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World Health Organization Issues Guidelines on Hand Hygiene in Healthcare


May 6, 2009 — The World Health Organization (WHO) has issued Guidelines on Hand Hygiene in Health Care, offering a thorough review of evidence on hand hygiene in healthcare and specific recommendations to improve hygiene practices and reduce transmission of pathogenic microorganisms to patients and healthcare workers (HCWs).

The guidelines target hospital administrators and public health officials as well as HCWs, and they are designed to be used in any setting in which healthcare is delivered either to a patient or to a specific group, including all settings where healthcare is permanently or occasionally performed, such as home care by birth attendants.

Individual adaptation of the recommendations is encouraged, based on local regulations, settings, needs, and resources.

Hand Hygiene Indications Indications for hand hygiene are as follows: • Wash hands with soap and water when visibly dirty, when soiled with blood or other body fluids, or after using the toilet.

Handwashing with soap and water is preferred when exposure to potential spore-forming pathogens, such as Clostridium difficile, is strongly suspected or proven.

In all other clinical situations, use an alcohol-based handrub as the preferred means for routine hand antisepsis, if hands are not visibly soiled.

Wash hands with soap and water if alcohol-based handrub is not available.

Hand hygiene is needed before and after touching the patient; before touching an invasive device used for patient care, whether gloves are used; after contact with body fluids or excretions, mucous membranes, nonintact skin, or wound dressings; if moving from a contaminated body site to another body site on the same patient; after touching inanimate surfaces and objects in the immediate vicinity; and after removing gloves.

Hand hygiene is needed before handling medication or preparing food, with an alcohol-based handrub or handwashing with water and either plain or antimicrobial soap.

Soap and alcohol-based handrub should not be used together.

Hand Hygiene Techniques Specific recommendations for hand hygiene technique are as follows: • Rub a palmful of alcohol-based handrub over all hand surfaces until dry.

When washing hands, wet hands with water and apply enough soap to cover all surfaces; rinse hands with water and dry thoroughly with a single-use towel.

Whenever possible, use clean, running water.

Avoid hot water, which may increase the risk for dermatitis.

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