THE BUILDING AND CARE OF THE BODY: AN ELEMENTARY TEXT-BOOK IN PRACTICAL PHYSIOLOGY AND HYGIENE

By JAMES MOORE

CONTENTS PART I REVIEW OF SCIENTIFIC DATA RELATED TO HAND HYGIENE 1 DEFINITION OF TERMS 2 GUIDELINE PREPARATION PROCESS FINALIZATION OF THE WHO GUIDELINES ON HAND HYGIENE IN HEALTH CARE 3 THE BURDEN OF HEALTH CARE-ASSOCIATED INFECTION BURDEN OF HEALTH-CARE ASSOCIATED INFECTION IN DEVELOPING COUNTRIES 4 HISTORICAL PERSPECTIVE ON HAND HYGIENE IN HEALTH CARE 5 NORMAL BACTERIAL FLORA ON HANDS 6 PHYSIOLOGY OF NORMAL SKIN 7 TRANSMISSION OF PATHOGENS BY HANDS CROSS-TRANSMISSION OF ORGANISMS BY CONTAMINATED HANDS 8 MODELS OF HAND TRANSMISSION MATHEMATICAL MODELS 9 RELATIONSHIP BETWEEN HAND HYGIENE AND THE ACQUISITION OF HEALTH CARE-ASSOCIATED PATHOGENS 10 METHODS TO EVALUATE THE ANTIMICROBIAL EFFICACY OF HANDRUB AND THE NEED FOR BETTER METHODS 11 REVIEW OF PREPARATIONS USED FOR HAND HYGIENE RELATIVE EFFICACY OF PLAIN SOAP, ANTISEPTIC SOAPS AND DETERGENTS, AND ALCOHOLS 12 WHO-RECOMMENDED HANDRUB FORMULATION LESSONS LEARNT FROM LOCAL PRODUCTION OF THE WHO-RECOMMENDED HANDRUB FORMULATIONS IN DIFFERENT SETTINGS WORLDWIDE 13 SURGICAL HAND PREPARATION: STATE-OF-THE-ART SURGICAL HAND SCRUB WITH MEDICATED SOAP OR SURGICAL HAND PREPARATION WITH ALCOHOL-BASED FORMULATIONS 14 SKIN REACTIONS RELATED TO HAND HYGIENE METHODS TO REDUCE ADVERSE EFFECTS OF AGENTS 15 FACTORS TO CONSIDER WHEN SELECTING HAND HYGIENE PRODUCTS SELECTION FACTORS 16 HAND HYGIENE PRACTICES AMONG HEALTH-CARE WORKERS FACTORS AFFECTING ADHERENCE 17 RELIGIOUS AND CULTURAL ASPECTS OF HAND HYGIENE POSSIBLE SOLUTIONS 18 BEHAVIOURAL CONSIDERATIONS BEHAVIOURAL ASPECTS OF HAND HYGIENE 19 ORGANIZING AN EDUCATIONAL PROGRAMME TO PROMOTE HAND HYGIENE THE INFECTION CONTROL LINK HEALTH-CARE WORKER 20 FORMULATING STRATEGIES FOR HAND HYGIENE PROMOTION MARKETING TECHNOLOGY FOR HAND HYGIENE PROMOTION 21 THE WHO MULTIMODAL HAND HYGIENE IMPROVEMENT STRATEGY LESSONS LEARNT FROM THE TESTING OF THE WHO HAND HYGIENE IMPROVEMENT STRATEGY IN PILOT AND COMPLEMENTARY SITES 22 IMPACT OF IMPROVED HAND HYGIENE 23 PRACTICAL ISSUES AND POTENTIAL BARRIERS TO OPTIMAL HAND HYGIENE PRACTICES SAFETY ISSUES RELATED TO ALCOHOL-BASED PREPARATIONS 24 HAND HYGIENE RESEARCH AGENDA PART II CONSENSUS RECOMMENDATIONS 1 RANKING SYSTEM FOR EVIDENCE 2 INDICATIONS FOR HAND HYGIENE 3 HAND HYGIENE TECHNIQUE 4 RECOMMENDATIONS FOR SURGICAL HAND PREPARATION 5 SELECTION AND HANDLING OF HAND HYGIENE AGENTS 6 SKIN CARE 7 USE OF GLOVES 8 OTHER ASPECTS OF HAND HYGIENE 9 EDUCATIONAL AND MOTIVATIONAL PROGRAMMES FOR HEALTH-CARE WORKERS 10 GOVERNMENTAL AND INSTITUTIONAL RESPONSIBILITIES 11 FOR HEALTH-CARE ADMINISTRATORS 12 FOR NATIONAL GOVERNMENTS PART III PROCESS AND OUTCOME MEASUREMENT 1 HAND HYGIENE AS A PERFORMANCE INDICATOR AUTOMATED MONITORING OF HAND HYGIENE 2 HAND HYGIENE AS A QUALITY INDICATOR FOR PATIENT SAFETY 3 ASSESSING THE ECONOMIC IMPACT OF HAND HYGIENE PROMOTION FINANCIAL STRATEGIES TO SUPPORT NATIONAL PROGRAMMES PART IV TOWARDS A GENERAL MODEL OF CAMPAIGNING FOR BETTER HAND HYGIENE – A NATIONAL APPROACH TO HAND HYGIENE IMPROVEMENT 1 INTRODUCTION 2 OBJECTIVES 3 HISTORICAL PERSPECTIVE 4 PUBLIC CAMPAIGNING, WHO, AND THE MASS MEDIA NATIONAL CAMPAIGNS WITHIN HEALTH CARE 5 BENEFITS AND BARRIERS IN NATIONAL PROGRAMMES 6 LIMITATIONS OF NATIONAL PROGRAMMES 7 THE RELEVANCE OF SOCIAL MARKETING AND SOCIAL MOVEMENT THEORIES HAND HYGIENE IMPROVEMENT CAMPAIGNS OUTSIDE OF HEALTH CARE 8 NATIONALLY DRIVEN HAND HYGIENE IMPROVEMENT IN HEALTH CARE 9 TOWARDS A BLUEPRINT FOR DEVELOPING, IMPLEMENTING AND EVALUATING A NATIONAL HAND HYGIENE IMPROVEMENT PROGRAMME WITHIN HEALTH CARE 10 CONCLUSION PART V PATIENT INVOLVEMENT IN HAND HYGIENE PROMOTION 1 OVERVIEW AND TERMINOLOGY 2 PATIENT EMPOWERMENT AND HEALTH CARE 3 COMPONENTS OF THE EMPOWERMENT PROCESS CREATION OF A FACILITATING ENVIRONMENT AND POSITIVE DEVIANCE 4 HAND HYGIENE COMPLIANCE AND EMPOWERMENT PATIENT AND HEALTH-CARE WORKER EMPOWERMENT 5 PROGRAMMES AND MODELS OF HAND HYGIENE PROMOTION, INCLUDING PATIENT PROGRAMMES 6 WHO GLOBAL SURVEY OF PATIENT EXPERIENCES 7 STRATEGY AND RESOURCES FOR DEVELOPING, IMPLEMENTING, AND EVALUATING A PATIENT/HEALTH-CARE WORKER EMPOWERMENT PROGRAMME IN A HEALTH-CARE FACILITY OR COMMUNITY PART VI COMPARISON OF NATIONAL AND SUB-NATIONAL GUIDELINES FOR HAND HYGIENE REFERENCES