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Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene

  • Katherine Ellingson (a1), Janet P. Haas (a2), Allison E. Aiello (a3), Linda Kusek (a4), Lisa L. Maragakis (a5), Russell N. Olmsted (a6), Eli Perencevich (a7) (a8), Philip M. Polgreen (a7), Marin L. Schweizer (a7) (a8), Polly Trexler (a5), Margaret VanAmringe (a4) and Deborah S. Yokoe (a9)...


Previously published guidelines provide comprehensive recommendations for hand hygiene in healthcare facilities. The intent of this document is to highlight practical recommendations in a concise format, update recommendations with the most current scientific evidence, and elucidate topics that warrant clarification or more robust research. Additionally, this document is designed to assist healthcare facilities in implementing hand hygiene adherence improvement programs, including efforts to optimize hand hygiene product use, monitor and report back hand hygiene adherence data, and promote behavior change. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

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1. Boyce, JM, Pittet, D. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Am } Infect Control 2002;30: S1S46.
2. Pittet, D, Allegranzi, B, Boyce, J. The World Health Organization Guidelines on Hand Hygiene in Health Care and their consensus recommendations. Infect Control Hosp Epidemiol 2009; 30:611622.
3. Yokoe, DS, Anderson, DJ, Berenholtz, SM, et al. Introduction to “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates.” Infect Control Hosp Epidemiol 2014;35:455459.
4. Lane, HJ, Blum, N, Fee, E. Holmes, Oliver Wendell (1809-1894) and Semmelweis, Ignaz Philipp (1818-1865): preventing the transmission of puerperal fever. Am J Public Health 2010;100: 10081009.
5. Gould, IM. Alexander Gordon, puerperal sepsis, and modern theories of infection control—Semmelweis in perspective. Lancet Infect Dis 2010;10:275278.
6. Mortimer, EA Jr, Lipsitz, PJ, Wolinsky, E, Gonzaga, AJ, Rammelkamp, CH Jr. Transmission of staphylococci between new-borns: importance of the hands to personnel. Am J Dis Child 1962;104:289295.
7. Allegranzi, B, Pittet, D. Role of hand hygiene in healthcare-associated infection prevention. J Hosp Infect 2009;73:305315.
8. Mody, L, Saint, S, Kaufman, SR, Kowalski, C, Krein, SL. Adoption of alcohol-based handrub by United States hospitals: a national survey. Infect Control Hosp Epidemiol 2008;29:11771180.
9. Voss, A, Widmer, AF. No time for handwashing!? handwashing versus alcoholic rub: can we afford 100% compliance? Infect Control Hosp Epidemiol 1997;18:205208.
10. Kownatzki, E. Hand hygiene and skin health. J Hosp Infect 2003; 55:239245.
11. Erasmus, V, Daha, TJ, Brug, H, et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol 2010;31:283294.
12. Harris, AD, Samore, MH, Nafziger, R, DiRosario, K, Roghmann, MC, Carmeli, Y. A survey on handwashing practices and opinions of healthcare workers. J Hosp Infect 2000;45:318321.
13. Lankford, MG, Zembower, TR, Trick, WE, Hacek, DM, Noskin, GA, Peterson, LR. Influence of role models and hospital design on hand hygiene of healthcare workers. Emerg Infect Dis 2003; 9:217223.
14. World Health Organization (WHO). A Guide to the Implementation of the WHO Multimodal Hand Hygiene Improvement Strategy. Geneva: WHO, 2009.
15. The Joint Commission Center for Transforming Healthcare. Targeted Solutions Tool for Hand Hygiene. Accessed December 27, 2013.
16. Allegranzi, B, Conway, L, Larson, E, Pittet, D. Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities. Am } Infect Control 2014;42:224230.
17. The Joint Commission. Measuring Hand Hygiene Adherence: Overcoming the Challenges, Published 2009. Accessed May 18, 2013.
18. World Health Organization. SAVE LIVES: Clean Your Hands, Tools and Resources for Evaluation and Feedback. Accessed May 18, 2013.
19. McGuckin, M, Govednik, J. Hand hygiene product volume measurement: an integral part of a multiple-method program. Infect Control Hosp Epidemiol. 2010;31:980981.
20. Boyce, JM. Hand hygiene compliance monitoring: current perspectives from the USA. J Hosp Infect 2008;70(suppl l):27.
21. Gould, DJ, Moralejo, D, Drey, N, Chudleigh, JH. Interventions to improve hand hygiene compliance in patient care. Cochrane Database Syst Rev 2010:CD005186.
22. Schweizer, ML, Reisinger, HS, Ohi, M, et al. Searching for an optimal hand hygiene bundle: a meta-analysis. Clin Infect Dis 2014;58:248259.
23. Talbot, TR, Johnson, JG, Fergus, C, et al. Sustained improvement in hand hygiene adherence: utilizing shared accountability and financial incentives. Infect Control Hosp Epidemiol 2013;34: 11291136.
24. Eveillard, M, Hitoto, H, Raymond, F, et al. Measurement and interpretation of hand hygiene compliance rates: importance of monitoring entire care episodes. J Hosp Infect 2009;72:211217.
25. Haas, JP, Larson, EL. Measurement of compliance with hand hygiene. J Hosp Infect 2007;66:614.
26. Sax, H, Allegranzi, B, Uckay, I, Larson, E, Boyce, J, Pittet, D. “My Five Moments for Hand Hygiene”: a user-centred design approach to understand, train, monitor and report hand hygiene. J Hosp Infect 2007;67:921.
27. Sax, H, Allegranzi, B, Chraiti, MN, Boyce, J, Larson, E, Pittet, D. The World Health Organization hand hygiene observation method. Am J Infect Control 2009;37:827834.
28. Stewardson, A, Sax, H, Longet-Di Pietro, S, Pittet, D. Impact of observation and analysis methodology when reporting hand hygiene data. J Hosp Infect 2011;77:358359.
29. Marra, AR, Camargo, TZ, Cardoso, VJ, et al. Hand hygiene compliance in the critical care setting: a comparative study of 2 different alcohol handrub formulations. Am J Infect Control 2013;41:136139.
30.Canada’s Hand Hygiene Challenge. Hand Hygiene Toolkit. Your 4 Moments for Hand Hygiene [poster], Accessed April 3, 2014.
31. Centers for Disease Control and Prevention, National Healthcare Safety Network. Multidrug-Resistant Organism and Clostridium difficile Infection (MDRO/CDI) Module. Accessed April 2, 2014.
32. Reisinger, HS, Yin, J, Radonovich, L, et al. Comprehensive survey of hand hygiene measurement and improvement practices in the Veterans Health Administration. Am J Infect Control 2013; 41:989993.
33. Al-Tawfiq, JA, Abed, MS, Al-Yami, N, Birrer, RB. Promoting and sustaining a hospital-wide, multifaceted hand hygiene program resulted in significant reduction in health care-associated infections. Am J Infect Control 2013;41:482486.
34. Gould, DJ, Chudleigh, J, Drey, NS, Moralejo, D. Measuring handwashing performance in health service audits and research studies. J Hosp Infect 2007;66:109115.
35. Gould, DJ, Drey, NS, Creedon, S. Routine hand hygiene audit by direct observation: has nemesis arrived? J Hosp Infect 2011; 77:290293.
36. van de Mortel, T, Murgo, M. An examination of covert observation and solution audit as tools to measure the success of hand hygiene interventions. Am J Infect Control 2006;34:9599.
37. Boyce, JM. Measuring healthcare worker hand hygiene activity: current practices and emerging technologies. Infect Control Hosp Epidemiol 2011;32:10161028.
38. Kohli, E, Ptak, J, Smith, R, Taylor, E, Talbot, EA, Kirkland, KB. Variability in the Hawthorne effect with regard to hand hygiene performance in high- and low-performing inpatient care units. Infect Control Hosp Epidemiol 2009;30:222225.
39. Dhar, S, Tansek, R, Toftey, EA, et al. Observer bias in hand hygiene compliance reporting. Infect Control Hosp Epidemiol 2010;31:869870.
40. Pan, SC, Tien, KL, Hung, IC, et al. Compliance of health care workers with hand hygiene practices: independent advantages of overt and covert observers. PloS ONE 2013;8:e53746.
41. Larson, EL, Aiello, AE, Cimiotti, JP. Assessing nurses’ hand hygiene practices by direct observation or self-report. J Nurs Meas 2004;12:7785.
42. Kowitt, B, Jefferson, J, Mermel, LA. Factors associated with hand hygiene compliance at a tertiary care teaching hospital. Infect Control Hosp Epidemiol 2013;34:11461152.
43. Fries, J, Segre, AM, Thomas, G, Herman, T, Ellingson, K, Polgreen, PM. Monitoring hand hygiene via human observers: how should we be sampling? Infect Control Hosp Epidemiol 2012; 33:689695.
44. Sharma, D, Thomas, GW, Foster, ED, et al. The precision of human-generated hand-hygiene observations: a comparison of human observation with an automated monitoring system. Infect Control Hosp Epidemiol 2012;33:12591261.
45. Hlady, CS, Severson, MA, Segre, AM, Polgreen, PM. A mobile handheld computing application for recording hand hygiene observations. Infect Control Hosp Epidemiol 2010;31:975977.
46. Chen, LF, Carriker, C, Staheli, R, et al. Observing and improving hand hygiene compliance: implementation and refinement of an electronic-assisted direct-observer hand hygiene audit program. Infect Control Hosp Epidemiol 2013;34:207210.
47. Erasmus, V, Kuperus, MN, Richardus, JH, Vos, MC, Oenema, A, van Beeck, EF. Improving hand hygiene behaviour of nurses using action planning: a pilot study in the intensive care unit and surgical ward. J Hosp Infect 2010;76:161164.
48. Graf, K, Ott, E, Wolny, M, et al. Hand hygiene compliance in transplant and other special patient groups: an observational study. Am J Infect Control 2013;41:503508.
49. Davis, CR. Infection-free surgery: how to improve hand-hygiene compliance and eradicate methicillin-resistant Staphylococcus aureus from surgical wards. Ann R Coll Surg Engl 2010;92:316319.
50. Armellino, D, Trivedi, M, Law, I, et al. Replicating changes in hand hygiene in a surgical intensive care unit with remote video auditing and feedback. Am J Infect Control 2013;41:925927.
51. Armellino, D, Hussain, E, Schilling, ME, et al. Using high-technology to enforce low-technology safety measures: the use of third-party remote video auditing and real-time feedback in healthcare. Clin Infect Dis 2012;54:17.
52. Palmore, TN, Henderson DK. Big brother is washing … video surveillance for hand hygiene adherence, through the lenses of efficacy and privacy. Clin Infect Dis 2012;54:89.
53. Behnke, M, Gastmeier, P, Geffers, C, Monch, N, Reichardt, C. Establishment of a national surveillance system for alcohol-based hand rub consumption and change in consumption over 4 years. Infect Control Hosp Epidemiol 2012;33:618620.
54. Marra, AR, Moura, DF Jr, Paes, AT, dos Santos, OF, Edmond, MB. Measuring rates of hand hygiene adherence in the intensive care setting: a comparative study of direct observation, product usage, and electronic counting devices. Infect Control Hosp Epidemiol 2010;31:796801.
55. McGuckin, M, Waterman, R, Govednik, J. Hand hygiene compliance rates in the United States—a one-year multicenter collaboration using product/volume usage measurement and feedback. Am J Med Qual 2009;24:205213.
56. Scheithauer, S, Oude-Aost, J, Heimann, K, et al. Hand hygiene in pediatric and neonatal intensive care unit patients: daily opportunities and indication- and profession-specific analyses of compliance. Am J Infect Control 2011;39:732737.
57. Larson, EL, Early, E, Cloonan, P, Sugrue, S, Parides, M. An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med 2000;26:1422.
58. Larson, EL, Albrecht, S, O’Keefe, M. Hand hygiene behavior in a pediatric emergency department and a pediatric intensive care unit: comparison of use of 2 dispenser systems. Am J Cut Care 2005;14:304311.
59. Kinsella, G, Thomas, AN, Taylor, RJ. Electronic surveillance of wall-mounted soap and alcohol gel dispensers in an intensive care unit. J Hosp Infect 2007;66:3439.
60. Whitby, M, McLaws, ML, Slater, K, Tong, E, Johnson, B. Three successful interventions in health care workers that improve compliance with hand hygiene: is sustained replication possible? Am J Infect Control 2008;36:349355.
61. Koff, MD, Corwin, HL, Beach, ML, Surgenor, SD, Loftus, RW. Reduction in ventilator associated pneumonia in a mixed intensive care unit after initiation of a novel hand hygiene program. J Crit Care 2011;26:489495.
62. Helder, OK, Weggelaar, AM, Waarsenburg, DC, et al. Computer screen saver hand hygiene information curbs a negative trend in hand hygiene behavior. Am J Infect Control 2012;40:951954.
63. Boyce, JM, Cooper, T, Dolan, MJ. Evaluation of an electronic device for real-time measurement of alcohol-based hand rub use. Infect Control Hosp Epidemiol 2009;30:10901095.
64. Marra, AR, D’Arco, C, Bravim Bde, A, et al. Controlled trial measuring the effect of a feedback intervention on hand hygiene compliance in a step-down unit. Infect Control Hosp Epidemiol 2008;29:730735.
65. Marra, AR, Guastelli, LR, de Araujo, CM, et al. Positive deviance: a program for sustained improvement in hand hygiene compliance. Am J Infect Control 2011;39:15.
66. Marra, AR, Guastelli, LR, de Araujo, CM, et al. Positive deviance: a new strategy for improving hand hygiene compliance. Infect Control Hosp Epidemiol 2010;31:1220.
67. Koff, MD, Loftus, RW, Burchman, CC, et al. Reduction in intraoperative bacterial contamination of peripheral intravenous tubing through the use of a novel device. Anesthesiology 2009; 110:978985.
68. Pittet, D, Hugonnet, S, Harbarth, S, et al; Infection Control Programme. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000; 356(9238):13071312.
69. Boyce, JM, Ligi, C, Kohan, C, Dumigan, D, Havill, NL. Lack of association between the increased incidence of Clostridium difficile-associated disease and the increasing use of alcohol-based hand rubs. Infect Control Hosp Epidemiol 2006;27:479483.
70. Eldridge, NE, Woods, SS, Bonello, RS, et al. Using the Six Sigma process to implement the Centers for Disease Control and Prevention Guideline for Hand Hygiene in 4 intensive care units. J Gen Intern Med 2006;21(suppl 2):S35S42.
71. Magiorakos, AP, Leens, E, Drouvot, V, et al. Pathways to clean hands: highlights of successful hand hygiene implementation strategies in Europe. Euro Surveill 2010;15:19560.
72. Muller, A, Denizot, V, Mouillet, S, et al. Lack of correlation between consumption of alcohol-based solutions and adherence to guidelines for hand hygiene. J Hosp Infect 2005;59:163164.
73. Morgan, DJ, Pineles, L, Shardell, M, et al. Automated hand hygiene count devices may better measure compliance than human observation. Am J Infect Control 2012;40:955959.
74. Boscart, VM, Gorski, S, Holliday, PJ, et al. Advanced technologies to curb healthcare-associated infections. Healthc Pap 2009;9: 5155.
75. Ferenc, J. Handy solutions: hygiene compliance monitoring goes high-tech. Health Facil Manage 2012;25:3236.
76. Swoboda, SM, Earsing, K, Strauss, K, Lane, S, Lipsett, PA. Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit. Crit Care Med 2004;32:358363.
77. Venkatesh, AK, Lankford, MG, Rooney, DM, Blachford, T, Watts, CM, Noskin, GA. Use of electronic alerts to enhance hand hygiene compliance and decrease transmission of vancomycin-resistant Enterococcus in a hematology unit. Am J Infect Control 2008;36:199205.
78. Swoboda, SM, Earsing, K, Strauss, K, Lane, S, Lipsett, PA. Isolation status and voice prompts improve hand hygiene. Am J Infect Control 2007;35:470476.
79. Fakhry, MG, Hanna, B, Anderson, O, Holmes, A, Nathwani, D. Effectiveness of an audible reminder on hand hygiene adherence. Am J Infect Control 2012;40:320323.
80. Cheng, VC, Tai, JW, Ho, SK, et al. Introduction of an electronic monitoring system for monitoring compliance with moments 1 and 4 of the WHO “My 5 Moments for Hand Hygiene” methodology. BMC Infect Dis 2011;11:151.
81. Sahud, AG, Bhanot, N. Measuring hand hygiene compliance: a new frontier for improving hand hygiene. Infect Control Hosp Epidemiol 2009;30:1132.
82. Polgreen, PM, Hlady, CS, Severson, MA, Segre, AM, Herman, T. Method for automated monitoring of hand hygiene adherence without radio-frequency identification. Infect Control Hosp Epidemiol 2010;31:12941297.
83. Edmond, MB, Goodell, A, Zuelzer, W, Sanogo, K, Elam, K, Bearman, G. Successful use of alcohol sensor technology to monitor and report hand hygiene compliance. J Hosp Infect 2010;76: 364365.
84. Sahud, AG, Bhanot, N, Radhakrishnan, A, Bajwa, R, Manyam, H, Post, JC. An electronic hand hygiene surveillance device: a pilot study exploring surrogate markers for hand hygiene compliance. Infect Control Hosp Epidemiol 2010;31:634639.
85. Pineles, LL, Morgan, DJ, Limper, HM, et al. Accuracy of a radiofrequency identification (RFID) badge system to monitor hand hygiene behavior during routine clinical activities. Am J Infect Control 2014;42:144147.
86. Polgreen, P. Badge brings automated edge to infection control. Mater Manag Health Care 2009:1517.
87. Boscart, VM, McGilton, KS, Levchenko, A, Hufton, G, Holliday, P, Fernie, GR. Acceptability of a wearable hand hygiene device with monitoring capabilities, J Hosp Infect 2008;70:216222.
88. Levchenko, AI, Boscart, M, Fernie, GR. The feasibility of an automated monitoring system to improve nurses’ hand hygiene. Int J Med Inform 2011;80:596603.
89. Ellingson, K, Polgreen, PM, Schneider, A, et al. Healthcare personnel perceptions of hand hygiene monitoring technology. Infect Control Hosp Epidemiol 2011;32:10911096.
90. Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 2007;35(10 suppl 2):S65S164.
91. MacCannell, T, Umscheid, CA, Agarwal, RK, Lee, I, Kuntz, G, Stevenson, KB. Guideline for the prevention and control of norovirus gastroenteritis outbreaks in healthcare settings. Infect Control Hosp Epidemiol 2011;32:939969.
92. Gould, CV, Umscheid, CA, Agarwal, RK, Kuntz, G, Pegues, DA. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol 2010;31:319326.
93. Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR; Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 1999;20:250278.
94. O’Grady, NP, Alexander, M, Burns, LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control 2011;39(4 suppl 1):S1S34.
95. Ayliffe, GA, Bridges, K, Lilly, HA, Lowbury, EJ, Varney, J, Wilkins, MD. Comparison of two methods for assessing the removal of total organisms and pathogens from the skin. J Hyg (Lond) 1975;75:259274.
96. Blech, MF, Hartemann, P, Paquin, JL. Activity of non antiseptic soaps and ethanol for hand disinfection. Zentralbl Bakteriol Mikrobiol Hyg B 1985;181:496512.
97. Ehrenkranz, NJ, Alfonso ВС. Failure of bland soap handwash to prevent hand transfer of patient bacteria to urethral catheters. Infect Control Hosp Epidemiol 1991;12:654662.
98. Zaragoza, M, Salles, M, Gomez, J, Bayas, JM, Trilla, A. Hand-washing with soap or alcoholic solutions? a randomized clinical trial of its effectiveness. Am J Infect Control 1999;27:258261.
99. Winnefeld, M, Richard, MA, Drancourt, M, Grob JJ. Skin tolerance and effectiveness of two hand decontamination procedures in everyday hospital use. Br J Dermatol 2000;143:546550.
100. Girou, E, Loyeau, S, Legrand, P, Oppein, F, Brun-Buisson, C. Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial. BMJ 2002;325(7360):362.
101. Kac, G, Podglajen, I, Gueneret, M, Vaupre, S, Bissery, A, Meyer, G. Microbiological evaluation of two hand hygiene procedures achieved by healthcare workers during routine patient care: a randomized study. J Hosp Infect 2005;60:3239.
102. Abaza, AF, Amine, AE, Hazzah, WA. Comparative study on efficacy of different alcohol hand rubs and routine hand wash in a health-care setting, Alexandria, Egypt. J Egypt Public Health Assoc 2010;85(5-6):273283.
103. Pickering, AJ, Julian, TR, Mamuya, S, Boehm, AB, Davis, J. Bacterial hand contamination among Tanzanian mothers varies temporally and following household activities. Trop Med Int Health 2011;16:233239.
104. Chow, A, Arah, OA, Chan, SP, et al. Alcohol handrubbing and chlorhexidine handwashing protocols for routine hospital practice: a randomized clinical trial of protocol efficacy and time effectiveness. Am J Infect Control 2012;40:800805.
105. Larson, EL, Aiello, AE, Bastyr, J, et al. Assessment of two hand hygiene regimens for intensive care unit personnel. Crit Care Med 2001;29:944951.
106. Bellamy, K, Alcock, R, Babb, JR, Davies, JG, Ayliffe, GA. A test for the assessment of “hygienic” hand disinfection using rotavirus. J Hosp Infect 1993;24:201210.
107. Sattar, SA. Microbicides and the environmental control of nosocomial viral infections. J Hosp Infect 2004;56(suppl 2):S64S69.
108. Lages, SL, Ramakrishnan, MA, Goyal, SM. In-vivo efficacy of hand sanitisers against feline calicivirus: a surrogate for noro-virus. J Hosp Infect 2008;68:159163.
109. Turner, RB, Fuis, JL, Rodgers, ND. Effectiveness of hand sanitizers with and without organic acids for removal of rhinovirus from hands. Antimicrob Agents Chemother 2010;54:13631364.
110. Steinmann, J, Paulmann, D, Becker, B, Bischoff, B, Steinmann, E, Steinmann, J. Comparison of virucidal activity of alcohol-based hand sanitizers versus antimicrobial hand soaps in vitro and in vivo. J Hosp Infect 2012;82:277280.
111. Davies, JG, Babb, JR, Bradley, CR, Ayliffe, GA. Preliminary study of test methods to assess the virucidal activity of skin disinfectants using poliovirus and bacteriophages. J Hosp Infect 1993; 25:125131.
112. Grayson, ML, Melvani, S, Druce, J, et al. Efficacy of soap and water and alcohol-based hand-rub preparations against live H1N1 influenza virus on the hands of human volunteers. Clin Infect Dis 2009;48:285291.
113. Liu, P, Escudero, B, Jaykus, LA, et al. Laboratory evidence of norwalk virus contamination on the hands of infected individuals. Appl Environ Microbiol 2013;79:78757881.
114. Savolainen-Kopra, C, Korpela, T, Simonen-Tikka, ML, et al. Single treatment with ethanol hand rub is ineffective against human rhinovirus—hand washing with soap and water removes the virus efficiently. J Med Virol 2012;84:543547.
115. Mukherjee, DV, Cohen, B, Bovino, ME, Desai, S, Whittier, S, Larson, EL. Survival of influenza virus on hands and fomites in community and laboratory settings. Am J Infect Control 2012; 40:590594
116. Larson, EL, Cohen, B, Baxter, KA. Analysis of alcohol-based hand sanitizer delivery systems: efficacy of foam, gel, and wipes against influenza A (H1N1) virus on hands. Am J Infect Control 2012;40:806809.
117. Gould, D, Drey, N. Hand hygiene technique. Nurs Stand 2008; 22(34):4246.
118. Smith, SM. A review of hand-washing techniques in primary care and community settings, J Clin Nurs 2009;18:786790.
119. Widmer, AE, Dangel, M. Alcohol-based handrub: evaluation of technique and microbiological efficacy with international infection control professionals. Infect Control Hosp Epidemiol 2004;25:207209.
120. Widmer, AF, Conzelmann, M, Tomic, M, Frei, R, Stranden, AM. Introducing alcohol-based hand rub for hand hygiene: the critical need for training. Infect Control Hosp Epidemiol 2007;28: 5054.
121. Tschudin Sutter, S, Frei, R, Dangel, M, Widmer, AF. Effect of teaching recommended World Health Organization technique on the use of alcohol-based hand rub by medical students. Infect Control Hosp Epidemiol 2010;31:11941195.
122. Kampf, G, Reichel, M, Feil, Y, Eggerstedt, S, Kaulfers, PM. Influence of rub-in technique on required application time and hand coverage in hygienic hand disinfection. BMC Infect Dis 2008;8:149.
123. Taylor, LJ. An evaluation of handwashing techniques—1. Nurs Times 1978;74:5455.
124. Longtin, Y, Sax, H, Allegranzi, B, Schneider, F, Pittet, D. Videos in clinical medicine: hand hygiene. N Engl J Med 2011;364:e24.
125. Macinga, DR, Edmonds, SL, Campbell, E, Shumaker, DJ, Arbogast, JW. Efficacy of novel alcohol-based hand rub products at typical in-use volumes. Infect Control Hosp Epidemiol 2013;34:299301.
126. Kampf, G, Marschall, S, Eggerstedt, S, Ostermeyer, C. Efficacy of ethanol-based hand foams using clinically relevant amounts: a cross-over controlled study among healthy volunteers. BMC Infect Dis 2010;10:78.
127. Kampf, G, Ruselack, S, Eggerstedt, S, Nowak, N, Bashir, M. Less and less—influence of volume on hand coverage and bactericidal efficacy in hand disinfection. BMC Infect Dis 2013;13: 472.
128. Larson, E, Friedman, C, Cohran, J, Treston-Aurand, J, Green, S. Prevalence and correlates of skin damage on the hands of nurses. Heart Lung 1997;26:404412.
129. Larson, E, Girard, R, Pessoa-Silva, CL, Boyce J, , Donaldson, L, Pittet, D. Skin reactions related to hand hygiene and selection of hand hygiene products. Am J Infect Control 2006;34:627635.
130. Chamorey, E, Marcy, P-Y, Dandine, M, et al. A prospective multicenter study evaluating skin tolerance to standard hand hygiene techniques. Am J Infect Control 2011;39:613.
131. Stutz, N, Becker, D, Jappe, U, et al. Nurses’ perceptions of the benefits and adverse effects of hand disinfection: alcohol-based hand rubs vs. hygienic handwashing: a multicentre questionnaire study with additional patch testing by the German contact dermatitis research group. Br J Dermatol 2009;160:565572.
132. Dulon, M, Pohrt, U, Skudlik, C, Nienhaus, A. Prevention of occupational skin disease: a workplace intervention study in geriatric nurses. Br J Dermatol 2009;161:337344.
133. Houben, E, DePaepe, K, Rogiers, V. Skin condition associated with intensive use of alcoholic gels for hand disinfection: a combination of biophysical and sensorial data. Contact Dermatitis 2006;54:261267.
134. Boyce, JM, Pittet, D; Society for Healthcare Epidemiology of America, Association for Professionals in Infection Control, Infectious Diseases Society of America. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR Recomm Rep 2002;51(RR-16):l45.
135. Ahmed-Lecheheb, D, Cunat, L, Hartemann, P, Hautemaniere, A. Prospective observational study to assess hand skin condition after application of alcohol-based hand rub solutions. Am J Infect Control 2012;40:160164.
136. Larson, EL, Cimiotti, J, Haas, J, et al. Effect of antiseptic hand-washing vs alcohol sanitizer on health care-associated infection in neonatal intensive care units. Arch Pediatr Adolesc Med 2005; 159:377383.
137. Kampf, G, Wigger-Alberti, W, Wilhelm, K-P. Do atopies tolerate alcohol-based hand rubs? a prospective, controlled, randomized double-blind clinical trial. Acta Derm Venereol 2006;86: 140143.
138. Ohlenschlaeger, J, Friberg, J, Ramsing, D, Agner, T. Temperature dependency of skin susceptibility to water and detergents. Acta Derm Venereol 1996;76:274276.
139. Williams, C, Wilkinson, SM, McShane, P, et al. A double-blind, randomized study to assess the effectiveness of different moisturizers in preventing dermatitis induced by hand washing to simulate healthcare use. Br J Dermatol 2010;162:11081192.
140. Ibler, KS, Jebec, GBE, Diepgen, TL, et al. Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema: randomised clinical trial. BMJ 2012;345(e7822):l14.
141. Jungbauer, FH, Steenstra, FB, Groothoff, JW, Coenraads, PJ. Characteristics of wet work in nurses. Int Arch Occup Environ Health 2005;78:248251.
142. Cimiotti, JP, Marmur, ES, Nesin, M, Hamlin-Cook, PH, Larson, EL. Adverse reactions associated with an alcohol-based hand antiseptic among nurses in a neonatal intensive care unit. Am J Infect Control 2003;31:4348.
143. Boyce, JM, Pearson, ML. Low frequency of fires from alcohol-based hand rub dispensers in healthcare facilities. Infect Control Hosp Epidemiol 2003;24:618619.
144. Kramer, A, Kampf, G. Hand rub–associated fire incidents during 25,038 hospital-years in Germany. Infect Control Hosp Epidemiol 2007;28:745746.
145. WHO Clean Care Is Safer Care. Glove use information leaflet. Accessed August 12, 2013.
146. Johnson, S, Gerding, DN, Olson, MM, et al. Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission. Am J Med 1990;88:137140.
147. Tenorio, AR, Badri, SM, Sahgal, NB, et al. Effectiveness of gloves in the prevention of hand carriage of vancomycin-resistant Enterococcus species by health care workers after patient care. Clin Infect Dis 2001;32:826829.
148. Olsen, RJ, Lynch, P, Coyle, MB, Cummings, J, Bokete, T, Stamm, WE. Examination gloves as barriers to hand contamination in clinical practice. JAMA 1993;270:350353.
149. Pessoa-Silva, CL, Dharan, S, Hugonnet, S, et al. Dynamics of bacterial hand contamination during routine neonatal care. Infect Control Hosp Epidemiol 2004;25:192197.
150. Duckro, AN, Blom, DW, Lyle, EA, Weinstein, RA, Hayden, MK. Transfer of vancomycin-resistant enterococci via health care worker hands. Arch Intern Med 2005;165:302307.
151. Guerrero, DM, Nerandzic, MM, Jury, LA, Jinno, S, Chang, S, Donskey, CJ. Acquisition of spores on gloved hands after contact with the skin of patients with Clostridium difficile infection and with environmental surfaces in their rooms. Am J Infect Control 2012;40:556558.
152. Rossoff, LJ, Lam, S, Hilton, E, Borenstein, M, Isenberg, HD. Is the use of boxed gloves in an intensive care unit safe? Am J Med 1993;94:602607.
153. Hughes, KA, Cornwall, J, Theis, JC, Brooks, HJ. Bacterial contamination of unused, disposable non-sterile gloves on a hospital orthopaedic ward. Australas Med J 2013;6:331338.
154. Rossoff, LJ, Borenstein, M, Isenberg, HD. Is hand washing really needed in an intensive care unit? Crit Care Med 1995;23:12111216.
155. Rock, C, Harris, AD, Reich, NG, Johnson, JK, Thorn, KA. Is hand hygiene before putting on nonsterile gloves in the intensive care unit a waste of health care worker time? a randomized controlled trial. Am J Infect Control 2013;41:994996.
156. Aiello, AE, Larson, EL, Levy, SB. Consumer antibacterial soaps: effective or just risky? Clin Infect Dis 2007;45(suppl 2):S137S147.
157. Perencevich, EN, Wong, MT, Harris, AD. National and regional assessment of the antibacterial soap market: a step toward determining the impact of prevalent antibacterial soaps. Am J Infect Control 2001;29:281283.
158.Proposed Amendment to 1994 Tentative Final Monograph on December 17, 2013. Accessed December 18, 2013.
159. Bergstrom, KG. Update on antibacterial soaps: the FDA takes a second look at triclosans. J Drugs Dermatol 2014;13:501503.
160. Webster, J, Faoagali, JL, Cartwright, D. Elimination of methicillin-resistant Staphylococcus aureus from a neonatal intensive care unit after hand washing with triclosan. J Paediatr Child Health 1994;30:5964.
161. Zafar, AB, Butler, RC, Reese, DJ, Gaydos, LA, Mennonna, PA. Use of 0.3% triclosan (Bacti-Stat) to eradicate an outbreak of methicillin-resistant Staphylococcus aureus in a neonatal nursery. Am J Infect Control 1995;23:200208.
162. Jones, RD, Jampani, HB, Newman, JL, Lee, AS. Triclosan: a review of effectiveness and safety in health care settings. Am J Infect Control 2000;28:184196.
163. Capretti, MG, Sandri, F, Tridapalli, E, Galletti, S, Petracci, E, Faldella, G. Impact of a standardized hand hygiene program on the incidence of nosocomial infection in very low birth weight infants. Am J Infect Control 2008;36:430435.
164. Drury, B, Scott, J, Rosi-Marshall, EJ, Kelly, JJ. Triclosan exposure increases triclosan resistance and influences taxonomic composition of benthic bacterial communities. Environ Sci Technol 2013;47:89238930.
165. D’Arezzo, S, Lanini, S, Puro, V, Ippolito, G, Visca, P. High-level tolerance to triclosan may play a role in Pseudomonas aeruginosa antibiotic resistance in immunocompromised hosts: evidence from outbreak investigation. BMC Res Notes 2012;5:43.
166. Syed, AK, Ghosh, S, Love, NG, Boles, BR. Triclosan promotes Staphylococcus aureus nasal colonization. MBio 2014;5:e01015.
167. Perron, MM, Ho, KT, Cantwell, MG, Burgess, RM, Pelletier, MC. Effects of triclosan on marine benthic and epibenthic organisms. Environ Toxicol Chem 2012;31:18611866.
168. Calafat, AM, Ye, X, Wong, LY, Reidy, JA, Needham, LL. Urinary concentrations of triclosan in the U.S. population: 2003-2004. Environ Health Perspect 2008;116:303307.
169. Koeppe, ES, Ferguson, KK, Colacino, JA, Meeker, JD. Relationship between urinary triclosan and paraben concentrations and serum thyroid measures in NHANES 2007-2008. Sci Total Environ 2013;445-446:299305.
170. Lankester, J, Patel, C, Cullen, MR, Ley, C, Parsonnet, J. Urinary triclosan is associated with elevated body mass index in NHANES. PLoS ONE 2013;8:e80057.
171. Clayton, EM, Todd, M, Dowd, JB, Aiello, AE. The impact of bisphenol A and triclosan on immune parameters in the U.S. population, NHANES 2003-2006. Environ Health Perspect 2011;119:390396.
172. Halden, RU. On the need and speed of regulating triclosan and triclocarban in the United States. Environ Sci Technol 2014;48: 36033611.
173. Park, GW, Barclay, L, Macinga, D, Charbonneau, D, Pettigrew, CA, Vinje, J. Comparative efficacy of seven hand sanitizers against murine norovirus, feline calicivirus, and GII.4 norovirus. J Food Prot 2010;73:22322238.
174. Kampf, G, Grotheer, D, Steinmann, J. Efficacy of three ethanol-based hand rubs against feline calicivirus, a surrogate virus for norovirus. J Hosp Infect 2005;60:144149.
175. Macinga, DR, Sattar, SA, Jaykus, LA, Arbogast, JW. Improved inactivation of nonenveloped enteric viruses and their surrogates by a novel alcohol-based hand sanitizer. Appl Environ Microbiol 2008;74:50475052.
176. Gehrke, C, Steinmann, J, Goroncy-Bermes, P. Inactivation of feline calicivirus, a surrogate of norovirus (formerly Norwalk-like viruses), by different types of alcohol in vitro and in vivo. J Hosp Infect 2004;56:4955.
177. Kramer, A, Galabov, AS, Sattar, SA, et al. Virucidal activity of a new hand disinfectant with reduced ethanol content: comparison with other alcohol-based formulations. J Hosp Infect 2006;62:98106.
178. Dubberke, ER, Gerding, DN, Classen, D, et al. Strategies to prevent Clostridium difficile infections in acute care hospitals. Infect Control Hosp Epidemiol 2008;29(suppl 1):S81S92.
179. Jabbar, U, Leischner, J, Kasper, D, et al. Effectiveness of alcohol-based hand rubs for removal of Clostridium difficile spores from hands. Infect Control Hosp Epidemiol 2010;31:565570.
180. Oughton, MT, Loo, VG, Dendukuri, N, Fenn, S, Libman, MD. Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile . Infect Control Hosp Epidemiol 2009;30:939944.
181. Edmonds, SL, Zapka, C, Kasper, D, et al. Effectiveness of hand hygiene for removal of Clostridium difficile spores from hands. Infect Control Hosp Epidemiol 2013;34:302305.
182. Landelle, C, Verachten, M, Legrand, P, Girou, E, Barbut, F, Buisson, CB. Contamination of healthcare workers’ hands with Clostridium difficile spores after caring for patients with C. difficile infection. Infect Control Hosp Epidemiol 2014;35:1015.
183.CDC Vital Signs. Stopping C. difficile infections. Published 2012. Accessed May 15, 2013.
184. Stone, SP, Fuller, C, Savage, J, et al. Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene: four year, prospective, ecological, interrupted time series study. BMJ 2012; 344:e3005.
185. Rupp, ME, Fitzgerald, T, Puumala, S, et al. Prospective, controlled, cross-over trial of alcohol-based hand gel in critical care units. Infect Control Hosp Epidemiol 2008;29:815.
186. Vernaz, N, Sax, H, Pittet, D, Bonnabry, P, Schrenzel, J, Harbarth, S. Temporal effects of antibiotic use and hand rub consumption on the incidence of MRSA and Clostridium difficile . J Antimicrob Chemother 2008;62:601607.
187. Gordin, FM, Schultz, ME, Huber, RA, Gill, JA. Reduction in nosocomial transmission of drug-resistant bacteria after introduction of an alcohol-based handrub. Infect Control Hosp Epidemiol 2005;26:650653.
188. Widmer, AF, Rotter, M, Voss, A, et al. Surgical hand preparation: state-of-the-art. J Hosp Infect 2010;74:112122.
189. Shen, NJ, Pan, SC, Sheng, WH, et al. Comparative antimicrobial efficacy of alcohol-based hand rub and conventional surgical scrub in a medical center. J Microbiol Immunol Infect, doi: 10.1016/j.jmii.2013.08.005. Electronically published September 21, 2013.
190. Carro, C, Camilleri, L, Traore, O, et al. An in-use microbiological comparison of two surgical hand disinfection techniques in cardiothoracic surgery: hand rubbing versus hand scrubbing. J Hosp Infect 2007;67:6266.
191. Tavolacci, MP, Pitrou, I, Merle, V, Haghighat, S, Thillard, D, Czernichow, P. Surgical hand rubbing compared with surgical hand scrubbing: comparison of efficacy and costs, J Hosp Infect 2006; 63:5559.
192. Parienti, JJ, Thibon, P, Heller, R, et al. Hand-rubbing with an aqueous alcoholic solution vs traditional surgical hand-scrubbing and 30-day surgical site infection rates: a randomized equivalence study. JAMA 2002;288:722727.
193. Gupta, C, Czubatyj, AM, Briski, LE, Malani, AK. Comparison of two alcohol-based surgical scrub solutions with an iodine-based scrub brush for presurgical antiseptic effectiveness in a community hospital. J Hosp Infect 2007;65:6571.
194. Tanner, J, Swarbrook, S, Stuart, J. Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Syst Rev 2008; (1):CD004288.
195. Weight, CJ, Lee, MC, Palmer, JS. Avagard hand antisepsis vs. traditional scrub in 3600 pediatric urologic procedures. Urology 2010;76:1517.
196. Haessler, S, Connelly, NR, Kanter, G, et al. A surgical site infection cluster: the process and outcome of an investigation—the impact of an alcohol-based surgical antisepsis product and human behavior. Anesth Analg 2010;110:10441048.
197. di Martino, P, Ban, KM, Bartoloni, A, Fowler, KE, Saint, S, Mannelli, F. Assessing the sustainability of hand hygiene adherence prior to patient contact in the emergency department: a 1-year postintervention evaluation. Am J Infect Control 2011;39:1418.
198. Blanchard, JBR, Bjerke, N, Boylard, E, Graves, P. Recommended practices for hand hygiene in the perioperative setting in perioperative standards and recommended practices, 2013 edition. AORN 2013:6667.
199. Moolenaar, RL, Crutcher, JM, San Joaquin, VH, et al. A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infect Control Hosp Epidemiol 2000;21:8085.
200. Gupta, A, Della-Latta, P, Todd, B, et al. Outbreak of extended-spectrum β-lactamase–producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails. Infect Control Hosp Epidemiol 2004;25:210215.
201. Tanner, J, Khan, D, Walsh, S, Chernova, J, Lamont, S, Laurent, T. Brushes and picks used on nails during the surgical scrub to reduce bacteria: a randomised trial. J Hosp Infect 2009;71(3): 234238.
202. Okgün Alean, A, Demir Korkmaz, F. Comparison of the efficiency of nail pick and brush used for nail cleaning during surgical scrub on reducing bacterial counts. Am J Infect Control 2012;40(9):826829.
203. Facility Guidelines Institute. 2010 guidelines. Accessed April 3, 2014.
204. Hanenkamp, N. The process model for shop floor management implementation. Adv Ind Eng Manag 2013;2:4046.
205. Larson, E, Girard, R, Pessoa-Silva, CL, Boyce, J, Donaldson, L, Pittet, D. Skin reactions related to hand hygiene and selection of hand hygiene products. Am J Infect Control 2006;34:627635.
206. Hayden, MK, Blom, DW, Lyle, EA, Moore, CG, Weinstein, RA. Risk of hand or glove contamination after contact with patients colonized with vancomycin-resistant Enterococcus or the colonized patients’ environment. Infect Control Hosp Epidemiol 2008;29:149154.
207. Wendt, C, Knautz, D, von Baum, H. Differences in hand hygiene behavior related to the contamination risk of healthcare activities in different groups of healthcare workers. Infect Control Hosp Epidemiol 2004;25:203206.
208. Rodriguez, EM, Parrott, C, Rolka, H, Monroe, SS, Dwyer, DM. An outbreak of viral gastroenteritis in a nursing home: importance of excluding ill employees. Infect Control Hosp Epidemiol 1996;17:587592.
209. Standaert, SM, Hutcheson, RH, Schaffner, W. Nosocomial transmission of Salmonella gastroenteritis to laundry workers in a nursing home. Infect Control Hosp Epidemiol 1994;15:2226.
210. Eggimann, P, Harbarth, S, Constantin, MN, Touveneau, S, Chevrolet, JC, Pittet, D. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet 2000;355(9218):18641868.
211. Hirschmann, H, Fux, L, Podusel, J, et al. The influence of hand hygiene prior to insertion of peripheral venous catheters on the frequency of complications. J Hosp Infect 2001;49:199203.
212. Lucet, JC, Rigaud, MP, Mentre, F, et al. Hand contamination before and after different hand hygiene techniques: a randomized clinical trial, J Hosp Infect 2002;50:276280.
213. Ejemot, RI, Ehiri, JE, Meremikwu, MM, Critchley, JA. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev 2008;(1):CD004265.
214. Luby, SP, Agboatwalla, M, Painter, J, Altaf, A, Billhimer, WL, Hoekstra, RM. Effect of intensive handwashing promotion on childhood diarrhea in high-risk communities in Pakistan: a randomized controlled trial. JAMA 2004;291:25472554.
215. Ray, AJ, Hoyen, CK, Taub, TF, Eckstein, EC, Donskey, CJ. Nosocomial transmission of vancomycin-resistant enterococci from surfaces. JAMA 2002;287:14001401.
216. Bhalla, A, Pultz, NJ, Gries, DM, et al. Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients. Infect Control Hosp Epidemiol 2004; 25:164167.
217. Larson, E. A causal link between handwashing and risk of infection? examination of the evidence. Infect Control Hosp Epidemiol 1988;9:2836.
218. Carrico, RM, Rebmann, T, English, JF, Mackey, J, Cronin, SN. Infection prevention and control competencies for hospital-based health care personnel. Am J Infect Control 2008;36:691701.
219. Milward, MR, Cooper, PR. Competency assessment for infection control in the undergraduate dental curriculum. Eur J Dent Educ 2007;11:148154.
220. Garcia-Williams, A, Brinsley-Rainisch, K, Schillie, S, Sinkowitz-Cochran, R. To ask or not to ask? the results of a formative assessment of a video empowering patients to ask their health care providers to perform hand hygiene. J Patient Saf 2010;6: 8085.
221. Jenner, EA, Jones, F, Fletcher, BC, Miller, L, Scott, GM. Hand hygiene posters: selling the message, J Hosp Infect 2005;59:7782.
222. Erasmus, V, Brouwer, W, van Beeck, EF, et al. A qualitative exploration of reasons for poor hand hygiene among hospital workers: lack of positive role models and of convincing evidence that hand hygiene prevents cross-infection. Infect Control Hosp Epidemiol 2009;30:415419.
223. Ivers, N, Jamtvedt, G, Flottorp, S, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev 2012;6:CD000259.
224. Muller, MP, Detsky, AS. Public reporting of hospital hand hygiene compliance—helpful or harmful? JAMA 2010;304:11161117.
225. Hugonnet, S, Perneger, TV, Pittet, D. Alcohol-based handrub improves compliance with hand hygiene in intensive care units. Arch Intern Med 2002;162:10371043.
226. Harbarth, S, Pittet, D, Grady, L, et al. Interventional study to evaluate the impact of an alcohol-based hand gel in improving hand hygiene compliance. Pediatr Infect Dis J 2002;21:489495.
227. Aboumatar, H, Ristaino, P, Davis, RO, et al. Infection prevention promotion program based on the PRECEDE model: improving hand hygiene behaviors among healthcare personnel. Infect Control Hosp Epidemiol 2012;33:144151.
228. Brown, SM, Lubimova, AV, Khrustalyeva, NM, et al. Use of an alcohol-based hand rub and quality improvement interventions to improve hand hygiene in a Russian neonatal intensive care unit. Infect Control Hosp Epidemiol 2003;24:172179.
229. Helder, OK, Brug, J, Looman, CW, van Goudoever, JB, Kornelisse RR The impact of an education program on hand hygiene compliance and nosocomial infection incidence in an urban neonatal intensive care unit: an intervention study with before and after comparison. Int J Nurs Stud 2010;47:12451252.
230. Talbot, TR, Johnson, JG, Fergus, C, et al. Sustained improvement in hand hygiene adherence: utilizing shared accountability and financial incentives. Infect Control Hosp Epidemiol 2013;34: 11291136.
231. Jang, JH, Wu, S, Kirzner, D, et al. Focus group study of hand hygiene practice among healthcare workers in a teaching hospital in Toronto, Canada. Infect Control Hosp Epidemiol 2010; 31:144150.
232. Zerr, DM, Allpress, AL, Heath, J, Bornemann, R, Bennett, E. Decreasing hospital-associated rotavirus infection: a multidisciplinary hand hygiene campaign in a children’s hospital. Pediatr Infect Dis J 2005;24:397403.
233. Bischoff, WE, Reynolds, TM, Sessler, CN, Edmond, MB, Wenzel, RP. Handwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med 2000;160:10171021.
234. Doron, SI, Kifuji, K, Hynes, BT, et al. A multifaceted approach to education, observation, and feedback in a successful hand hygiene campaign. Jt Comm J Qual Patient Saf 2011;37:310.
235. Tromp, M, Huis, A, de Guchteneire, I, et al. The short-term and long-term effectiveness of a multidisciplinary hand hygiene improvement program. Am J Infect Control 2012;40:732736.
236. Monistrol, O, Calbo, E, Riera, M, et al. Impact of a hand hygiene educational programme on hospital-acquired infections in medical wards. Clin Microbiol Infect 2012;18:12121218.
237. Mathai, E, Allegranzi, B, Seto, WH, et al. Educating healthcare workers to optimal hand hygiene practices: addressing the need. Infection 2010;38:349356.
238. Pessoa-Silva, CL, Hugonnet, S, Pfister, R, et al. Reduction of health care associated infection risk in neonates by successful hand hygiene promotion. Pediatrics 2007;120:e382e390.
239. Girard, R, Amazian, K, Fabry, J. Better compliance and better tolerance in relation to a well-conducted introduction to rub-in hand disinfection. J Hosp Infect 2001;47:131137.
240. Maury, E, Alzieu, M, Baudel, JL, et al. Availability of an alcohol solution can improve hand disinfection compliance in an intensive care unit. Am J Respir Crit Care Med 2000;162:324327.
241. Allegranzi, B, Sax, H, Bengaly, L, et al. Successful implementation of the World Health Organization hand hygiene improvement strategy in a referral hospital in Mali, Africa. Infect Control Hosp Epidemiol 2010;31:133141.
242. Santana, SL, Furtado, GH, Coutinho, AP, Medeiros, EA. Assessment of healthcare professionals’ adherence to hand hygiene after alcohol-based hand rub introduction at an intensive care unit in São Paulo, Brazil. Infect Control Hosp Epidemiol 2007; 28:365367.
243. Caniza, MA, Duenas, L, Lopez, B, et al. A practical guide to alcohol-based hand hygiene infrastructure in a resource-poor pediatric hospital. Am J Infect Control 2009;37:851854.
244. Grant, AM, Hofmann, DA. It’s not all about me: motivating hand hygiene among health care professionals by focusing on patients. Psychol Sci 2011;22:14941499.
245. Larson, EL, Patel, SJ, Evans, D, Saiman, L. Feedback as a strategy to change behaviour: the devil is in the details. J Eval Clin Pract 2013;19:230234.
246. Dubbert, PM, Dolce, J, Richter, W, Miller, M, Chapman, SW Increasing ICU staff handwashing: effects of education and group feedback. Infect Control Hosp Epidemiol 1990;11:191193.
247. Rosenthal, VD, McCormick, RD, Guzman, S, Villamayor, C, Orellano, PW. Effect of education and performance feedback on handwashing: the benefit of administrative support in Argentinean hospitals. Am J Infect Control. 2003;31:8592.
248. The Joint Commission. Measuring Hand Hygiene Adherence: Overcoming the Challenges. Oakbrook Terrace, IL: The Joint Commission, 2009.
249. Pugh, M, Reinertsen, J. Reducing harm to patients: using patient safety dashboards at the board level. Healthc Exec 2007;22:62, 64-65.
250. Sellick, JA Jr. The use of statistical process control charts in hospital epidemiology. Infect Control Hosp Epidemiol 1993;14: 649656.
251. Al-Tawfiq, JA, Abed, MS, Al-Yami, N, Birrer, RB. Promoting and sustaining a hospital-wide, multifaceted hand hygiene program resulted in significant reduction in health care-associated infections. Am J Infect Control 2013;41:482486.
252. Hilburn, J, Hammond, BS, Fendler, EJ, Groziak, PA. Use of alcohol hand sanitizer as an infection control strategy in an acute care facility. Am J Infect Control 2003;31:109116.
253. Pittet, D. Improving adherence to hand hygiene practice: a multidisciplinary approach. Emerg Infect Dis 2001;7:234240.
254. Schweon, SJ, Edmonds, SL, Kirk, J, Rowland, DY, Acosta, C. Effectiveness of a comprehensive hand hygiene program for reduction of infection rates in a long-term care facility. Am J Infect Control 2013;41:3944.
255. Institute for Healthcare Improvement. How to Guide: Hand Hygiene Improvement; A Guide for Improving Practices among Health Care Workers. Cambridge, MA: Institute for Healthcare Improvement, 2006. Accessed December 23, 2013.
256. Jenner, EA, Fletcher, BC, Watson, P, Jones, FA, Miller, L, Scott, GM. Discrepancy between self-reported and observed hand hygiene behaviour in healthcare professionals. J Hosp Infect 2006;63:418422.
257. Guyatt, GH, Oxman, AD, Vist, GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924926.
258. GRADE. Canadian Task Force on Preventive Health Care website. Accessed December 31, 2013.