Hand hygiene - comparison of international recommendations

The value of hand hygiene for the prevention of cross-infection was first o bserved in the middle of the 19th century Since then, which procedure is th e most suitable for hand hygiene has been repeatedly discussed and several different guidelines and recommendations have been published. The aim of th is review is to compare different recommendations for hand hygiene regardin g technique and indication. Medline, the internet and a personal library we re searched to obtain as many written recommendations as possible. In addit ion, a small questionnaire was sent by e-mail to 20 international colleague s. As a result written recommendations from 10 countries could be compared. Recommended methods of hand hygiene include handwashing (washing hands wit h plain soap), hygienic handwash (washing hands with medicated soap) and hy gienic hand-rub (use of antiseptic rubs). In most countries handwashing and hygienic handwash are the methods of choice and only in central European c ountries is hygienic hand-rub the preferred technique. Situations in which performance of hand hygiene is recommended are comparable. However, no sing le indication is recommended in all guidelines. Hand hygiene is most often recommended before performing invasive procedures and after microbial conta mination. Guidelines should be clear and easy to follow for them to become standard of care. Thus, guidelines are needed that do not leave to the heal th care worker a decision as to whether hand hygiene is indicated. (C) 2001 The Hospital Infection Society.