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Table I.9.2: Microbiological indicators for water quality in health-care settings in France Indicators Level Frequency Aerobic flora at 22° and 36° C No variation above a 10- fold compared to the usual value at the entry point 1 control/100 beds/year with a minimum of 4 controls per year Pseudomonas aeruginosa < 1 FCU/100 ml Quarterly Total coliforms < 1 FCU/100 ml Quarterly Adapted from: L’eau dans les établissements de santé – guide technique [Water in health-care facilities – technical guide]. Ministère des Solidarités, de la Santé et de la Famille en France, 2004.
Table I.9.3: Virucidal activity of antiseptic agents Reference Test method Viruses Agent Results 728 Suspension HIV 19% EA LR=2.0 in 5 min 729 Suspension HIV 50%EA 35%IPA LR>3.5 LR>3.7 730 Suspension HIV 70%EA LR=7.0 in 1 min 731 Suspension HIV 70%EA LR= 3.2–5.5 in 30 s 732 Suspension HIV 733 Suspension HIV 734 Suspension HIV 70% IPA + 0.5% CHG 4% CHG Chloroxylenol Benzalkonium chloride Povidone-iodine Chlorhexidine LR= 6.0 in 15 s LR= 6.0 in 15 s Inactivated in 1 min Inactivated in 1 min Inactivated Inactivated 735 Suspension HIV Detergent + 0.5% PCMX Inactivated in 30 s Enveloped viruses 736 Suspension/ dried plasma Chimpanzee challenge HBV 70% IPA LR= 6.0 in 10 min 737 Suspension/ plasma Chimpanzee challenge HBV 80% EA LR= 7.0 in 2 min 738 Suspension HSV 223 Suspension RSV 95% EA 75% EA 95% IPA 70% EA + 0.5% CHG 35% IPA 4% CHG LR>5.0 in 1 min LR>5.0 LR>5.0 LR>5.0 LR>4.3 in 1 min LR>3.3 235 Suspension Influenza Vaccinia 95% EA 95% EA Undetectable in 30 s Undetectable in 30 s 235 <strong>Hand</strong> test Influenza Vaccinia 95% EA 95% EA LR> 2.5 LR> 2.5
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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
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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
Page 161 and 162: Table I.8.1: Basic experimental des
Page 163: Table I.9.1: Waterborne pathogens a
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
Page 213 and 214: Garance Upham People’s Health Mov
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