Hand hygiene.pdf

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Consensus recommendations are that HCWs should not wear artificial fingernails or extenders when having direct contact with patients and that natural nails should be kept short (≤ 0.5 cm long). 21. HAND HYGIENE RESEARCH AGENDA Although the number of published studies dealing with hand hygiene has increased considerably in recent years, many questions regarding hand hygiene products and strategies for improving HCW compliance with recommended policies remain unanswered. Table I.21.1 lists a number of areas that should be addressed by researchers, scientists and clinical investigators. Table I.21.2 includes a series of open questions on specific unsolved issues, which require research activities and field testing. Some of the research questions will be covered by studies conducted within the framework of the World Alliance for Patient Safety. In particular, also taking advantage of integration with the other components of the Global Patient Safety Challenge, the implementation strategies of the Challenge are expected to evaluate the impact of some of these issues and find practical solutions in the field experience.
PART II. CONSENSUS RECOMMENDATIONS It was agreed that the CDC/HICPAC system for categorizing recommendations be adapted as follows: Category IA. Strongly recommended for implementation and strongly supported by welldesigned experimental, clinical, or epidemiological studies. Category IB. Strongly recommended for implementation and supported by some experimental, clinical, or epidemiological studies and a strong theoretical rationale. Category IC. Required for implementation, as mandated by federal and/or state regulation or standard. Category II. Suggested for implementation and supported by suggestive clinical or epidemiological studies or a theoretical rationale or a consensus by a panel of experts. 1. INDICATIONS FOR HANDWASHING AND HAND ANTISEPSIS A. Wash hands with soap and water when visibly dirty or contaminated with proteinaceous material, or visibly soiled with blood or other body fluids, or if exposure to potential spore-forming organisms is strongly suspected or proven (IB) or after using the restroom (II) 117,213,266,323,324,327,670-675 . B. Preferably use an alcohol-based handrub for routine hand antisepsis in all other clinical situations described in items C(a) to C(f) listed below, if hands are not visibly soiled (IA) 156,256,262,350,359-361,506 . Alternatively, wash hands with soap and water (IB) 132,133,262,500 . C. Perform hand hygiene: a) before and after having direct contact with patients (IB) 6,29,44,63,67,103,676 ; b) after removing gloves (IB) 29,69,85,377,677,678 ; c) before handling an invasive device for patient care, regardless of whether or not gloves are used (IB) 44,679 ; d) after contact with body fluids or excretions, mucous membranes, non-intact skin, or wound dressings (IA) 676 ; e) if moving from a contaminated body site to a clean body site during patient care (IB) 29,44,71,72,103 ; f) after contact with inanimate objects (including medical equipment) in the immediate vicinity of the patient (IB) 29,64,71,72,74,76,103 .
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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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Page 52 and 53: infection, risk factors that are la
Page 54 and 55: 11.4.4 SIDE-EFFECTS OF THE SURGICAL
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Page 58 and 59: 12.2 ALLERGIC CONTACT DERMATITIS RE
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Page 62 and 63: Handrubs are available as gels, sol
Page 64 and 65: 14. HAND HYGIENE PRACTICES AMONG HE
Page 66 and 67: quantified in observational studies
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Page 70 and 71: of water with special leaves) outsi
Page 72 and 73: Furthermore, according to Phra Depv
Page 74 and 75: 16. BEHAVIOURAL CONSIDERATIONS 16.1
Page 76 and 77: and community factors must be consi
Page 78 and 79: i. ii. iii. iv. v. vi. a) b) Educat
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Page 82 and 83: follow the intent 588 . Studies hav
Page 84 and 85: 18. FORMULATING STRATEGIES FOR HAND
Page 86 and 87: 18.2 DEVELOPING A STRATEGY FOR GUID
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Page 90 and 91: HCWs routinely to wear vinyl gloves
Page 92 and 93: quality gloves, reuse, shortage of
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Page 96 and 97: Figure l.20.2: Blood safety: crucia
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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
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524. Muto C et al. Hand hygiene rat
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578. Babcock HM et al. An education
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Interscience Conference on Antimicr
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679. Hirschmann H et al. The influe
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729. Martin LS, McDougal JS, Loskos
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Table I.8.1: Basic experimental des
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Table I.9.1: Waterborne pathogens a
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Table I.9.3: Virucidal activity of
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Table I.9.4: Studies comparing the
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Table I.9.6: Studies comparing the
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Table I.14.1: Hand hygiene frequenc
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Table I.14.2: Hand hygiene adherenc
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Table I.15.1: Hand hygiene indicati
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Table I.18.1: Strategies for succes
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Table l.20.1: Possible problems and
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Table I.21.1. Hand hygiene research
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Table I.21.1: Hand hygiene research
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Table I.21.2: Unsolved issues for r
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Table III.2.1: Quality indicators r
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Table V.3.1: Examples of public inf
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Table V.4.1: Examples of national p
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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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