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

<strong>WHO</strong> GUIDELINES ON HAND HYGIENE IN HEALTH CARE
represented, educational strategies should include focus
groups on this topic to allow HCWs to raise their concerns
openly regarding the use of alcohol-based handrubs, help
them to understand the scientific evidence underlying this
recommendation, and identify possible solutions to overcome
obstacles (Table I.17.2). Results of these discussions could
be summarized in an information leaflet to be produced and
distributed locally. It has been suggested to avoid the use of
the term “alcohol” in settings where the observance of related
religious norms is very strict and rather use the term “antiseptic”
handrubs. However, concealing the true nature of the product
behind the use of a non-specific term could be construed as
deceptive and considered unethical; further research is thus
needed before any final recommendation can be made.
Medical practices different from Western medicine, such
as traditional medicines, should be explored for further
opportunities to promote hand hygiene in different cultural
contexts. For instance, traditional Chinese medicine
practitioners are very open to the concept of hand hygiene.
During a usual traditional Chinese medicine consultation, both
inpatient and outpatient, there can be a vast array of direct
contacts with the patient. These include various kinds of
physical examination such as the routine taking of the pulse
and blood pressure for almost all patients, but may also involve
various kinds of massages and examination of the oral cavities
or other orifices, and contact can be often more intense than
in Western medicine. In this context, the potential for using
an alcohol-based handrub is tremendous for the practitioner,
given the high frequency of hand hygiene actions, and there is a
definite avenue for further research in this setting.
Finally, the opportunity to involve patients in a multimodal
strategy to promote hand hygiene in health care should be
carefully evaluated (see Part V). Despite its potential value, this
intervention through the use of alcohol-based handrubs may be
premature in settings where religious norms are taken literally;
rather, it could be a subsequent step, following the achievement
of awareness and compliance among HCWs.
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