Infection Prevention Manual

MEASURING HAND HYGIENE ADHERENCE: OVERCOMING THE CHALLENGES Appendix 1-1. World Health Organization (WHO) Hand Hygiene Guideline Recommendations: Comparison with Centers for Disease Control and Prevention (CDC) Guidelines Recommendation A. Visible dirt, blood or body fluids on hands of health care worker (HCW) B. No visible dirt, blood, or body fluids on hands of HCW in the following clinical situations: 1. Before direct patient contact 2. After removing gloves 3. Before handling invasive device for insertion 4. After contact with blood, body fluids, mucous membranes, non-intact skin, and wound dressings 5. Moving from contaminated patient body site to clean site during patient care 6. After contact with inanimate objects or medical equipment close to patient C. Potential exposure to spore- forming organisms CDC Guideline* A. (IA) Non-antimicrobial or antimicrobial soap and water B. (IA) Prefer alcohol hand rub or, alternatively, (IB) antimicrobial soap and water 1. (IB) Recommend 2. (IB) Recommend 3. (IB) Before donning sterile gloves for central venous catheter insertion; also for insertion of other invasive devices that do not require a surgical procedure using sterile gloves 4. (IA) Recommend 5. (II) Recommend 6. (II) Recommend C. (II) Non-antimicrobial or antimicrobial soap and water WHO Guideline* A. (IB) Soap and water B. (IA) Prefer alcohol hand rub or, alternatively, (IB) soap and water 1. (IB) Recommend before and after contact 2. (IB) Recommend 3. (IB) Before insertion of all invasive devices, regardless of glove use 4. (IA) Recommend 5. (IB) Recommend 6. (IB) Recommend C. (IB) Soap and water Key Points of WHO Guideline Simplifies terminology and does not differentiate between non- antimicrobial and antimicrobial soap, unless specified Clarifies expanded use of hand hygiene Clarifies clinical situations and simplify terminology Alcohol hand rub is ineffective against spore-forming organisms (e.g., Clostridium difficile, Bacillus anthracis) I. Indications for handwashing and hand antisepsis Your Agency Name (PN System)