 1 wearing gloves swabbed with Staphylococcus epidermidis”.

Person 2 now has transient bacteria on their gloves

4. Person 2, should inoculate the "transient" quadrant of the plate by gently pressing their forefinger.

5. Person 2 should disinfect the forefinger area of the glove by dipping their forefinger into anyone of the disinfectants provided.Rinse the forefinger with distilled water. Air dry the forefinger.

6. Person 2 should now inoculate the “sanitise” quadrant of the plate by gently pressing their forefinger.

Incubate the plate at 37oc for 24 – 48 hours.

Procedure 2

1.Prepare a spread plate on the Mueller-Hinton agar using Staphylococcus epidermidis.

2. Place a sterile paper disc using a sterile forceps into the one antiseptic solution and touch the sides of the container to remove excess antiseptic. Place the paper disc on the spread plate.

3. Select a second antiseptic and then a third antiseptic and place the discs equidistant on the spread plate.

4. Incubate the plate at 37oC for 24 – 48h and examine these in the next laboratory period.

Procedure 3

For this exercise you use lotion that contains UV reactive particles.

1. At least 4 students should participate in this experiment. It is important that as usual you are wearing gloves for this experiment.

2. Squirt “uv lotion” onto a student’s gloved hand designated as Infected 1. The student should now rub both gloved hands to spread the “uv lotion” all over the gloved hands.

3. Infected 2 should now shake their gloved hands with infected 1. Infected 2 should now proceed to shake hands with Infected 3. Finally infected 3 should shake hands with Infected 4.

4. Ensure that you are wearing UV goggles and without looking directly at the uv source, Place the hands under the uv light.

5. Score Infected 1 as ++++. Use this designation to score Infected 2 – 4.

6. Complete the table below Infected 1 Infected 2 Infected 3 Infected 4 20 Score ++++.

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