The following "Hand Hygiene Guidelines" were prepared and issued by the Centers for Disease Control and Prevention (CDC).
- Improved adherence to hand hygiene (i.e. hand washing
or use of alcohol-based hand rubs) has been shown to terminate
outbreaks in health care facilities, to reduce transmission of
antimicrobial resistant organisms (e.g. methicillin resistant
staphylococcus aureus) and reduce overall infection rates.
- CDC
is releasing guidelines to improve adherence to hand hygiene in health
care settings. In addition to traditional handwashing with soap and
water, CDC is recommending the use of alcohol-based handrubs by health
care personnel for patient care because they address some of the
obstacles that health care professionals face when taking care of
patients.
- Handwashing
with soap and water remains a sensible strategy for hand hygiene in
non-health care settings and is recommended by CDC and other experts.
- When health care personnel's hands are visibly soiled, they should wash with soap and water.
- The
use of gloves does not eliminate the need for hand hygiene. Likewise,
the use of hand hygiene does not eliminate the need for gloves. Gloves
reduce hand contamination by 70 percent to 80 percent, prevent
cross-contamination and protect patients and health care personnel from
infection. Handrubs should be used before and after each patient just
as gloves should be changed before and after each patient.
- When
using an alcohol-based handrub, apply product to palm of one hand and
rub hands together, covering all surfaces of hands and fingers, until
hands are dry. Note that the volume needed to reduce the number of
bacteria on hands varies by product.
- Alcohol-based
handrubs significantly reduce the number of microorganisms on skin, are
fast acting and cause less skin irritation.
- Health
care personnel should avoid wearing artificial nails and keep natural
nails less than one quarter of an inch long if they care for patients
at high risk of acquiring infections (e.g. Patients in intensive care
units or in transplant units
- When
evaluating hand hygiene products for potential use in health care
facilities, administrators or product selection committees should
consider the relative efficacy of antiseptic agents against various
pathogens and the acceptability of hand hygiene products by personnel.
Characteristics of a product that can affect acceptance and therefore
usage include its smell, consistency, color and the effect of dryness
on hands.
- As
part of these recommendations, CDC is asking health care facilities to
develop and implement a system for measuring improvements in adherence
to these hand hygiene recommendations. Some of the suggested
performance indicators include: periodic monitoring of hand hygiene
adherence and providing feedback to personnel regarding their
performance, monitoring the volume of alcohol-based handrub used/1000
patient days, monitoring adherence to policies dealing with wearing
artificial nails and focused assessment of the adequacy of health care
personnel hand hygiene when outbreaks of infection occur.
- Allergic
contact dermatitis due to alcohol hand rubs is very uncommon. However,
with increasing use of such products by health care personnel, it is
likely that true allergic reactions to such products will occasionally
be encountered.
- Alcohol-based
hand rubs take less time to use than traditional hand washing. In an
eight-hour shift, an estimated one hour of an ICU nurse's time will be
saved by using an alcohol-based handrub.
- Please note: These guidelines should not be construed to legalize product claims that are not allowed by an FDA product approval by FDA's Over-the-Counter Drug Review. The recommendations are not intended to apply to consumer use of the products discussed.
