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Table I.9.7: Efficacy of surgical handrub solutions in reducing the release of resident skin flora from clean hands Rub n-Propanol Isopropanol Isopropanol + chlorhexidine gluc. (m/V) Ethanol Concentration a (%) Time (min) Mean log reduction Immediate Persistent (3h) 60 5 2.9 b 1.6 b 5 2.7 b NA 5 2.5 b 1.8 b 5 2.3 b 1.6 b 3 2.9 c NA 3 2.0 b 1.0 b 1 1.1 b 0.5 b 90 3 2.4 c 1.4 c 80 3 2.3 c 1.2 c 70 5 2.4 b 2.1 b 5 2.1 b 1.0 b 3 2.0 c 0.7 c 3 1.7 c NA 3 1.5 b 0.8 b 2 1.2 0.8 1 0.7 b 0.2 1 0.8 NA 60 5 1.7 1.0 70 + 0.5 5 2.5 b 2.7 b 2 1.0 1.5 95 2 2.1 NA 85 3 2.4 c NA 80 2 1.5 NA 70 2 1.0 0.6 95 + 0.5 2 1.7 NA Ethanol + chlorhexidine gluc. (m/V) 77 + 0.5 5 2.0 1.5 d 70 + 0.5 2 0.7 1.4 Chlorhexidine gluc. (aq. Sol., m/V) 0.5 2 0.4 1.2 Povidone-iodine (aq. Sol., m/V) 1.0 5 1.9 b 0.8 b Peracetic acid (m/V) 0.5 5 1.9 NA Rotter M, reprinted with permission from 1. NA = not available. a volume/volume (V/V) unless otherwise stated. b Tested according to Deutsche Gesellschaft fur Hygiene and Mikrobiologic (DGHM), German Society of Hygiene and Microbiology. c Tested according to European Standard prEN. d After 4 h.
Table I.14.1: <strong>Hand</strong> <strong>hygiene</strong> frequency among health-care workers Reference Year Frequency of handwashing episodes Average no./ time period Range Average no./h 82 1988 5/8 h N.S. 153 1984 5–10/shift N.S. 188 2000 10/shift N.S. 469 2000 12–18/day 2–60 190 2000 13–15/8 h 5–27 1.6–1.8/h 154 1977 20–42/8 h 10–100 743 2000 21/12 h N.S. 468 2000 22/day 0–70 527 2002 0.7/h 152 1991 1.7–2.1/h 35 1998 2.1/h 531 2004 2.2/h 457 1978 3/h 515 1994 3.3/h 459 2001 3.5/h 530 2003 10/h 499 2003 11.6/h 744 2001 12/h N.S. = not stated.
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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
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Case study: United Kingdom national
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PART IV. PROMOTING HAND HYGIENE ON
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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 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: Table I.9.6: Studies comparing the
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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