Hand Hygiene - References

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CDC / HICPAC Guideline for Hand Hygiene in Healthcare Settings, 2002
These recommendations are designed to improve hand hygiene practices and to reduce transmission of pathogenic microorganisms. Content includes: indications for handwashing and hand antisepsis, hand hygiene technique, selection of hand hygiene agents, hand lotions and creams, fingernails, glove use, educational and motivational programs, administrative measures and performance indicators. This Guideline includes a strong recommendation for using alcohol-based hand rub unless hands are visibly dirty or contaminated or exposure to spores is suspected. Evidence that alcohol-based products are more effective for standard handwashing than soap or antimicrobial soaps is also referenced. According to the CDC Guideline, alcohol solutions containing 60%-95% alcohol are most effective. This Guideline advises that to maximize acceptance of hand-hygiene products, employers should solicit input from healthcare workers regarding the feel, fragrance and skin tolerance of these products.
Specific recommendations for surgical hand antisepsis are contained on pages 32-33. 
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Learn more at cdc.gov >

WHO Guidelines on Hand Hygiene in Healthcare Facilities, 2009
The content of the World Health Organization guidelines is similar to that in the CDC hand hygiene guideline. These guidelines include pictorial instructions for surgical hand preparation with an alcohol-based hand rub (pgs. 59-60). The WHO guidelines include a statement that “Brushes are not recommended for surgical hand preparation” (pg. 152).

According to the WHO, one surgical hand preparation episode with traditional agents uses approximately 20 litres of warm water, or 60 litres and more for the entire surgical team (pg. 56). 
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WHO Posters - How to Handwash, How to Handrub
This World Health Organization site has free downloadable posters and an educational leaflet to teach healthcare workers when and how to perform routine hand hygiene.
Learn more at who.int >

IHI How-to-Guide: Improving Hand Hygiene
To provide organizations with a roadmap toward improved compliance with good hand hygiene practices, the Institute for Healthcare Improvement collaborated with the Division of Healthcare Quality Promotion of CDC, APIC and SHEA to develop this toolkit.
Learn more at ihi.org  >

Joint Commission Monograph Measuring Hand Hygiene Adherence: Overcoming the Challenges, 2009
This publication includes a comparison of hand hygiene guidelines from the CDC and the WHO. You’ll also find pros and cons of a variety of measurement methods including: observation, measuring product use, conducting surveys and electronic monitoring systems. Contained in the appendix are several hand hygiene observation tools as well as hand hygiene knowledge questionnaires.
Learn more at ihi.org >

Joint Commission National Patient Safety Goals (NPSGs) for Ambulatory Care
Ambulatory Care NPSG.07.01.01 requires compliance with HH guidelines from either the CDC or the WHO. Elements of performance include setting goals for improving hand hygiene compliance and improving compliance based on the established goals.
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Learn more at jointcommission.org >  

Hand Hygiene Observation Form 
View observation form >

Fire Code Regulations and Alcohol Based Hand Rubs
   Download fire code summary with FAQ's and definitions >
 

GOJO Hand Hygiene Posters, Signs, Compliance Building Tools
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GOJO offers clinical support for CMS survey readiness. Contact us at Healthcare@GOJO.com for more information.