Rub it in: Alcohol washes near official endorsement

[Editor’s note: The following are selected key recommendations from the Centers for Disease Control and Prevention’s (CDC) draft hand-hygiene guideline. While these are expected to remain largely unchanged in the final version, please consult the final document when it is issued by the CDC. The complete text and recommendations of the final version will be posted on your subscriber web site at www.HIConline.com as soon as they are available. Look under "Guidelines and Regulations."]

• To improve hand hygiene adherence among personnel in units or instances where high workloads and high intensity of patient care are anticipated, make an alcohol-based waterless antiseptic agent available at the entrance to the patient’s room or at the bedside, in other convenient locations, and in individual pocket-size containers to be carried by health care workers.

• Wash hands with a nonantimicrobial soap and water or an antimicrobial soap and water when hands are visibly dirty or contaminated with proteinaceous material.

• If hands are not visibly soiled, use an alcohol-based waterless antiseptic agent for routinely decontaminating hands in all other clinical situations.

• When decontaminating hands with a waterless antiseptic agent such as an alcohol-based hand rub, apply product to palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry. Follow the manufacturer’s recommendations on the volume of product to use. If an adequate volume of an alcohol-based hand rub is used, it should take 15 to 25 seconds for hands to dry.

• Decontaminate hands after contact with a patient’s intact skin (as in taking a pulse or blood pressure, or lifting a patient).

• Decontaminate hands after contact with body fluids or excretions, mucous membranes, nonintact skin, or wound dressings, as long as hands are not visibly soiled.

• Decontaminate hands if moving from a contaminated body site to a clean body site during patient care.

• Decontaminate hands after contact with inanimate objects (including medical equipment) in the immediate vicinity of the patient.

• Decontaminate hands before caring for patients with severe neutropenia or other forms of severe immune suppression.

• Decontaminate hands before donning sterile gloves when inserting a central intravascular catheter.

• Decontaminate hands before inserting indwelling urinary catheters or other invasive devices that do not require a surgical procedure. Decontaminate hands after removing gloves.