WHO Hand Hygiene

1. Which of the following is a recommendation of the World Health Organization (WHO)? Perform hand hygiene:

Before and after having direct contact with patients

With alcohol-based hand rub if hands are not visibly soiled

After removing gloves

Before handling an invasive device (regardless of whether or not gloves are used)

All are WHO recommendations

Correct answer 4. All of these are recommendations regarding hand hygiene from the WHO.1

Explanation

Correct answer 4. All of these are recommendations regarding hand hygiene from the WHO.1

2. Improved hand hygiene in recent hospital studies was associated with which of the following?

A reduction of catheter-related infections from 7.7 per 1000 catheter-days to 1.3 per 1000 catheter-days in 103 ICUs.2

A significant hospital-wide reduction (57%) in MRSA bacteraemia.3

A significant reduction in health care-associated infections (HCAI) in adult ICUs (from 47.5/1000 patient-days to 27.9/1000 patient-days). 5

All are correct.

Hand hygiene is the primary measure proven to be effective in preventing health care-associated infections and the spread of antimicrobial resistance in hospitals and ICUs.1

2. Pronovost PJ, et al. Sustaining reductions in catheter related blood stream infections in Michigan intensive care units: Observational study. BMJ 2010, 0340:c309.
3. Johnson PD et al. Efficacy of an alcohol/chlorhexidine hand hygiene program in a hospital with high rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection. Medical Journal of Australia, 2005, 183:509-514.
4. Le TA et al. Reduction in surgical site infections in neurosurgical patients associated with a bedside hand hygiene program in Vietnam. Infection Control and Hospital Epidemiology, 2007, 8:583-588.
5. Rosenthal VD, Guzman S, Safdar N. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. American Journal of Infection Control, 2005, 33:392-397.

Explanation

Hand hygiene is the primary measure proven to be effective in preventing health care-associated infections and the spread of antimicrobial resistance in hospitals and ICUs.1

2. Pronovost PJ, et al. Sustaining reductions in catheter related blood stream infections in Michigan intensive care units: Observational study. BMJ 2010, 0340:c309.
3. Johnson PD et al. Efficacy of an alcohol/chlorhexidine hand hygiene program in a hospital with high rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection. Medical Journal of Australia, 2005, 183:509-514.
4. Le TA et al. Reduction in surgical site infections in neurosurgical patients associated with a bedside hand hygiene program in Vietnam. Infection Control and Hospital Epidemiology, 2007, 8:583-588.
5. Rosenthal VD, Guzman S, Safdar N. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. American Journal of Infection Control, 2005, 33:392-397.

3. Which one of the following is FALSE?

In a large Swiss university hospital, doctors cleansed their hands 57% of the times that they should have.1

In an Australian hospital hand washing campaign, mean compliance improved significantly from 21% at baseline to 48%.129

In the USC University hospital in 2009, doctors’ compliance with hand hygiene guidelines was 67%.

Option 3. is FALSE. In 2009 at USC University Hospitals, mean compliance with hand hygiene was only 55% (mean of monthly physician observation reports).8

Please help reduce health care-associated infections in our hospital by improving your hand hygiene. We want all of our physicians to become good role models for the rest of the hospital staff. Thank you.

7. Pittet A, Simon S, et. Al. Hand Hygiene among Physicians: Performance, Beliefs, and Perceptions. Annals of Internal Medicine 2004 (volume 141, pages 1-8).
8. Grayson ML et al. Significant reductions in methicillin-resistant Staphylococcus aureus bacteraemia and clinical isolates associated with a multisite, hand hygiene culture-change program and subsequent successful statewide roll-out. Medical Journal of Australia, 2008, 188:633-640.
9. Mean data from USCUH 2009.

Explanation

Option 3. is FALSE. In 2009 at USC University Hospitals, mean compliance with hand hygiene was only 55% (mean of monthly physician observation reports).8

Please help reduce health care-associated infections in our hospital by improving your hand hygiene. We want all of our physicians to become good role models for the rest of the hospital staff. Thank you.

7. Pittet A, Simon S, et. Al. Hand Hygiene among Physicians: Performance, Beliefs, and Perceptions. Annals of Internal Medicine 2004 (volume 141, pages 1-8).
8. Grayson ML et al. Significant reductions in methicillin-resistant Staphylococcus aureus bacteraemia and clinical isolates associated with a multisite, hand hygiene culture-change program and subsequent successful statewide roll-out. Medical Journal of Australia, 2008, 188:633-640.
9. Mean data from USCUH 2009.

4. Which one of the following is a risk factor for poor handwashing?

Female gender

Not wearing gowns/gloves

Being a nurse (rather than a physician)

Being a physician (rather than a nurse)

Working on a medicine ward (rather than intensive care)

Correct answer - 4. Being a physician, as compared to being a nurse, has been shown to indicate increased risk for poor hand hygiene practices.

Explanation

Correct answer - 4. Being a physician, as compared to being a nurse, has been shown to indicate increased risk for poor hand hygiene practices.

5. Which one of the following is CORRECT?

Hand hygiene with alcohol-based cleanser should take 10-20 seconds

Hand hygiene with alcohol-based cleanser should take 20-30 seconds

Washing hands with soap and water should take 10-20 seconds

Washing hands with soap and water should take 20-30 seconds

The entire procedure for hand washing with soap and water should take 40-60 seconds, and alcohol-based hygiene should take 20-30 seconds.1

1. WHO Guidelines on Hand Hygiene in health care: a summary. 2006

Explanation

The entire procedure for hand washing with soap and water should take 40-60 seconds, and alcohol-based hygiene should take 20-30 seconds.1

1. WHO Guidelines on Hand Hygiene in health care: a summary. 2006

Who Hand Hygiene