WHO Guidelines on Hand Hygiene in Health Care - Safe Care ...

APPENDICES
• Health-care workers should wear gloves and aprons
when providing care for patients with C. difficile and
should discard them immediately after they have been
worn for a patient-care activity. Hand hygiene must then
be performed. There is evidence that wearing gloves
significantly reduces C. difficile infection and is therefore
crucial, even though handwashing reduces spores and
alcohol-based handrubs are effective against non-spore
forms of C. difficile.
Washing of clothing (including staff uniforms), bed linen, etc.
– both in health-care settings using industrial processes and
in the home – is also important when someone has C. difficile
infection. Careful handling of contaminated clothing is essential
in order to prevent the spread of any of the bacteria or its spores
to hands or other items. Key points to consider for laundering
include:
• always hold laundry away from yourself;
• do not sort through laundry unless absolutely necessary
and do not shake it;
Summary
Preventing and controlling the spread of all diarrhoeal
diseases is important. The main message is that
hands should be washed thoroughly with soap and
water when they are: visibly dirty or visibly soiled with
blood or other body fluids; after using the toilet; or
when exposure to potential spore-forming pathogens
is strongly suspected or proven, including during
outbreaks of C. difficile.
Performing hand hygiene using an alcohol-based
handrub is the recommended and most effective
method to clean hands in most patient-care situations.
According to recent evidence, alcohol-based handrubs
have been a major factor in the reduction of serious
infections such as MRSA, for example in the United
Kingdom.
It is important that the correct technique for hand
hygiene is always applied.
• perform hand hygiene after handling laundry;
• use normal detergent to wash the laundry;
• dry laundry either in a tumble dryer or on a washing line;
• iron clothes according to their instructions, using a hot
steam iron if possible;
• keep clean the machines or sink areas where laundry has
been washed.
Organizational steps are also important in aiding prevention and
control. An adequate health-care infrastructure should be in
place, including:
• a functioning and effective infection prevention and control
team;
• functioning and effective communication strategies and
information available for patients and visitors;
• written guidance that sets standards and assigns
responsibilities, including monitoring of recommended
practices against the standards;
• surveillance and education programmes, with
multidisciplinary teams working to ensure targeted
management and control.
There are also other specific measures that are recommended
during outbreaks of C. difficile (http://www.cdc.gov/ncidod/
dhqp/id_Cdiff.html) 1
1
Vonberg RP et al. Infection control measures to limit the spread of
Clostridium difficile. Clinical Microbiology and Infection, 2008, 14(Suppl.
5):2-20.
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