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Evidence-based model for hand transmission during patient care and the role of improved practices

Dharan, Sasi
Pessoa-Silva, C. L.
Donaldson, Liam
Boyce, John
Published in Lancet. Infectious diseases. 2006, vol. 6, no. 10, p. 641-652
Abstract Hand cleansing is the primary action to reduce health-care-associated infection and cross-transmission of antimicrobial-resistant pathogens. Patient-to-patient transmission of pathogens via health-care workers' hands requires five sequential steps: (1) organisms are present on the patient's skin or have been shed onto fomites in the patient's immediate environment; (2) organisms must be transferred to health-care workers' hands; (3) organisms must be capable of surviving on health-care workers' hands for at least several minutes; (4) handwashing or hand antisepsis by the health-care worker must be inadequate or omitted entirely, or the agent used for hand hygiene inappropriate; and (5) the caregiver's contaminated hand(s) must come into direct contact with another patient or with a fomite in direct contact with the patient. We review the evidence supporting each of these steps and propose a dynamic model for hand hygiene research and education strategies, together with corresponding indications for hand hygiene during patient care.
Keywords EducationFomites/microbiologyHand/ microbiologyHandwashingHealth Personnel/educationHumansInfectious Disease Transmission, Professional-to-Patient/ prevention & controlMicrobial ViabilityModels, BiologicalSkin/microbiology
PMID: 17008173
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Research group Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
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PITTET, Didier et al. Evidence-based model for hand transmission during patient care and the role of improved practices. In: Lancet. Infectious diseases, 2006, vol. 6, n° 10, p. 641-652. doi: 10.1016/S1473-3099(06)70600-4 https://archive-ouverte.unige.ch/unige:7489

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Deposited on : 2010-06-21

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