Transcript Hand Dermatitis

Aims of the resource
The aim of this education and training resource is to
equip facilitators with the knowledge and skills to:
recognise skin damage to hands which may be
associated with work-related substances
educate colleagues how to better understand good
hand care and how to prevent skin damage
Structure of the resource
This resource was developed to complement hand surveillance skills.
The presentation may also be used by the link person to educate other
health care workers how to protect their hands and prevent skin damage.
Carrying out hand surveillance is out with the scope of this
resource. This education will be provided by your local
Occupational Health Department.
A hand dermatitis pocket guide to
complement this presentation can be
found on the website at:
www.nes-hai.info
Content
Introduction
Normal structure and function of the skin
What we can do to keep hands healthy
Early warning signs of skin damage
Most common types of hand dermatitis
Treatment for hand dermatitis
Other skin conditions affecting the hands
Introduction
Introduction
Hand dermatitis is a common condition
Health care workers are vulnerable
Good hand care and simple precautions can
reduce your risk of developing hand
dermatitis
Structure and
function of the skin
Structure and function of the skin
Consider the normal structure and function
Our skin has the capacity to renew itself
Largest and most visible organ of the body
Main protective barrier against damage
Skin barrier is like a brick wall
Healthy Skin
Preventative approach
Skin remains intact
Barrier function strong
Healthy skin
Damaged Skin
Skin barrier breakdown
Cracks in the skin
Loss of natural oils
Damaged skin
What we can do to
keep hands healthy
Good hand care: the background
World Health Organisation (WHO)
“skin irritation is the most common barrier to good hand
hygiene technique”
Health and Safety at Work etc. Act 1974
Employees and employer are responsible for good
introduction of hand care techniques
NHSScotland
Strong focus on patient safety. Good hand hygiene is
essential in reducing risk of infection
Good hand care: the background
Health and Safety Executive
Most common causes of dermatitis in health care
workers - working with wet hands and contact with soaps
and cleansing materials
CoSHH
Employers are required to control exposure to
substances that are hazardous to health
Good hand care: practical advice
5 moments of hand hygiene
WHO acknowledges the Hôpitaux Universitaires de Genève (HUG), in particular the members of the Infection Control Programme, for their active participation in developing this material.
Good hand care: practical advice
Emollient
Soap substitute and moisturiser
Alcohol based hand rubs
Work by evaporation which protects the skin
May produce a stinging sensation
Hand cleansing technique
Early warning signs
of skin damage
Early warning signs of skin damage
Hand dermatitis is a common condition
Hand dermatitis is an inflammatory condition
Regularly inspect your hands
Changes you may see on the skin
Check other body areas
Changes in sensation
Images of damaged skin
Most common types
of hand dermatitis
Most common types of
hand dermatitis
Three main types of hand dermatitis:
Irritant contact dermatitis
Allergic contact dermatitis – including latex rubber allergy
Contact urticaria
Irritant Contact Dermatitis
Most common form of contact dermatitis
Two main types
acute
chronic
Changes you might
experience in your hands
Mild dryness to severe reaction
Inflammation
Pain
Rash in finger webs which may spread to palms and/or
backs of the hands
Note: the affected area tends to be sore rather than itchy
Steps you can take
Identify cause
Avoid substance
Exercise good skin care
Note: if your hands do not improve with avoidance and
good skin care seek advice
Common substances causing
reactions
The most common substances which can cause reactions in
health care workers
Allergic Contact Dermatitis
Develops in two stages:
Phase 1 - the skin becomes sensitive to a specific
substance which results in an allergic reaction
Phase 2 - repeated contact results in long term
sensitivity to the substance
Note: it may take several days for the skin to react
Changes you might
experience in your hands
Mild to severe reaction
Intense itching
Well defined patches of redness
Blistering may also occur
Note: if untreated or substance not identified, long term
problems can lead to dryness, scaling and cracking of
the hands
Steps you can take
Speak to line manager if you know or suspect a
substance is causing any harm
Referral to occupational health department
Possible referral to dermatologist for patch testing to
confirm or exclude allergy to a specific substance
Note: if allergy is confirmed by patch testing it will be lifelong
Latex / rubber allergy
One of the more common causes of allergic reaction in
health care workers
Thought to be due to repeated exposure through use of
latex gloves, medical devices
Powder free, low protein latex has reduced occurrence
Note: if latex allergy or sensitivity is confirmed this will be
life-long
For a few people a severe reaction to latex may be a
medical emergency
Contact Urticaria
Common condition also known as:
Nettle rash
Wheals
Hives
Changes you might experience
in your hands
A reaction to a substance usually happens very quickly:
Swelling
Red border with white centre
Itching
Blistering
Note: this may last for a few hours but can last for up to
24 hours
Steps you can take
If you know or suspect a substance is causing changes to your
hands, discuss with your line manager for advice on avoidance
Treatment for hand
dermatitis
Treatment for hand dermatitis
Avoiding or minimising contact with the identified
substance
Good general skin care
Practice appropriate skin cleansing at work
Other skin conditions
affecting hands
Other skin conditions affecting hands
There
A
are many other skin conditions which may
affect the hands.
If you have any change in your skin it is always best to
seek advice from GP, practice nurse, pharmacist,
occupational health department or line manager.
Conclusion
Health care workers should regularly examine
their hands
To keep hands healthy, good hand care should be
carried out by all health care workers
If irritation is present remember the three key
elements of treatment
Seek help if there is no improvement
References
WHO:
http://www.who.int/en/
http://www.who.int/gpsc/tools/GPSC-HandRub-Wash.pdf
CoSHH:
http://www.hse.gov.uk/coshh/
Health & Safety Executive Skin at Work
http://www.hse.gov.uk/skin/index.htm
NHS Scotland Infection Prevention and Control Manual:
http://www.hps.scot.nhs.uk/haiic/ic/guidelinedetail.aspx?id=49785
Credits
Authors:
Janice Bianchi, Independent Medical Education Specialist
Barbara Page, MBE, Dermatology Nurse Specialist, NHS Fife
Sheila Robertson, Dermatology Nurse Specialist, NHS Fife
Contact Details:
NHS Education for Scotland
Healthcare Association Infections Team
e-mail: [email protected]
web: www.nes-hai.info
Produced November 2014
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© NHS Education for Scotland 2014
You can copy, reproduce or distribute this resource for use within NHSScotland and for noncommercial educational purposes. Use of this resource for commercial purposes is permitted only
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