Hand washing is the most effective way to prevent healthcare-associated infections and the spread of antimicrobial resistance. The document outlines the proper techniques and indications for hand hygiene in healthcare settings. It recommends washing hands with soap and water when visibly soiled and using an alcohol-based hand rub in all other clinical situations. Proper hand hygiene includes washing or rubbing all surfaces of the hands for 20-60 seconds depending on the agent used. Following correct hand hygiene procedures is important for patient safety.
2. INTRODUCTION
WHO Patient Safety aims to create an environment that ensures the safety of patient care globally by bringing
together experts, heads of agencies, policy-makers and patient groups and matching experiences, expertise
and evidence on various aspects of patient safety.
The goal of this effort is to catalyze discussion and action and to formulate recommendations and facilitate
their implementation.
“Clean Care is Safer Care” was launched in October 2005 as the first Global Patient Safety Challenge (1st GPSC),
aimed at reducing health care-associated infection (HCAI) worldwide.
These infections occur both in developed and in transitional and developing countries and are among the
major causes of death and increased morbidity for hospitalized patients.
8. Hand hygiene compliance among HCWs
Hand hygiene is the primary measure proven to be effective in preventing HCAI and
the spread of antimicrobial resistance.
However, it has been shown that HCWs encounter difficulties in complying with hand
hygiene indications at different levels.
12. Indications for hand hygiene
A. Wash hands with soap and water when visibly dirty or visibly soiled with blood or other body fluids (IB) or
after using the toilet (II).
B. If exposure to potential spore-forming pathogens is strongly suspected or proven, including outbreaks of C.
difficile, hand washing with soap and water is the preferred means (IB).
C. Use an alcohol-based hand rub as the preferred means for routine hand antisepsis in all other clinical
situations described in items D(a) to D(f) listed below if hands are not visibly soiled (IA).
If alcohol-based hand rub is not obtainable, wash hands with soap and water (IB).75, 150, 151 D. Perform hand hygiene:
a) before and after touching the patient (IB)
b) before handling an invasive device for patient care, regardless of whether or not gloves are used (IB);
c) after contact with body fluids or excretions, mucous membranes, non-intact skin, or wound dressings (IA)
13. Indications for hand hygiene
d) if moving from a contaminated body site to another body site during care of the same patient (IB);
e) after contact with inanimate surfaces and objects (including medical equipment) in the immediate vicinity of the patient
(IB);
f) after removing sterile (II) or non-sterile gloves (IB)
E. Before handling medication or preparing food perform hand hygiene using an alcohol-based hand rub or
wash hands with either plain or antimicrobial soap and water (IB).
F. Soap and alcohol-based hand rub should not be used concomitantly (II)
27. Hand Hygiene Technique with Alcohol-
Based Formulation
Duration of the entire procedure: 20-30 seconds
Follow the steps 2-7 which are explained above
Step1 and step 8 differs which is shown below
28. Hand cleansing agents can be divided into
three types:
Detergents (plain soaps) with water to
physically remove transient
Antimicrobial agents, eg. chlorhexidine
Antiseptic surgical scrubs, eg.