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Table 1 Procedures in all species considered “clean” or “dirty” for hand hygiene monitoring in veterinary clinics

From: Video observation of hand hygiene practices during routine companion animal appointments and the effect of a poster intervention on hand hygiene compliance

Clean procedures: Dirty procedures:
Those more likely to result in contamination of sterile or privileged body sites/tissues with potentially infectious microbes carried on the hands Those more likely to result in contamination of the hands with potentially infectious microbes from the patient or clinical specimens
-Injections (including but not limited to subcutaneous, intramuscular, intravenous)1 -Ear swabs and/or ear cleaning2
-Venipuncture (any vein) -Digital rectal exam and/or expression of anal glands3
-Fine needle aspirate (including but not limited to cystocentesis, arthrocentesis, abdominocentesis, aspiration of masses, aspiration of lymph nodes) -Removal of an old/dirty bandage from over a skin lesion/wound/incision
-Direct contact with a surgical incision (including suture removal) -Cleaning and/or debridement of a skin lesion/wound/incision
-Application of a new/clean bandage over a skin lesion/wound/incision -Abscess drainage or other contact with pus
-Application of solution or ointment to the eye (including fluorescein stain) -Any contact with feces
-Placement (but not removal) of acupuncture needles -Manipulation inside an animal’s mouth4
  -Skin scrapings
  1. 1injection of any substance into an animal to facilitate or carry out euthanasia was not considered a clean procedure.
  2. 2direct application of ear medication/drops was not considered a dirty procedure if no material/fluid was subsequently removed from the ear canal.
  3. 3use of a rectal thermometer was not considered a dirty procedure.
  4. 4manipulation inside an animal’s mouth included direct administration of pills (i.e. not using a pilling wand, syringe or any means by which the animal consumed the medication voluntarily (e.g. hidden in food)); examination of the buccal gingiva if the fingers were not placed in the buccal sulcus or further into the mouth was not considered a dirty procedure.