Hand Hygiene and Personal Protective Equipment

  • Arti Kapil


Healthcare-associated infections (HAIs) are responsible for increase in morbidity and mortality in hospitalized patients in developing countries [1]. These infections add to the cost of the already burdened healthcare settings in resource-limited countries, and strategies to control them need to be cost-effective and evidence based. Hand hygiene has been considered as a single most important intervention to reduce preventable HAIs to the resource-poor countries [2]. Hand hygiene has been an important cultural practice in India. Though in ancient times the mode of transmission of disease through hands was not scientifically proven, contaminated hands were associated with unhygienic practices leading to illness. Semmelweiss in the nineteenth century showed that use of clean hands for conducting delivery reduced the maternal mortality rate, which was further evidenced through research that hand antisepsis reduces the transmission of pathogens and the incidence of HAIs [2, 3].


Hand Hygiene Personal Protective Equipment Patient Safety Culture Standard Precaution Hand Hygiene Practice 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Gupta A, Kapil A, Lodha R, Kabra SK, Sood S, Dhawan B, Das BK, Sreenivas V. Burden of healthcare-associated infections in a paediatric intensive care unit of a developing country: a single centre experience using active surveillance. J Hosp Infect. 2011;78(4):323–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Allegranzi B, Pittet D. Role of hand hygiene in healthcare-associated infection prevention. J Hosp Infect. 2009;73:305–15.PubMedCrossRefGoogle Scholar
  3. 3.
    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. Am J Infect Control. 2000;28:3.CrossRefGoogle Scholar
  4. 4.
    Pittet D. Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol. 2000;21(6):381–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Siegel JD, Rhinehart E, Jackson M, Chiarello L. Preventing transmission of infectious agents in healthcare settings. 2007.
  6. 6.
    Aiello AE, Larson EL. What is the evidence for a causal link between hygiene and infections? S Lancet Infect Dis. 2002;2:103–10.CrossRefGoogle Scholar
  7. 7.
    WHO Guidelines on Hand Hygiene in Health Care. World Health Organization. 2009.
  8. 8.
    Wing Kin Yeung, Wai San Wilson Tam, Tze Wai Wong. Clustered Randomized Controlled Trial of a Hand Hygiene Intervention Involving Pocket-Sized Containers of Alcohol-Based Hand Rub for the Control of Infections in Long-Term Care Facilities. Infect Control Hosp Epidemiol 2011;32(1):67–76.Google Scholar
  9. 9.
    Rupp ME, Fitzgerald T, Puumala S, et al. Prospective, controlled, crossover trial of alcohol-based hand gel in critical care units. Infect Control Hosp Epidemiol. 2008;29(1):8–15.PubMedCrossRefGoogle Scholar
  10. 10.
    Jabbar EU, Leischner J, Kasper D, Gerber R, Sambol SP. Effectiveness of alcohol-based hand rubs for removal of Clostridium difficile from hands. Infect Control Hosp Epidemiol. 2010;31(6):565–70.PubMedCrossRefGoogle Scholar
  11. 11.
    Boyce JM F, 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(5):479–83.PubMedCrossRefGoogle Scholar
  12. 12.
    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;30:939–44.PubMedCrossRefGoogle Scholar
  13. 13.
    Pitter D, Simon A, Hugonnet S, Pessoa-Silva CL, Sauvan V. Hand hygiene among physicians: performance, beliefs, and perceptions. Ann Intern Med. 2004;141:1–8.CrossRefGoogle Scholar
  14. 14.
    Longtin Yves, Sax Hugo, Allegranzi Benedetta, Schneider Franck, Pitter Didier. Hand hygiene. N Engl J Med. 2011;364:e24.Google Scholar
  15. 15.
    Ashraf MS, Hussain SW, Agarwal N, Ashraf S, EL-Kass G. Hand hygiene in long-term care facilities: a multicenter study of knowledge, attitudes, practices, and barriers. Infect Control Hosp Epidemiol. 2010;31(7):758–62.PubMedCrossRefGoogle Scholar
  16. 16.
    Gupta A, Kapil A, Lodha R, Sreenivas V. Knowledge, attitudes & practices towards infection control amongst the healthcare professionals. Natl Med J India. 2013;26:35–36.Google Scholar
  17. 17.
    Gould DJ, Moralejo D, Drey N, Chudleigh JH. Interventions to improve hand hygiene compliance in patient care. Cochrane Database Syst Rev. 2010;9, CD005186.PubMedGoogle Scholar
  18. 18.
    Mei-lin Ho, Wing-hong Seto, Lai-chin Wong, Tin-yau Wong. Effectiveness of Multifaceted Hand Hygiene Interventions in Long-Term Care Facilities in Hong Kong: A Cluster-Randomized Controlled Trial. Infect Control Hosp Epidemiol 2012;33(8):761–67Google Scholar
  19. 19.
    Siegel JD, Rhinehart E, Jackson M, Chiarello L. Management of multidrug-resistant organisms in healthcare settings. 2006.
  20. 20.
    Larson EL, RN, Quiros D, Giblin T, RN, Lin S. Relationship of antimicrobial control policies and hospital infection control characteristics to antimicrobial resistance rates. Am J Crit Care. 2007;16:110–20.Google Scholar
  21. 21.
    Aboelela SW, Saiman L, Stone P, Lowy FD, Quiros D, Larson E. Effectiveness of barrier precautions and surveillance cultures to control transmission of multidrug-resistant organisms: a systematic review of the literature. Am J Infect Control. 2006;34:484–94.PubMedCrossRefGoogle Scholar
  22. 22.
    Wilton P, Smith R, Coast J, Millar M. Strategies to contain the emergence of antimicrobial resistance: a systematic review of effectiveness and cost-effectiveness. J Health Serv Res Policy. 2002;7(2):111–17.PubMedCrossRefGoogle Scholar

Copyright information

© Springer India 2014

Authors and Affiliations

  1. 1.Department of MicrobiologyAIIMSNew DelhiIndia

Personalised recommendations