Hand Hygiene

CDC Guidelines The focus of the review of data by the Advisory Committee and various Hand Hygiene Task Force organizations was to improve hand-hygiene practices and thus reduce rates of hosital-acquired infection. Their recommendations follow an established system to categorize the importance of each recommendation for implementation based on the extensive research and evidence-based data they reviewed. The categories can best be described as follows: Category I (A, B & C) covers the things that everyone should be doing. These are supported by well-structured studies. Category II recommendations are those that you can do at your institution if you think they will work for you. These studies, supporting Category II recommendations, are not as strong as the Category I recommendations. Category III recommendations are unresolved. There is not enough supporting evidence or research out there to reach a consensus in making a clear recommendation. These are summarized in the chart on the following page. The CDC/HICPAC system is as follows: Category Recommendation for Implementation Rationale IA Strongly recommended Strongly supported by certain experimental, clinical or epidemiological studies and a strong theoretical rationale IB Strongly recommended Supported by certain experimental, clinical or epidemiological studies and a strong theoretical rationale IC Required for implementation As mandated by federal or state regulation or standard II Suggested for implementation Supported by suggestive clinical or epidemiological studies or a theoretical rationale No Recommendation Unresolved issue No sufficient evidence or consensus regarding efficiacy exist (MMWR)     The CDC Guidelines include specific recommendations for: Handwashing and hand antisepsis (see recommendations on page 11) Hand hygiene techniques Surgical hand antisepsis Selection of hand hygiene agents Skin care Miscellaneous aspects of hand hygiene Artificial nails Wearing and removal of gloves When to change gloves Healthcare worker educational and motivational programs Administrative measures The entire document can be seen at the cdc.gov Web site. It is a very inclusive document and is well worth the effort to review in its entirety.

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