<str<strong>on</strong>g>WHO</str<strong>on</strong>g> GUIDELINES ON HAND HYGIENE IN HEALTH CARE SUMMARY 9. Governmental and <strong>in</strong>stituti<strong>on</strong>al resp<strong>on</strong>sibilities 9.1 For health-care adm<strong>in</strong>istrators A. It is essential that adm<strong>in</strong>istrators ensure that c<strong>on</strong>diti<strong>on</strong>s are c<strong>on</strong>ducive to the promoti<strong>on</strong> of a multifaceted, multimodal hand hygiene strategy and an approach that promotes a patient safety culture by implementati<strong>on</strong> of po<strong>in</strong>ts B–I below. B. Provide HCWs with access to a safe, c<strong>on</strong>t<strong>in</strong>uous water supply at all outlets and access to the necessary facilities to 276, 282, 283 perform handwash<strong>in</strong>g (IB). C. Provide HCWs with a readily accessible alcohol-based 75, 82, 94, 95, 284-288 handrub at the po<strong>in</strong>t of patient care (IA). D. Make improved hand hygiene adherence (compliance) an <strong>in</strong>stituti<strong>on</strong>al priority and provide appropriate leadership, adm<strong>in</strong>istrative support, f<strong>in</strong>ancial resources and support for hand hygiene and other <strong>in</strong>fecti<strong>on</strong> preventi<strong>on</strong> and c<strong>on</strong>trol 75, 111, 113, 119, 289 activities (IB). E. Ensure that HCWs have dedicated time for <strong>in</strong>fecti<strong>on</strong> c<strong>on</strong>trol 270, 290 tra<strong>in</strong><strong>in</strong>g, <strong>in</strong>clud<strong>in</strong>g sessi<strong>on</strong>s <strong>on</strong> hand hygiene (II). F. Implement a multidiscipl<strong>in</strong>ary, multifaceted and multimodal programme designed to improve adherence of HCWs to 75, 119, 129 recommended hand hygiene practices (IB). G. With regard to hand hygiene, ensure that the water supply is physically separated from dra<strong>in</strong>age and sewerage with<strong>in</strong> the health-care sett<strong>in</strong>g and provide rout<strong>in</strong>e system m<strong>on</strong>itor<strong>in</strong>g and management (IB). 291 H. Provide str<strong>on</strong>g leadership and support for hand hygiene and other <strong>in</strong>fecti<strong>on</strong> preventi<strong>on</strong> and c<strong>on</strong>trol activities (II). 119 I. Alcohol-based handrub producti<strong>on</strong> and storage must adhere to the nati<strong>on</strong>al safety guidel<strong>in</strong>es and local legal requirements (II). 18 9.2 For nati<strong>on</strong>al governments A. Make improved hand hygiene adherence a nati<strong>on</strong>al priority and c<strong>on</strong>sider provisi<strong>on</strong> of a funded, coord<strong>in</strong>ated implementati<strong>on</strong> programme while ensur<strong>in</strong>g m<strong>on</strong>itor<strong>in</strong>g and l<strong>on</strong>g-term susta<strong>in</strong>ability (II). 292-295 B. Support strengthen<strong>in</strong>g of <strong>in</strong>fecti<strong>on</strong> c<strong>on</strong>trol capacities with<strong>in</strong> 290, 296, 297 health-care sett<strong>in</strong>gs (II). C. Promote hand hygiene at the community level to strengthen 71, 138-140, both self-protecti<strong>on</strong> and the protecti<strong>on</strong> of others (II). 298-300 D. Encourage health-care sett<strong>in</strong>gs to use hand hygiene as a quality <strong>in</strong>dicator (Australia, Belgium, France, Scotland, USA) 278, 301 (II).
Figure II.3 Surgical hand preparati<strong>on</strong> technique with an alcohol-based hand rub formulati<strong>on</strong> PART II. CONSENSUS RECOMMENDATIONS 19