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Table I.8.1: Basic experimental design of current methods to test the efficacy of hand <strong>hygiene</strong> and surgical hand preparation formulations (Cont.) Method no. Test organism(s) Basic procedure ASTM E-2276 (fingerpad method for bacteria) ASTM E-2011 (whole hand method for viruses) prEN 12791 (surgical hand preparation): ASTM E-1115 (test method for evaluation of surgical hand scrub formulations) Escherichia coli, Serratia marcescens, Staphylococcus aureus and Staphylococcus epidermidis Rotavirus and rhinovirus Resident skin flora (no artificial contamination) Resident skin flora (no artificial contamination) Similar to ASTM E-1838. This method is designed to confirm the findings of the fingerpad method (E-1838), if necessary. Both hands are contaminated with the test virus and test formulation is used to wash or rub on them. The entire surface of both hands eluted and the eluates assayed for infectious virus. Same as for EN 1500 with the following exceptions: no artificial contamination, reference hand antisepsis 3 min rub with n-propanol 60% V/V, longest allowed treatment with product 5 min, 1 week between tests with reference and product. Test for persistence (3 h) with split hands model is optional (product shall be significantly superior to reference). The method is designed to assess immediate or persistent activity against the resident flora. Volunteers perform simulated surgical scrub and hands sampled by kneading them in loose-fitting gloves with an eluent. The eluates are assayed for viable bacteria.
Table I.9.1: Waterborne pathogens and their significance in water supplies Pathogen Health significance Persistence in water supplies Relative infectivity Bacteria Campylobacter jejuni, C. coli High Moderate Moderate Pathogenic Escherichia coli High Moderate Low Enterohaemorrhagic E. coli High Moderate High Legionella spp. High Multiply Moderate Non-tuberculosis mycobacteria Low Multiply Low Pseudomonas aeruginosa Moderate May multiply Low Salmonella typhi High Moderate Low Other salmonellae High Short Low Shigella spp. High Short Moderate Vibrio cholerae High Short Low Burkholderia pseudomallei Low May multiply Low Yersinia enterocolitica High Long Low Viruses Adenoviruses High Long High Enteroviruses High Long High Hepatitis A High Long High Hepatitis E High Long High Noroviruses and sapoviruses High Long High Rotaviruses High Long High Protozoa Acanthamoeba spp. High Long High Cryptosporidium parvum High Long High Cyclospora cayetanensis High Long High Entamoeba histolytica High Moderate High Giardia lamblia High Moderate High Naegleria fowleri High May multiply High Toxoplasma gondii High Long High Helminths Dracunculus medinensis High Moderate High Schistosoma spp. High Short High Source: WHO Guidelines for drinking-water quality, 2004.
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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
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D. Wash hands with either plain or
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5. SKIN CARE A. B. C. Include infor
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PART III. OUTCOME MEASUREMENTS 1. M
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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 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
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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
Page 202: Data in coloured cells can be chang
Page 206: NHS NICU n-P NPSA NA NS OPD PACU PA
Page 211 and 212: AUTHORS: John Boyce Saint Raphael H
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Garance Upham People’s Health Mov
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