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Hand Hygiene Issue Toolkit

Hand Washing

Background | Resources | Articles





Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. It is best to wash your hands with soap and clean running water for 20 seconds. However, if soap and clean water are not available, use an alcohol-based product to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast acting. Clean Hands Save Lives! (Source: CDC)

In 2002, the CDC issued Guideline for Hand Hygiene in Healthcare Settings. These hand hygiene guidelines were developed by the CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC), in collaboration with the Society for Healthcare Epidemiology of America (SHEA), the Association of Professionals in Infection Control and Epidemiology (APIC), the Infectious Disease Society of America (IDSA).

Regarding dentistry, Guidelines for Infection Control in Dental Health-Care Settings --- 2003 contains a section about hand hygiene.


Hand Hygiene Saves Lives: Patient Admission Video
This video, available in English and Spanish, teaches two key points to hospital patients and visitors to help prevent infections: the importance of practicing hand hygiene while in the hospital, and that it is appropriate to ask or remind their healthcare providers to practice hand hygiene as well.
Hand Hygiene & Other Standard Precautions to Prevent Healthcare-Associated Infections This course and promotional materials review key concepts of hand hygiene and Standard Precautions.
Hand Hygiene in Healthcare Settings

Hand Hygiene in Healthcare Settings provides healthcare workers and patients with a variety of resources including guidelines for providers, patient empowerment materials, the latest technological advances in hand hygiene adherence measurement, frequently asked questions, and links to promotional and educational tools published by the WHO, universities, and health departments.

Hand Hygiene in Healthcare Settings/Training Includes a variety of educational resources including PowerPoints and Posters.
Hand Hygiene FAQ's from infection control indental settings.
Hand Hygiene Self-Assessment Framework The World Health Organization offers an evidence-based diagnostic tool to help any healthcare setting, including dental facilities, improve hand hygiene policies and practices.
Hand Hygiene Resource Center The HHRC's mission is to advance the quality of patient care and reduce infection by improving hand hygiene practices in healthcare settings.

Hand Hygiene for Healthcare Workers

Adapted from: Boyce, J., Pittet, D, the Healthcare InfectionControl Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand HygieneTask Force. Guideline for Hand Hygiene in Health-Care Settings. MMWR, 2002, 51, RR-16

WHO Guidelines on Hand Hygiene in Health Care
First Global Patient Safety Challenge Clean Care is Safer Care

The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to improve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population.

Hand-washing: What you need to know

Fact Sheets en Español

From the American Public Health Association.
Hand Hygiene Video Offered by NEJM

The New England Journal of Medicine is featuring a 14-minute hand hygiene video as part of its Videos in Clinical Medicine.

Hygiène des mains Hôpitaux Universitaires de Genève VigiGerme

A la demande du Service Prévention et Contrôle de l'Infection des Hôpitaux Universitaires de Genève, et dans le cadre du programme VigiGerme, les Rythmakers vous donnent le rythme pour vous frictionner efficacement les mains avec une solution hydro-alcoolique! Alors entrez dans la danse et devenez un Cleanmaker!

At the request of the Infection Control Programme of the University of Geneva Hospitals and its VigiGerme initiative, the Rythmakers set the tempo for you to efficiently clean your hands with an alcohol-based hand rub solution! So join the dance and become a Cleanmaker!

Handwashing Requirements in a Restaurant

Contains some interesting information and links to other resources.

All Washed Up! Fourteen-year-old scientist Hyrum Grenny cracks the code on how to get kids to wash their hands, and in doing so, exposes insightful strategies for influencing behavior change.
Hand Hygiene From the University of Michigan Health System.

How-to Guide: Improving Hand Hygiene A Guide for Improving Practices among Health Care Workers

This guide was prepared in collaboration with the Centers for Disease Control and Prevention (CDC), the Association for Professionals in Infection Control and Epidemiology (APIC), and the Society of Healthcare Epidemiology of America (SHEA), and has been endorsed by APIC and SHEA. Valuable input also was provided by the World Health Organization's World Alliance for Patient Safety through the Global Patient Safety Challenge.





National Survey Finds Americans Lax in Handwashing Habits A national handwashing survey reveals the majority of Americans are not washing their hands long enough. Fifty-seven percent of respondents estimate they wash their hands for just 5 to 15 seconds. In fact, the Centers for Disease Control and Prevention (CDC) recommends washing for at least 20 seconds and suggests singing "Happy Birthday" twice to allow enough time to remove and rinse off germs.
WHO Hand Hygiene Self-Assessment Framework: Hospital Performance in the US and Around the Globe The World Health Organization (WHO) taught the global healthcare community that there are five critical moments in hand hygiene that can make or break infection prevention efforts. Now, using a framework provided by the WHO, hospitals around the world can conduct assessments of their hand hygiene compliance efforts within the context of the larger issues of institutional cultures of safety and other key measures impacting patient outcomes. A recent survey of U.S. healthcare facilities reveals that while great strides are being made, there is much more work to be done to boost hand hygiene monitoring and self-assessment.
Hospital Installs Cameras to Boost Hand Hygiene in the ICU An NBC News affiliate in New York is reporting that North Shore University Hospital in Manhasset, N.Y., has installed 39 cameras in its intensive care unit to boost hand hygiene compliance and control healthcare-acquired infections. The hospital conducted a study of its hand hygiene practices in 2008 and discovered that compliance among physicians was just 10 percent. Today, the hospital reports compliance rates of around 80 percent.
Patient Safety Tool: Hand Rub Selection Checklist The Hand Hygiene Resource Center — a project of the Saint Raphael Healthcare System and John M. Boyce, MD, in New Haven, Conn. — offers a free, downloadable checklist of considerations when healthcare providers are selecting hand rubs.
Medical Students Unwilling to Speak Up to Senior Staff Regarding Poor Hand Hygiene Practices In a letter to the editor published in the August 2012 issue of Infection Control and Hospital Epidemiology, Rohit Samuel, of Monash University in Melbourne, Victoria, Australia, and colleagues, conducted a cross-sectional study assessing the willingness of medical students to speak up about subpar hand hygiene practices among their colleagues and supervising physicians.
Hand-washing knowledge and practices among dentists and dental specialists. Hand washing is the most important way to prevent the spread of infection. However, studies have shown that there is a lack of knowledge among physicians about proper hand hygiene. The purpose of this study was to determine the knowledge of general dentists and dental specialists regarding the correct agents to use and the appropriate times to wash hands.
Patient Safety Tool: VA's Sample Hand Hygiene/Glove Use Observation Tool E-mail Patient Safety Tool: VA's Sample Hand Hygiene/Glove Use Observation Tool
It's not all about me: motivating hand hygiene among health care professionals by focusing on patiens This comparison of different methods for promoting hand hygiene found that patient-centered reminders were effective at improving hand hygiene rates.
Researchers Say WHO Multi-Prong Interventions Work in Improving Hand Hygiene Compliance During the Severe Acute Respiratory Syndrome (SARS) outbreak, high compliance in healthcare workers with hand hygiene was primarily driven by fear. However, the post-SARS period confirmed that this practice was not sustainable. At the Singapore General Hospital, a 1,600-bedded acute tertiary care hospital, the hand hygiene program was revised in early 2007 following Singapore's signing of the pledge to the World Health Organization (WHO) "Clean Care is Safer Care" program.
Debunking Hand Hygiene Myths Thorough and regular hand hygiene is one of the most important strategies for reducing the number of microorganisms in health care settings and minimizing the risk of their transmission. Gloves do not provide complete protection from pathogenic contamination.
Report Says Hand Hygiene Champions the Cause of Infection Control Frost & Sullivan's new report, "Hand Hygiene Champions the Cause of Infection Control" available from Research & Markets, says that a reduction in healthcare-acquired infections (HAIs) could drive an uptake of hand hygiene products.
Multi-modal Infection Prevention Program Boosts Hand Hygiene Compliance Healthcare-associated infections (HAIs) result in significant morbidity and mortality. Hand hygiene remains a cornerstone intervention for preventing HAIs. Unfortunately, adherence to hand hygiene guidelines among healthcare personnel is poor. Hanan Aboumatar MD, MPH, of the Center for Innovation in Quality Patient Care, Johns Hopkins Medicine in Baltimore, and colleagues, sought to assess short- and long-term effects of an infection prevention promotion program on healthcare workers' hand hygiene behaviors. Their study was conducted at a tertiary-care academic center.
Discrepancy Between Self-Reported and Observed Hand Hygiene in Nurses, Physicians One of the most effective methods to promote healthcare workers' hand hygiene (HH) is observation; an investigation of perceptions concerning hand hygiene further increases effectiveness, points out a researcher from the Department of Infection Control at Okayama University Hospital in Okayama, Japan.

Hand Hygiene: Back to Basics in Infection Prevention

Safe Healthcare Hosted by CDC's Division of Healthcare Quality Promotion

Healthcare Workers Disregarding Key Step in Hand Hygiene Protocol A survey from the World Health Organization (WHO) shows that almost 50 percent of healthcare workers around the globe are not washing their hands before providing care to a patient.
CDC joins WHO push for better hand hygiene in healthcare The WHO is in its second year of a "Save Lives: Clean Your Hands Campaign," a global effort to help clinicians improve hand hygiene to reduce the number of healthcare-associated infections (HAIs). To build support for the campaign, the WHO has said it hopes to register 10,000 healthcare facilities to participate in the movement by May 5. As of Apr 23, 8,173 had registered, according to the WHO.
Hand Hygiene Among General Practice Dentists

A Survey of Knowledge, Attitudes and Practices

Hand hygiene (HH) is a primary practice used toreduce the risk and spread of infection. The authors conducteda study to examine the self-reported knowledge, attitudes andpractices of general practice dentists (GPDs) regarding HH andfactors associated with HH and skin condition.
The Critical Component Effective hand hygiene is a fundamental part of an infection prevention and control program.

Ensuring the Success of a Hand Hygiene Protocol


Proper hand hygiene is integral to an effective infection control protocol. Understanding how to ensure the viability of barrier protection, ie, gloves, and what may affect the durability of gloves are necessary to ensure their efficacy and to maintain safety for both practitioner and patient in the dental office. Choosing the right antiseptic hand hygiene agent that is effective and also compatible with the practitioner using it is also a crucial part of hand hygiene. The successful management of both of these issues will help dental offices maintain an effective hand hygiene program.

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