Skin Hygiene and Infection Prevention: More of the Same or Different Approaches?

Larson, Elaine

doi:10.1086/313468

Cited by 268 publications

(153 citation statements)

References 92 publications

(84 reference statements)

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“…Some experts may refer to the action of de-germing with detergent-based antiseptics or alcohol. 1 Hygienic hand rub consists in rubbing hands with a small quantity (2-3 mL) of a highly effective and fast-acting antiseptic agent.…”

Section: E F I N I T I O N Smentioning

confidence: 99%

“…These issues recently were reviewed in detail by Elaine Larson. 1 The need for ready access to hand-hygiene supplies, whether sink, soap, medicated detergent, or waterless alcohol-based hand-rub solution, is self-evident. Asking busy HCWs to walk away from the patient bed to reach a wash basin or to get a hand antisepsis solution invites noncompliance with hand-hygiene recommendations.…”

Section: Compliance W I T H H a N D H Y G I E N Ementioning

confidence: 99%

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Improving Compliance With Hand Hygiene in Hospitals

Pittet

2000

Infect. Control Hosp. Epidemiol.

469

279

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Hand hygiene prevents cross-infection in hospitals, but compliance with recommended instructions often is poor among healthcare workers. Although some previous interventions to improve compliance have been successful, none has achieved lasting improvement. This article reviews reported barriers to appropriate hand hygiene and factors associated with poor compliance.Easy access to hand hygiene in a timely fashion and the availability of skin-care lotion both appear to be necessary prerequisites for appropriate hand-hygiene behavior. In particular, in high-demand situations, hand rub with an alcohol-based solution appears to be the only alternative that allows a decent compliance. The hand-hygiene compliance level does not rely on individual factors alone, and the same can be said for its promotion. Because of the complexity of the process of change, it is not surprising that solo interventions often fail, and multimodal, multidisciplinary strategies are necessary. A framework that includes parameters to be considered for hand-hygiene promotion is proposed, based on epidemiologically driven evidence and review of the current knowledge. Strategies for promotion in hospitals should include reasons for noncompliance with recommendations at individual, group, and institutional levels. Potential tools for change should address each of these elements and consider their interactivity {Infect Control Hosp Epidemiol 2000;21:381-386).Hand hygiene is considered the most important measure to reduce the transmission of nosocomial pathogens in healthcare settings. As recently reviewed by Larson in a comprehensive article, 1 seven quasi-experimental hospitalbased studies of the impact of hand hygiene on the risk of nosocomial infection have been published between 1977 and 1995. 2 " 8 Despite study limitations, most reports showed a temporal relation between improved hand-hygiene practices and reduced infection rates. Similarly, the beneficial effects of hand-hygiene promotion on the risk of crosstransmission have been reported in surveys conducted in schools or day-care centers, 9 " 12 as well as in a community setting. 1315 Despite such evidence, studies in the literature have repeatedly documented that the importance of this simple procedure is not sufficiently recognized by healthcare workers (HCWs), 16 and compliance with recommended hand-hygiene practices is unacceptably low. 8,16 " 21 This article reviews factors that may explain the lack of adherence by HCWs to hand-hygiene procedures and suggests strategies for promotion in hospitals.

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Section: E F I N I T I O N Smentioning

confidence: 99%

Section: Compliance W I T H H a N D H Y G I E N Ementioning

confidence: 99%

Improving Compliance With Hand Hygiene in Hospitals

Pittet

2000

Infect. Control Hosp. Epidemiol.

469

279

View full text Add to dashboard Cite

show abstract

“…Hand hygiene education 60,140,334,429,648,651,666,676,684,686,687,698,705,707,708,[714][715][716][717]813,814,819,851,858 3. Promote/facilitate skin care for HCWs' hands 60,180,608,609 4. Routine observation and feedback 60,334,651,657,665,676,684,686,687,715,716,858 5.…”

Section: Marketing Technology For Hand Hygiene Promotionmentioning

confidence: 99%

“…58,179,180 In what would be considered an intervention trial using historical controls, Semmelweis 179 demonstrated in 1847 that the mortality rate among mothers delivering at the First Obstetrics Clinic at the General Hospital of Vienna was significantly lower when hospital staff cleaned their hands with an antiseptic agent than when they washed their hands with plain soap and water.…”

mentioning

confidence: 99%

Hand Hygiene

Longtin¹,

Sax²,

Allegranzi³

et al. 2011

N Engl J Med

108

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“…Dr Elaine Larson published an extensive review of this topic recently and concluded that despite some methodological flaws and data gaps, evidence for a causal relationship between hand hygiene and reduced transmission of infections is convincing. But she also concluded that frequent handwashing causes skin damage, with resultant changes in microbial flora, increased skin shedding, and increased risk of microorganism transmission, suggesting that some traditional hand hygiene practices need reexamination (Larson 1999).…”

Section: Antimicrobials In Soapsmentioning

confidence: 99%

Products containing biocides: perceptions and realities

Favero

2002

Journal of Applied Microbiology

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Skin Hygiene and Infection Prevention: More of the Same or Different Approaches?

Cited by 268 publications

References 92 publications

Improving Compliance With Hand Hygiene in Hospitals

Improving Compliance With Hand Hygiene in Hospitals

Hand Hygiene

Products containing biocides: perceptions and realities

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