Hand hygiene full size

Jerry Jee article, page one and two

CDC Hand Hygiene Home see pdf p29 re subungual

See Prevention here, references to Ayliffe technique

? diagrams of technique at  Hand Hygiene Australia?

1. GENERAL
   1. BMJ
   2. Lancet
   3. JAMA
2. HAND WASHING
3. AQUEOUS ALCOHOL
4. ALCOHOL GELS
5. ANTIMICROBIALS IN CONSUMER PRODUCTS
6. PUBLIC EDUCATION
7. RESOURCES
8. ETC

BMJ

1. Teare (2001;323:411-412 ( 25 August ) “Mathematical modelling suggests that even small increments in hand hygiene may be highly effective in controlling, for example,endemic methicillin resistant S aureus.”

Lancet

1. Pittet 10/00
2. letters re Pittet article

The epic Project at DoH UK, and Standard Principles (dl’d, see standardprinciples)

DRAFT Infection Control Guidelines: for the prevention of transmission of infectious diseases in the health care setting  CDNA; see ch 12 Handwashing

Guideline for Hand Hygiene in Health-Care Settings

Chicago Tribune (Michael Berens) series on HAI. SEE FILES #1823

JAMA

1. Leape, Berwick & Bates re ‘To err is human”: “For policymakers to wait for incontrovertible proof of effectiveness before recommending a practice would be a prescription for inaction and an abdication of responsibility. “
2. Shojania et al list handwashing compliance with a lot of others (table)

Making Health Care Safer ( Agency for Healthcare Research and Quality)  Ch 12 Handwashing

NEJM — Infection Control — A Problem for Patient Safety also refs Petersen
Remarkably, the use of waterless antiseptic hand rubs, when part of a multifaceted campaign that encourages appropriate hand washing, has been shown to be more practical than standard hand washing alone and has been shown to improve the adherence of health care workers to hand-hygiene guidelines and to prevent the transmission of methicillin-resistant S. aureus to patients.¹⁶

New Zealand MOH MRSA prevention guidelines: “Most … protocols … bear little resemblance to what actually occurs …”

Hand-Rubbing With an Aqueous Alcoholic Solution vs Traditional Surgical Hand-Scrubbing and 30-Day Surgical Site Infection Rates  JAMA “Hand-rubbing with liquid aqueous alcoholic solution can thus be safely used as an alternative to traditional surgical hand-scrubbing.”

Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap BMJ 8/02 Girou

Rapid responses to:  Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial BMJ “Given the choice I’d take the alcohol any day.”- Matt Thomas, ICU, Sydney

New Zealand public health report 6/01 ref to reduction of HAI reporrted by Pittet 2000

Hospitals Finding Alcohol Gels Clean Better Than Soap ref Murray, Larson, Hooper, Pittet

An Outbreak of Conjunctivitis Due to Atypical Streptococcus pneumoniae
M. Martin and Others
Abstract | Full Text |
To limit transmission of infection, we disseminated messagesabout prevention through e-mail, posters, and the daily collegenewspaper. Messages about prevention encouraged students, staff members, and faculty members to wash their hands frequently,to avoid sharing eating utensils, and to seek care for symptomsof conjunctivitis. Once the bacterial cause was known, a topicalantibiotic (sulfacetamide or bacitracin) was recommended for students with symptoms of conjunctivitis. Two days before spring break, we distributed 4-oz bottles of alcohol-based hand gel (Endure 300, Ecolab) to undergraduate students through the college mailroom.

Use of Antimicrobial Agents in Consumer Products ARCH DERM “The use of common antimicrobials for which acquired bacterial resistance has been demonstrated should be discontinued in consumer products unless data emerge to conclusively show that such resistance has no effect on public health and that such products are effective at preventing infection. ”

PUBLIC EDUCATION

RESOURCES

HICPAC – Healthcare Infection Control Practices Advisory Committee – Publications
(Formerly Hospital Infection Control Practices Advisory Committee)

FAQ: Artificial and Long Fingernails

NurseZone – Feature Stories – Spotlight on nurses – Archive

Fingernail Infection Control Issue References – UMHHC IC&E

Infection Control and Hospital Epidemiology

NurseWeek: Scratch That

Infection Control Today – 07/2002: Disinfecting Those Digits is …

Guideline for the Prevention of Surgical Site Infection, 1999 Download/Print/View Guideline
stored as cdc_ssi_99 – SEE P 258 RE TECHNIQUE

Guideline for Isolation Precautions in Hospitals
Guideline for Isolation Precautions in Hospitals. Julia S. Garner … Commitee.
ref hands 7 gloves, but not fingernails

Standard principals for Handwashing
… Guidelines for Preventing Hospital-acquired Infections in England – Standard Principles:

New action to tackle hospital acquired infections Wednesday 1 September 2004
Lord Warner launches national campaign to promote hand cleaning by healthcare staff

http://www.publications.parliament.uk/pa/cm200304/cmselect/cmpubacc/uc1044-i/uc104402.htm
Richard Bacon

New products in battle on MRSA Wednesday 1 December 2004John Reid names three products identified by the rapid review panel set up to look at new equipment to help improve hospital cleanliness and infection control.

ETC

To rid skin of anthrax, soap and water beats alcohol
CIDRAP – 17 Mar 2003
Mar 17, 2003 (CIDRAP News) – People whose hands may be contaminated by anthrax
should wash them with either antimicrobial or conventional soap and water, but …

Article for HIC journal

The crusade against puerperal fever  [Full Text] [PDF]

The OlympianWash your hands to ward off illness
… They teach hand washing at … In some restaurants, a reminder sign in the bathroom is being replaced by high-tech gadgets to monitor workers’ hygiene habits. …
**long nails** stored

www.hospitalinfectionrates.org J&J

Empowering patients
SIR – The National Patient Safety Agency supports the Welsh Community Health Council view that patients should ask healthcare staff if they have washed their hands to reduce the spread of hospital acquired infections.
As your story (August 3) correctly stated we have piloted a clean-your-hands campaign aimed at improving hand hygiene among healthcare staff – for the benefit of patients.
It involves making alcohol-gel hand disinfectant easily accessible at the point of patient care and, importantly, actively encourages patients to ask healthcare staff if they have cleaned their hands before treating them.
Our findings do not concur with the comments from Unison that the scheme could drive a wedge between staff and the patients they are trying to treat. Feedback from the six-month pilot at six acute Trusts in England demonstrated clearly that the majority of patients – 70% – do want to be involved in this way. In addition, hand cleaning by staff almost trebled.
We stress, there is no obligation for patients to ask. It is a case of empowering them by giving them information and making them feel comfortable about their own care.
SUSAN WILLIAMS/SUE OSBORN
Joint Chief Executive National Patient Safety Agency
Maple Street, London W1
17/8 by form
In the e-letter to icWales(‘Empowering patients’, 13/8) by the Joint Chief Executive, you mentioned “hand cleaning by staff almost trebled”.
Will the data and observations that back the claim be published?
I am very interested in pushing the ‘hand hygiene’ message to my laboratory staff. (I am not in the institutional Infection Control loop) But one tentative foray blew back in my face – over the subject of fingernails. I believe it would be very easy to prove that, the longer the nail overhang, the more carriage of bacteria, especially the ones that love the wet. My fear is that the fashion for long nails, even on Olympic athletes, is so entrenched that, not only will the younger women in healthcare resist demands to keep them short (ie, less than 2mm) but we will see more outbreaks of serious gram-negative infections in intensive neonatal care units.
We have a (new) female chief executive.
So, I guess I am wondering, do you have an opinion on the argument for stricter controls over fingernails in health care?
REPLIED
In answer to your specific points:

1. The report into the findings of the pilot will be published – as a
stand alone report available on our website from next month.

2. Re fingernails – very topical (I get asked about this often). SWe did
not specifically address this as part of the remit of the project – it
is covered off in the national evidence based guidelines in UK and I
note CDC Atlanta paid attention to it in 2002 – basically supporting
your comments.  I do agree that long fingernails are not conducive to
microbe free hands and leave it to local teams (through their local
policies) to pursue this.

see corresp with Baker

Many healthcare practitioners feel they don’t have the time to take the extra 30 seconds to clean their hands. CONTINUES…………..www.physweekly.com

Research shows children make parents sick
New research from Food Standards Australia shows that it really is our children that make us sick, with evidence pointing to children under five as the most likely to spread intestinal bugs like gastroenteritis.

ebiox
Unique, EU compliant, Non-Alcohol Based Solution for Combating Hospital Acquired Infections/MRSA
Healthcare Enterprise Group PLC (‘HCEG’) announces the conclusion of further controlled tests carried out by the NHS Hospital Infection Research Laboratory City Hospital, Birmingham on its Ebiox Handrub product. These results show that
the Ebiox Handrub is compliant with EN1500, the EU standard for continental Europe and the UK.
EN1500 is the standard by which the efficacy of non-water based products is tested under practical conditions. Ebiox Handrub exceeded the standards set by EN1500 when tested against e-coli bacteria. The Handrub has previously passed
prEN12054 including efficacy against other bacteria including MRSA. These earlier tests demonstrated a 99.999% reduction in all test organisms within 30 seconds, significantly exceeding the one-minute test target.
HCEG believes that the Ebiox Handrub is the first non-alcohol based product that is compliant with EU standards and has been developed to be better than alcohol as a hand hygiene solution. The Ebiox non-alcohol Handrub decontaminates hands
without drying or irritating the skin, and has been specifically designed to be user-friendly to encourage more hand cleaning than the existing washing protocol achieves.

Fear of Flu Sparks Home Remedies
Public health officials have urged people to slow the spread of flu by washing their hands frequently or using a hand sanitizer. Executives at GoJo Industries Inc. in Akron, Ohio, said that has driven up demand for the company’s Purell hand-sanitizer lotion, which the company says combines moisturizers and ethyl alcohol to kill germs. GoJo executives said the biggest increase in sales has come from companies whose flu-shot programs for employees were scrapped because of the vaccine shortage. GoJo has a new product for them: a plastic desktop cradle that can hold a 12-ounce bottle of Purell. It won’t be available until next month, but the company is offering retractable clips and lanyards that hold smaller bottles.