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578. Babcock HM et al. An educational intervention to reduce ventilator-associated pneumonia in an integrated health system: a comparison of effects. Chest, 2004, 125:2224-2231. 579. Seto WH, et al. Brief report: reduction in the frequency of needle recapping by effective education: a need for conceptual alteration. Infection Control and Hospital Epidemiology, 1990, 11:194-196. 580. Cromer AL et al. Impact of implementing a method of feedback and accountability related to contact precautions compliance. American Journal of Infection Control, 2004, 32:451-455. 581. Falsey AR et al. Evaluation of a handwashing intervention to reduce respiratory illness rates in senior day-care centers. Infection Control and Hospital Epidemiology, 1999, 20:200-205. 582. Gould D et al. Improving hand hygiene in community healthcare settings: the impact of research and clinical collaboration. Journal of Clinical Nursing, 2000, 9:95-102. 583. Pittet D et al. Revolutionising hand hygiene in health-care settings: guidelines revisited. Lancet Infectious Diseases, 2003, 3:269-270. 584. Seto WH, et al. Evaluation of staff compliance with ‘influencing’ tactics in relation to infection control policy implementation. Journal of Hospital Infection, 1990, 15:157-166. 585. Afif W et al. Compliance with methicillin-resistant Staphylococcus aureus precautions in a teaching hospital. American Journal of Infection Control, 2002, 30:430-433. 586. Seto WH et al. Brief report: a scheme to review infection control guidelines for the purpose of implementation in the hospital. Infection Control and Hospital Epidemiology, 1990, 11:255-257. 587. Ling ML, et al. Implementing infection control guidelines. In: A handbook of infection control for the Asian healthcare worker, 2nd ed. Singapore, Elsevier, 2004: 101-108. 588. Ajzen I et al. Understanding attitudes and predicting social behavior. Englewood Cliffs, USA, Prentice-Hall, 1980. 589. Seto WH. Training the work force - models for effective education in infection control. Journal of Hospital Infection, 1995, 30 (Suppl):241-247. 590. Ching TY, et al. Evaluating the efficacy of the infection control liaison nurse in the hospital. Journal of Advanced Nursing, 1990, 15:1128-1131. 591. Colombo C et al. Impact of teaching interventions on nurse compliance with hand disinfection. Journal of Hospital Infection, 2002, 51:69-72. 592. Gopal Rao et al. Marketing hand hygiene in hospitals-a case study. Journal of Hospital Infection , 2002, 50:42-47. 593. Hugonnet S et al. Nosocomial bloodstream infection and clinical sepsis. Emerging Infectious Diseases, 2004, 10:76.81. 594. Webster J. Handwashing in a neonatal intensive care nursery: product acceptability and effectiveness of chlorhexidine gluconate 4% and triclosan 1%. Journal of Hospital Infection, 1992, 21:137-141. 595. Kelen GD et al. Substantial improvement in compliance with universal precautions in an emergency department following institution of policy. Archives of Internal Medicine, 1991, 151:2051-2056. 596. Lundberg GD. Changing physician behavior in ordering diagnostic tests. JAMA, 1998,280:2036-2036. 597. Phillips DF. «New look» reflects changing style of patient safety environment. JAMA, 1999, 281:217-219. 598. Institute for Healthcare Improvement. 100k Lives campaign. ( accessed 15 January 2006). 599. Harbarth S et al. Effect of delayed infection control measures on a hospital outbreak of methicillin-resistant Staphylococcus aureus. Journal of Hospital Infection, 2000, 46:43-49. 600. Ng PC et al. Combined use of alcohol hand rub and gloves reduces the incidence of late onset infection in very low birthweight infants. Archives of Disease in Childhood. Fetal and Neonatal Edition, 2004, 89:336-340. 601. Early E et al. Effect of several interventions on the frequency of handwashing among elementary public school children. American Journal of Infection Control, 1998, 26:263-269. 602. Butz AM. Occurrence of infectious symptoms in children in day care homes. American Journal of Infection Control, 1990, 6:347-353. 603. Kimel LS. Handwashing education can decrease illness absenteeism. Journal of School Nursing, 1996, 12:14-16.
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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
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Figure l.20.2: Blood safety: crucia
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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 146 and 147: 474. West DP et al. Evaluation of a
Page 148 and 149: 524. Muto C et al. Hand hygiene rat
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
Page 197 and 198: APPENDIX 1. DEFINITIONS OF HEALTH-C
Page 199: 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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