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Hand Hygiene in Outpatient and Home-based Care and Long ...

Hand Hygiene in Outpatient andHome-based Care and Long-term Care FacilitiesA Guide to the Application of the WHO Multimodal Hand Hygiene Improvement Strategy and the My Five Moments for Hand Hygiene ApproachHand Hygiene in Outpatient and Home-based Care and Long-term Care Facilities A Guide to the Application of the WHO Multimodal Hand HygieneImprovement Strategy and the My Five Moments for Hand Hygiene pproachWHO Library Cataloguing-in-Publication Data:Hand Hygiene in Outpatient and Home-based care and long-term care facilities: a guide to the application of the WHO multimodal hand Hygiene improvementstrategy and the My Five Moments For Hand Hygiene standards .

1.Handwashing – standards. 2.Patient care – standards. 3.Hygiene. ... Physiotherapy and mobility exercise care to an elderly person in a nursing home ... on hand hygiene best practices and improvement strategies are considered the gold standard for health-care worldwide.

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Transcription of Hand Hygiene in Outpatient and Home-based Care and Long ...

1 Hand Hygiene in Outpatient andHome-based Care and Long-term Care FacilitiesA Guide to the Application of the WHO Multimodal Hand Hygiene Improvement Strategy and the My Five Moments for Hand Hygiene ApproachHand Hygiene in Outpatient and Home-based Care and Long-term Care Facilities A Guide to the Application of the WHO Multimodal Hand HygieneImprovement Strategy and the My Five Moments for Hand Hygiene pproachWHO Library Cataloguing-in-Publication Data:Hand Hygiene in Outpatient and Home-based care and long-term care facilities: a guide to the application of the WHO multimodal hand Hygiene improvementstrategy and the My Five Moments For Hand Hygiene standards .

2 Care standards . infection prevention and control. care services care. Health 978 92 4 150337 2(NLM classification: WB 300) World Health Organization 2012 All rights reserved. Publications of the World Health Organization are availableon the WHO web site ( ) or can be purchased from WHOP ress, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: for permission to reproduce or translate WHOpublications whetherfor sale or for noncommercial distribution should be addressed to WHO Pressthrough the WHO web site( ).The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country,territory, city or area or of its authorities, or concerning the delimitation of itsfrontiers or boundaries.)

3 Dotted lines on maps represent approximate borderlines for which there may not yet be full mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the World HealthOrganization in preference to others of a similar nature that are not and omissions excepted, the names of proprietary products are distinguished by initial capital reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the publishedmaterial is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lieswith the reader.

4 In no event shall the World Health Organization be liable fordamages arising from its by Common Sense, GreecePrinted by the WHO Document Production Services, Geneva, and essential notes for the and is hand Hygiene important in Outpatient care?.. of the My five moments for Hand Hygiene approach in Outpatient The patient zone and health-care area concepts in Outpatient The My five moments for hand Hygiene approach in Outpatient of the WHO Multimodal Hand Hygiene Improvement Strategy and accompanying toolkit in Outpatient System Training and Evaluation and Reminders in the Institutional safety examples of hand Hygiene requirements in a broad range of Outpatient care Introduction and essential notes for the Practical vaccination Blood drawing in a Visit to a general practitioner s Paediatric consultation in a health Consultation in an

5 Emergency Home care helping a disabled patient to Home care wound Chest X-ray in a diagnostic Haemodialysis in a specialized ambulatory clinic start of Haemodialysis in a specialized ambulatory clinic during the dialysis Haemodialysis in a specialized ambulatory clinic disconnection at the end of Haemodialysis in a specialized ambulatory clinic after patient Childbirth and delivery Childbirth and delivery assistance during Childbirth and delivery assistance at time of Childbirth and delivery assistance after the departure of mother and child from the delivery care in a clinic .. of vital and clinical parameters in a bedridden resident of a nursing the diaper of a bedridden resident in a and mobility exercise care to an elderly person in a nursing Hygiene IN Outpatient AND Home-based CARE AND LONG-TERM CARE FACILITIES4 ACKNOWLEDGEMENTSThis publication is the product of contributions by severalindividuals.

6 The publication was written by BenedettaAllegranzi and Sepideh Bagheri Nejad, WHO PatientSafety Programme, Geneva, Switzerland, and by Marie-No lle Chraiti, WHO Collaborating Centreon Patient Safety, University of Geneva Hospitals,Geneva, Switzerland. The publication was developedthanks to the essential technical input and support by the Ministry of Health, Social Services and Equality of Spain. Critical technical input was also provided by the WHO Collaborating Centre on Patient Safety,University of Geneva Hospitals and Faculty of Medicine,Geneva, Benedetta AllegranziWHO Patient Safety Programme, Geneva, SwitzerlandSepideh Bagheri NejadWHO Patient Safety Programme, Geneva, SwitzerlandMarie-No lle ChraitiWHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine,Geneva, SwitzerlandContributors Yolanda Agra-VarelaDirectorate General of Public Health, Quality and Innovation, Ministry of Health, Social Services and Equality, Madrid.

7 Spain Mar a del Mar Fern andez-Ma llo Directorate General of Public Health, Quality and Innovation, Ministry of Health, Social Services and Equality, Madrid, Spain Soledad Alonso-Humada Almer a Primary Healthcare District, Andaluc a RegionHealth Service, Almeria, Spain M. Carmen G mez-Gonz alez Spanish Society of Primary Health Care Practitioners(SEMERGEN), Badajoz, Spain B atrice JansScientific Institute of Public Health, Brussels, BelgiumAna Mart nez-Rubio Spanish Association of Primary Healthcare Pediatrics,Sevilla, Spain Jes us Molina-Cabrillana Spanish Society of Preventive Medicine, Public Healthand Hygiene , Las Palmas de Gran Canaria, SpainMaria Luisa MoroAgenzia Sanitaria e Sociale Regionale Regione Emilia-Romagna, Bologna, ItalyFernando P rez-Escanilla Spanish Society of General Practitioners and FamilyDoctors, Spain Teresa Pi-Sunyer-Ca~nellas External Consultant, Barcelona.

8 SpainDidier PittetWHO Collaborating Centre on Patient SafetyUniversity of Geneva Hospitals and Faculty of Medicine,Geneva, SwitzerlandChristiane ReichardtInstitute of Hygiene and Environmental Medicine, University Medicine Berlin, Charit , GermanyLisa RitchieHealth Protection Scotland, Glasgow, United KingdomPhilip L Russo Austin Health, Heidelberg, Victoria, AustraliaHugo Sax Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, SwitzerlandLuisa Torijano-Casaluenga Spanish Society of Community and Family Medicine,Talavera de la Reina, Toledo, SpainReviewersPilar Astier-Pe~naSpanish Society of Community and Family Medicine,Zaragoza, Spain Barry CooksonHealth Protection Agency, London, United KingdomNizam DamaniCraigavon Area Hospital, Portadown, Craigavon, UnitedKingdomFrancisco Javier Hern andez-HerreroLa Gomera Primary Healthcare, Canary Islands HealthService, San Sebastian de La Gomera, Canary Islands,Spain Claire KilpatrickHealth Protection Scotland, Glasgow, United KingdomEdward KelleyWHO Patient Safety Programme, Geneva, SwitzerlandElaine LarsonColumbia University School of Nursing, New York, USAM aribel Maci an-Morro Nursing Federation of Community and Primary HealthCare.

9 Caravaca de la Cruz, Murcia, Spain Shaheen MehtarTygerberg Hospital and Stellenbosch University, Tygerberg, Cape Town, South AfricaAndreas VossCanisius-Wilhelmina Hospitals and Radboud UniversityNijmegen Medical Centre, Nijmegen, The NetherlandsEditorRosemary Sudan, Freelance editorDesign and figures Common Sense, Athens, GreeceThe Ministry of Health, Social Services and Equality of Spain kindly funded and hosted an experts consultation in Madrid on 17 November 2011 to discussthe content of this handrubsESBL extended-spectrum beta-lactamasesHBVhepatitis B virusHCAI health care-associated infectionHCVhepatitis C virusHCWhealth-care workerLCTF long-term care facilityMRSA methicillin-resistant Staphylococcus aureusUSAU nited States of AmericaUTIurinary tract infectionVREvancomycin-resistant enterococciWHOW orld Health OrganizationHAND Hygiene IN Outpatient AND Home-based CARE AND LONG-TERM CARE FACILITIES67 INTRODUCTION AND ESSENTIAL NOTESFOR THE READERThe World Health Organization (WHO)

10 Recommendations on hand Hygiene best practices and improvement strategiesare considered the gold standard for health-care the last six years they have been implemented in thousands of facilities as well as at national level in manycountries. Although these recommendations and strategieshave been developed primarily for the hospital setting, highinterest in the possibility to implement them in primary careand other types of Outpatient settings has arisen in recentyears. Concurrently, several questions have emerged aboutthe transmission and infection risks and the application of hand Hygiene concepts in these settings. The availablescientific evidence is limited and knowledge on the implementation of infection control solutions in such settingsis at an early stage.


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