Glossary


 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

The following terms are referred to throughout this website:

A

Alcohol-based hand rub (ABHR)
An alcohol-containing preparation designed for application to the hands in order to reduce the number of viable organisms with maximum efficacy and speed.
 
Alcohol Wipes
An alcohol-containing wipe used to clean non-soiled shared patient equipment in between each patient use e.g. BP cuffs.
 Top

B

Bacteraemia
The presence of bacteria in the blood.
 Top
Body Fluids
Any substance secreted by the body with the exception of sweat. These include:
Blood, Lochia, Saliva, Secretions from mucous membranes, Pus, Gastric and respiratory secretions, Semen, Tears, Wax, Breast milk, Colostrum, Urine, Faeces, Meconium, Vomitus, Pleural fluid, Cerebrospinal fluid, Ascites fluid, Biliary fluid, Bone Marrow, Organic body samples – eg. Biopsy samples, organ and cell samples.
 Top
Body Fluid Exposure Risk
Any situation where contact with body fluids may occur. Such contact may pose a contamination risk to either HCW or the environment.
 Top

C

Confidence Intervals
Confidence intervals calculate the range in which the true compliance result lies, based on the data collected & the compliance measured, thus providing an indication of the reliability of the reported HHC level. When only a small number of moments are collected, the confidence interval will be larger, as it is more difficult to establish the true compliance level from a small sample of moments. If a large number of moments are collected the confidence interval will be smaller, meaning the reliability of the result is higher. HHA calculate 95% confidence intervals, indicating the intervals in which 95% of the time the true compliance level lies.
 
Contact
The touching of any patient, their immediate surroundings or performing any procedure.
 Top

D

Decontaminate hands
Application of either an antimicrobial soap/solution and water or an alcohol-based hand rub product, to the surface of the hands. This process reduces microbial counts on hands.
 
Detergent Wipes 
A detergent-containing wipe used for cleaning lightly soiled shared patient equipment in between each patient use. 
 Top

E

 Emollient / Humectant
Ingredient(s) added to hand hygiene products to moisturise and protect the skin from frequent product use.

G

Glove use
Glove use by HCWs is recommended for two main reasons: to prevent micro-organisms which may be infecting, commensally carried, or transiently present on HCW’s hands from being transferred to patients and from one patient to another; and to reduce the risk of HCWs acquiring infections from patients (1) (see Appendix 9 for The WHO recommended guidelines).
 Top

H

Hand Care 
Actions to reduce the risk of skin damage or irritation. For example, using a moisturiser regularly throughout the day.
 
Hand Hygiene (HH)
A process that reduces the number of micro-organisms on hands. Hand hygiene is a general term applying to the use of soap/solution (non-antimicrobial or antimicrobial) and water or a waterless antimicrobial agent to the surface of the hands (e.g. alcohol-based hand rub).
 Top
Hand Hygiene Action
A Hand Hygiene Action can be undertaken either by rubbing with an ABHR, or hand washing with soap and water.
 Top
Hand Hygiene Compliance
Is a measurement of appropriate HH. It is defined when HH is considered necessary and is classified according to one of the “5 Moments” (see below). If the action is performed when there is no indication and it has no impact in terms of preventing microbial transmission, then it is not considered to be an act of HH compliance.    The number of Moments constitutes the denominator for assessing HH compliance. The actual HH actions undertaken are compared to the number of Moments observed to calculate the rate of HH compliance. HH non-compliance is defined when there is an indication for HH (i.e. a “Moment”) and yet no HH was undertaken.
 Top
Hand Hygiene inter-observer reliability
A measure of the agreement or consistency of ratings between two or more HH observers after observing the HH compliance on a series of subjects (see section 7.3..2.3).
 Top
Hand Hygiene Moments
Moments are based on those defined by the WHO Guidelines on Hand Hygiene (1). Some minor modifications have been made for Australian healthcare conditions. A Moment is when there is a perceived or actual risk of pathogen transmission from one surface to another via the hands. HCWs’ hands will come in contact with many different types of surfaces while undertaking a succession of tasks.
 
The 5 Moments for HH are:
 
Moment 1:      Before touching a patient
Moment 2:      Before a procedure
Moment 3:      After a procedure or body fluid exposure risk
Moment 4:      After touching a patient
Moment 5:      After touching a patient’s surroundings
 Top
Hand Hygiene Opportunity
In Australia, this term is no longer commonly used; instead the term ‘Moment’ is used.
 Top
Hand Hygiene Product
Any product used for the purpose of HH, including soap and water.
 Top
Hand washing
The application of non-antimicrobial soap and water to the surface of the hands.
 Top
Healthcare-Associated Infections (HCAI)
Infections that originate from, or are related to, a healthcare setting or the delivery of healthcare.
 Top
Healthcare Surroundings
Refers to all regions outside of the Patient zone. This includes the curtains, partitions and doors between separate patient areas.
 Top
Health Care Worker (HCW)
Any employee of a healthcare institution who has patient care responsibilities and / or contact with a patient (see Contact).

 Top
 
Hospital-associated infections (HAI)
An infection that was not present or incubating prior to the patient being admitted to the hospital, but occurred > 48 hours after admittance to the hospital. HAI’s are also termed nosocomial infections.
 Top

I

Inter-rater (or Observer) Reliability
A measure of agreement or consistency of ratings by two or more observers on a series of subjects.
 Top
Intra-rater Reliability
A measure of agreement or consistency of two or more ratings by a single observer on a series of subjects.
 Top
Invasive Medical Device
Any piece of equipment that enters a patient’s skin or body cavity. This encompasses the entire device (eg. IV line, IV pump and IV pole).
 Top

M

Methicillin-resistant Staphylococcus aureus (MRSA)
Staphylococcus aureus that is resistant to methicillin/flucloxacillin. Commonly referred to as “golden staph”.
 Top
Methicillin-susceptable Staphylococcus aureus
Staphylococcus aureus that is susceptible to methicillin/flucloxacillin.
 Top

O

Occupational Health and Safety (OH&S)
Is an area concerned with protecting the safety, health and welfare of people engaged in work or employment.  The goal of all occupational safety and health programs is to foster a safe work environment.
 Top
Occupied Bed Days (OBDs)
Is the sum of the number of occupied beds for each day of the specified period.
 Top
Outcome Measure
A feature used to describe the effectsof care on the health status of patients and populations (e.g. infection rate).
 Top

P

Patient
Refers to any part of the patient, their clothes, or any medical device that is connected to the patient.
 Top
Patient contact or direct patient contact
This involves touching the patient, and their immediate surroundings or performing any procedure on the patient.
 Top
Patient Immediate Surroundings
The Patient Surroundings is the space temporarily dedicated to an individual patient for that patient’s stay. This includes, furniture, medical equipment,medical chart and personal belongings that are touched by the patient and HCWs while caring for that patient.
 Top
Patient Zone
Includes the Patient and the Patient Immediate Surroundings.
 Top
Point of Care 
The place where three elements come together: the patient, the HCW, and the care or treatment involving contact with the patient or his/her surroundings. A hand hygiene product should be easily accessible and as close as possible – within arms reach of where patient care or treatment is taking place. Point of care products should be accessible without having to leave the patient zone.
 
Procedure
Is an act of care for a patient where there is a risk of direct introduction of a pathogen into the patient’s body.
 Top
Process Measure
Is a measurement of what is actually done in givingand receiving care, e.g. timing of surgical antibiotic prophylaxis, measuring how many times staff wash hands.
 Top

R

Recommendation 
A guideline; sample suggestion; to advise
 
Reliability
The extent to which a measurement is consistent and free from error.
 Top

S

Separations
A separation from a healthcare facility occurs anytime a patient leaves due to discharge, death, or transfer.
 Top
Sterile task
A task performed in such a way as to avoid microbial contamination or inoculation.
 Top
Structured observation
A method to quantify HCW behaviour using a format that is structured in a manner that is likely to avoid bias and improve consistency. Structured observations provide information on what people actually do, rather than on what they say they do or did. They also provide information on the associated activities and behaviours that precede and follow HH compliance (2).
 
Surgical Hand Hygiene / Surgical Hand Preparation
Antiseptic handwash or antiseptic handrub performed preoperatively by the surgical team to eliminate transient flora and reduce resident skin flora. Such antiseptics often have persistent antimicrobial activity.
 Top

V

Validity
Refers to the accuracy of a measure. It is the extent to which a measuring instrument actually measures what it is supposed to measure

Top

W

WHO
The World Health Organisation