HAND HYGIENE: A HANDBOOK FOR MEDICAL PROFESSIONALS.

1. The Burden of Healthcare-Associated Infection 1
2. Historical Perspectives 8
3. Flora and Physiology of Normal Skin 12
4. Dynamics of Hand Transmission 18
5. Mathematical Models of Handborne Transmission of Nosocomial Pathogens 28
6. Methodological Issues in Hand Hygiene Science 36
7. Statistical Issues: How to Overcome the Complexity of Data Analysis in Hand Hygiene Research? 42
8. Hand Hygiene Agents 51
9. Methods to Evaluate the Antimicrobial Efficacy of HandHygiene Agents 58
10. Hand Hygiene Technique 70
11. Compliance with Hand Hygiene Best Practices 76
12. Barriers to Compliance 85
13. Physicians and Hand Hygiene 89
14. Surgical Hand Preparation 94
15. Skin Reaction to Hand Hygiene 101
16. Alcohol-Based Handrub Safety 105
17. Rinse, Gel, Foam, Soap … Selecting an Agent 109
18. Behavior and Hand Hygiene 115
19. Hand Hygiene Promotion Strategies 123
20. My Five Moments for Hand Hygiene 134
21. System Change 144
22. Education of Healthcare Professionals 152
23. Glove Use and Hand Hygiene 156
24. Monitoring Hand Hygiene Performance 162
25. Performance Feedback 172
26. Marketing Hand Hygiene 180
27. Human Factors Design 185
28. Institutional Safety Climate 193
29. Personal Accountability for Hand Hygiene 201
30. Patient Participation and Empowerment 206
31. Religion and Hand Hygiene 216
32. Hand Hygiene Promotion from the US Perspective: PuttingWHO and CDC Guidelines into Practice 221
33. WHO Multimodal Promotion Strategy 230
34. Monitoring Your Institution (Hand Hygiene Self-Assessment Framework) 244
35. National Hand Hygiene Campaigns 249
36. Hand Hygiene Campaigning: From One Hospital to the Entire Country 256
37. Improving Hand Hygiene through Joint Commission Accreditation and the Joint Commission Center for Transforming Healthcare 263
38. A Worldwide WHO Hand Hygiene in Healthcare Campaign 275
39. The Economic Impact of Improved Hand Hygiene 285
40. Hand Hygiene: Key Principles for the Manager 294
41. Effect of Hand Hygiene on Infection Rates 299
42A.Hand Hygiene in Specific Patient Populations and Situations: Critically Ill Patients 317
42B. Hand Hygiene in Specific Patient Populations and Situations: Neonates and Pediatrics 324
42C. Hand Hygiene in Long-Term Care Facilities and Home Care 329
42D.Hand Hygiene in Ambulatory Care 337
42E. Hand Hygiene in Hemodialysis 344
42F. Hand Hygiene in Specific Patient Populations and Situations: Anesthesiology 350
43. Hand Hygiene in Resource-Poor Settings 357
44A. Role of Hand Hygiene in MRSA Control 367
44B. Role of Hand Hygiene in Clostridium difficile Control 373
44C. Role of Hand Hygiene in Respiratory Diseases Including Influenza 378
44D. Handborne Spread of Noroviruses and its Interruption 385
45. Conducting a Literature Review on Hand Hygiene 391

Appendix 400
Index 409

The first comprehensive, authoritative review of one of the most fundamental and important issues in infection control and patient safety, hand hygiene. Developed and presented by the world's leading scholar-clinicians, Hand Hygiene is an essential resource for all medical professionals.

• Developed and presented by the world leaders in this fundamental topic
• Fully integrates World Health Organization (WHO) guidelines and policies
• Offers a global perspective in tackling hand hygiene issues in developed and developing countries
• Coverage of basic and highly complex clinical applications of hand hygiene practices
• Includes novel and unusual aspects and issues in hand hygiene such as religious and cultural aspects and patient participation
• Offers guidance at the individual, institutional, and organizational levels for national and worldwide hygiene promotion campaigns

Authors
• Didier Pittet MD, MS, CBE, Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
• John M. Boyce MD, Hospital Epidemiology and Infection Control, Yale-New Haven Hospital, and Yale University School of Medicine, New Haven, CT, USA
• Benedetta Allegranzi MD, Infection Prevention and Control Global Unit, Department of Service Delivery and Safety, World Health Organization, and Faculty of Medicine, University of Geneva, Geneva, Switzerland