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474. West DP et al. Evaluation of aloe vera gel gloves in the treatment of dry skin associated with occupational exposure. American Journal of Infection Control, 2003, 31:40-42. 475. Mayer JA et al. Increasing handwashing in an intensive care unit. Infection Control, 1986, 7:259-262. 476. Preston GA et al. The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit. American Journal of Medicine, 1981,70:641-645. 477. Nobile CG et al. Healthcare personnel and hand decontamination in intensive care units: knowledge, attitudes, and behaviour in Italy. Journal of Hospital Infection, 2002, 51:226-232. 478. Kampf G et al. Dermal tolerance of Sterillium, a propanol-based hand rub. Journal of Hospital Infection, 2003, 55:295-298. 479. Kramer A et al. Clinical double-blind trial on the dermal tolerance and user acceptability of six alcohol-based hand disinfectants for hygienic hand disinfection. Journal of Hospital Infection, 2002, 51:114-120. 480. Kaplan LM et al. Increasing handwashing compliance with more accessible sinks. Infection Control, 1986, 7:408-410. 481. Freeman J. Prevention of nosocomial infections by location of sinks for hand washing adjacent to the bedside. In: American Society for Microbiology, ed. In: Proceedings of the 33rd Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, LA, 1993: abstr 60. 482. Wurtz R et al. Handwashing machines, handwashing compliance, and potential for crosscontamination. American Journal of Infection Control, 1994, 22:228-230. 483. King S. Provision of alcohol hand rub at the hospital bedside: a case study. Journal of Hospital Infection, 2004, 56 (Suppl 2):S10-12. 484. Vernon MO et al. Adherence with hand hygiene: does number of sinks matter? Infection Control and Hospital Epidemiology, 2003, 24:224-225. 485. Pittet D et al. Compliance with handwashing in a teaching hospital. Annals of Internal Medicine, 1999, 130:126-130. 486. Pittet D. Compliance with hand disinfection and its impact on hospital-acquired infections. Journal of Hospital Infection, 2001, 48 (Suppl A):S40-46. 487. Brooks SE et al. Chlorhexidine resistance in antibiotic-resistant bacteria isolated from the surfaces of dispensers of soap containing chlorhexidine. Infection Control and Hospital Epidemiology, 2002, 23:692-695. 488. Bignardi GE. An obstacle too many. Journal of Hospital Infection, 2002:159. 489. Swoboda SM et al. Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit. Critical Care Medicine, 2004, 32:358-363. 490. Kohan C, et al. The importance of evaluating product dispensers when selecting alcoholbased handrubs. American Journal of Infection Control, 2002, 30:373-375. 491. McBride ME. Microbial flora of in-use soap products. Applied Environmental Microbiology , 1984, 48:338-341. 492. Kabara JJ et al. Contamination of bar soap under in use condition. Journal of Environmental Pathology, Toxicology and Oncology, 1983, 5:1-14. 493. Gal D et al. Contamination of hand wash detergent linked to occupationally acquired melioidosis. American Journal of Tropical Medicine and Hygiene, 2004, 71:360-362. 494. Brooks SE et al. Intrinsic Klebsiella pneumoniae contamination of liquid germicidal hand soap containing chlorhexidine. Infection Control and Hospital Epidemiology, 2004, 25:883-885. 495. Parasakthi N et al. Epidemiology and molecular characterization of nosocomially transmitted multidrug-resistant Klebsiella pneumoniae. International Journal of Infectious Diseases, 2000, 4:123-128. 496. Hilburn J et al. Use of alcohol hand sanitizer as an infection control strategy in an acute care facility. American Journal of Infection Control, 2003, 31:109-116. 497. Cimiotti JP et al. A cost comparison of hand hygiene regimens. Nursing Economics, 2004, 22:196-199, 204, 175. 498. Taylor LJ. An evaluation of handwashing techniques-1. Nursing Times, 1978, 54-55.
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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
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in 2005 the costs of an alcohol-bas
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infection, risk factors that are la
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11.4.4 SIDE-EFFECTS OF THE SURGICAL
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• Repeat the process on the other
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12.2 ALLERGIC CONTACT DERMATITIS RE
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particularly when resources are lim
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Handrubs are available as gels, sol
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14. HAND HYGIENE PRACTICES AMONG HE
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quantified in observational studies
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According to behavioural theories (
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of water with special leaves) outsi
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Furthermore, according to Phra Depv
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16. BEHAVIOURAL CONSIDERATIONS 16.1
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and community factors must be consi
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i. ii. iii. iv. v. vi. a) b) Educat
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tion precautions 580 . There are al
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follow the intent 588 . Studies hav
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18. FORMULATING STRATEGIES FOR HAND
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18.2 DEVELOPING A STRATEGY FOR GUID
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1998 (P
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HCWs routinely to wear vinyl gloves
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quality gloves, reuse, shortage of
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• 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 100 and 101: D. Wash hands with either plain or
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 148 and 149: 524. Muto C et al. Hand hygiene rat
Page 150 and 151: 578. Babcock HM et al. An education
Page 152 and 153: Interscience Conference on Antimicr
Page 154 and 155: 679. Hirschmann H et al. The influe
Page 156: 729. Martin LS, McDougal JS, Loskos
Page 161 and 162: Table I.8.1: Basic experimental des
Page 163 and 164: Table I.9.1: Waterborne pathogens a
Page 165 and 166: Table I.9.3: Virucidal activity of
Page 167 and 168: Table I.9.4: Studies comparing the
Page 169 and 170: Table I.9.6: Studies comparing the
Page 171 and 172: Table I.14.1: Hand hygiene frequenc
Page 173 and 174: Table I.14.2: Hand hygiene adherenc
Page 175 and 176: Table I.15.1: Hand hygiene indicati
Page 177 and 178: Table I.18.1: Strategies for succes
Page 179 and 180: Table l.20.1: Possible problems and
Page 181 and 182: Table I.21.1. Hand hygiene research
Page 183 and 184: Table I.21.1: Hand hygiene research
Page 185 and 186: Table I.21.2: Unsolved issues for r
Page 187 and 188: Table III.2.1: Quality indicators r
Page 189 and 190: Table V.3.1: Examples of public inf
Page 191 and 192: Table V.4.1: Examples of national p
Page 193: 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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