Hand hygiene.pdf

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D. Wash hands with either plain or antimicrobial soap and water or rub hands with an alcohol-based formulation before handling medication or preparing food (IB) 670-675 . E. When alcohol-based handrub is already used, do not use antimicrobial soap concomitantly (II) 463 . 2. HAND HYGIENE TECHNIQUE A. B. C. D. Apply a palmful of the product and cover all surfaces of the hands. Rub hands until hands are dry (IB) 145 . (The technique for handrubbing is illustrated on page 100.) When washing hands with soap and water, wet hands with water and apply the amount of product necessary to cover all surfaces. Vigorously perform rotational handrubbing on both hand palms and backs, interlace and interlock fingers to cover all surfaces. Rinse hands with water and dry thoroughly with a single-use towel. Use running and clean water whenever possible. Use towel to turn off tap/faucet (IB) 93,155,157,498,680 . (The technique for handwashing is illustrated on page 101.) Make sure hands are dry. Use a method that does not recontaminate hands. Make sure towels are not used multiple times or by multiple people (IB) 31,65,142,183,434,512 . Avoid using hot water, as repeated exposure to hot water may increase the risk of dermatitis (IB) 433,434 . Liquid, bar, leaf or powdered forms of plain soap are acceptable when washing hands with a non-antimicrobial soap and water. When bar soap is used, small bars of soap in racks that facilitate drainage should be used (II) 191,192,491,492 . 3. RECOMMENDATIONS FOR SURGICAL HAND PREPARATION A. B. C. D. E. If hands are visibly soiled, wash hands with plain soap before surgical hand preparation (II). Remove debris from underneath fingernails using a nail cleaner, preferably under running water (II) 20,681 . Sinks should be designed to reduce the risk of splashes (II) 169,407 . Remove rings, wrist-watch, and bracelets before beginning the surgical hand preparation (II) 653,657,682 . Artificial nails are prohibited (IB) 96,390,663,665 . Surgical hand antisepsis should be performed using either an antimicrobial soap or an alcohol-based handrub, preferably with a product ensuring sustained activity, before donning sterile gloves (IB) 104,208,348,379,683,684 . If quality of water is not assured (as described in Table I.9.2) in the operating theatre, surgical hand antisepsis using an alcohol-based handrub is recommended before donning sterile gloves when performing surgical procedures (II) 104,178,208,348,379,683,684 .
F. G. H. I. When performing surgical hand antisepsis using an antimicrobial soap, scrub hands and forearms for the length of time recommended by the manufacturer, 2 to 5 minutes. Long scrub times (e.g. 10 minutes) are not necessary (IB) 210,302,304,345,396-398,402 . When using an alcohol-based surgical handrub product with sustained activity, follow the manufacturer’s instructions. Apply the product on dry hands only (IB) 418-420 . Do not combine surgical hand scrub and surgical handrub with alcohol-based products sequentially (II) 463 . When using an alcohol-based product, use sufficient product to keep hands and forearms wet with the handrub throughout the procedure (IB) 411,423 . After application of the alcohol-based product as recommended, allow hands and forearms to dry thoroughly before donning sterile gloves (IB) 134,348,411,423,683 . 4. SELECTION AND HANDLING OF HAND HYGIENE AGENTS A. Provide HCWs with efficacious hand hygiene products that have low irritancy potential (IB) 154,155,190,256,426 . B. To maximize acceptance of hand hygiene products by HCWs, solicit their input regarding the feel, fragrance, and skin tolerance of any products under consideration. In some settings, cost may be a primary factor (IB) 155,156,256,445,454,456,475 . C. When selecting hand hygiene products: – determine any known interaction between products used to clean hands, skin care products, and the types of gloves used in the institution (II) 268,627 ; – – – – – solicit information from manufacturers about the risk of contamination (IB) 101,494,495 ; ensure that dispensers are accessible at the point of care (IB) 263 ; ensure that dispensers function adequately and reliably and deliver an appropriate volume of the product (II) 262,490 ; ensure that the dispenser system for alcohol-based formulations is approved for flammable materials (IC); solicit information from manufacturers regarding any effect that hand lotions, creams, or alcohol-based handrubs may have on the effects of antimicrobial soaps being used in the institution (IB) 268,685,686 . D. Do not add soap to a partially empty soap dispenser. If soap dispensers are reused, follow recommended procedures for cleansing (IA) 102,282 .
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The WHO Guidelines on Hand Hygiene
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CONTENTS INTRODUCTION . ...........
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17. Organizing an education program
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INTRODUCTION The WHO Advanced Draft
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Handwashing. Washing hands with pla
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still considered the standard of ca
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treatment selectively removes glyce
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of the organism on their hands. Mak
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6. MODELS OF HAND TRANSMISSION 6.1
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In the 1960s, a prospective, contro
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for its ability to reduce the relea
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8.2 SHORTCOMINGS OF TRADITIONAL TES
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tions of short-chain aliphatic alco
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9.1.3 WATER QUALITY The physical, c
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Case study: experience of Egypt The
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and both reduced viral counts on ha
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activity of chlorhexidine is not se
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protein synthesis and alteration of
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in micelle structures formed by sur
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In all the studies that included pl
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isopropyl alcohol) were applied to
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3) Glycerol is added using a measur
Page 50 and 51: in 2005 the costs of an alcohol-bas
Page 52 and 53: infection, risk factors that are la
Page 54 and 55: 11.4.4 SIDE-EFFECTS OF THE SURGICAL
Page 56 and 57: • Repeat the process on the other
Page 58 and 59: 12.2 ALLERGIC CONTACT DERMATITIS RE
Page 60 and 61: particularly when resources are lim
Page 62 and 63: Handrubs are available as gels, sol
Page 64 and 65: 14. HAND HYGIENE PRACTICES AMONG HE
Page 66 and 67: quantified in observational studies
Page 68 and 69: According to behavioural theories (
Page 70 and 71: of water with special leaves) outsi
Page 72 and 73: Furthermore, according to Phra Depv
Page 74 and 75: 16. BEHAVIOURAL CONSIDERATIONS 16.1
Page 76 and 77: and community factors must be consi
Page 78 and 79: i. ii. iii. iv. v. vi. a) b) Educat
Page 80 and 81: tion precautions 580 . There are al
Page 82 and 83: follow the intent 588 . Studies hav
Page 84 and 85: 18. FORMULATING STRATEGIES FOR HAND
Page 86 and 87: 18.2 DEVELOPING A STRATEGY FOR GUID
Page 88 and 89: 1998 (P
Page 90 and 91: HCWs routinely to wear vinyl gloves
Page 92 and 93: quality gloves, reuse, shortage of
Page 94 and 95: • To test for holes, gloves shoul
Page 96 and 97: Figure l.20.2: Blood safety: crucia
Page 98 and 99: Consensus recommendations are that
Page 102 and 103: 5. SKIN CARE A. B. C. Include infor
Page 107 and 108: PART III. OUTCOME MEASUREMENTS 1. M
Page 109 and 110: 2. HAND HYGIENE AS A QUALITY INDICA
Page 111 and 112: can be seen during routine work. Da
Page 113 and 114: Case study: United Kingdom national
Page 115 and 116: PART IV. PROMOTING HAND HYGIENE ON
Page 117 and 118: ated to reinforce its principles (t
Page 119: 6. PRINCIPLES OF COUNTRYWIDE HAND H
Page 122 and 123: As many international and national
Page 124: debate that resulted in increasing
Page 128 and 129: 23. Lee YL et al. Colonization by S
Page 130 and 131: Interscience Conference on Antimicr
Page 132 and 133: 122. Vicca AF. Nursing staff worklo
Page 134 and 135: 171. Kauppinen J et al. Hospital wa
Page 136 and 137: 224. Krilov LR et al. Inactivation
Page 138 and 139: 276. Thomas L et al. Development of
Page 140 and 141: 326. Johnson S et al. Prospective,
Page 142 and 143: 34th Interscience Conference on Ant
Page 144 and 145: 423. Kampf G, et al. Influence of a
Page 146 and 147: 474. West DP et al. Evaluation of a
Page 148 and 149: 524. Muto C et al. Hand hygiene rat
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578. Babcock HM et al. An education
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Interscience Conference on Antimicr
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679. Hirschmann H et al. The influe
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729. Martin LS, McDougal JS, Loskos
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Table I.8.1: Basic experimental des
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Table I.9.1: Waterborne pathogens a
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Table I.9.3: Virucidal activity of
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Table I.9.4: Studies comparing the
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Table I.9.6: Studies comparing the
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Table I.14.1: Hand hygiene frequenc
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Table I.14.2: Hand hygiene adherenc
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Table I.15.1: Hand hygiene indicati
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Table I.18.1: Strategies for succes
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Table l.20.1: Possible problems and
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Table I.21.1. Hand hygiene research
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Table I.21.1: Hand hygiene research
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Table I.21.2: Unsolved issues for r
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Table III.2.1: Quality indicators r
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Table V.3.1: Examples of public inf
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Table V.4.1: Examples of national p
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Table V.5.1: The public information
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APPENDIX 1. DEFINITIONS OF HEALTH-C
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APPENDIX 2. HAND AND SKIN SELF-ASSE
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Data in coloured cells can be chang
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NHS NICU n-P NPSA NA NS OPD PACU PA
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AUTHORS: John Boyce Saint Raphael H
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Garance Upham People’s Health Mov
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