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Hand Hygiene: Understanding and Implementing the CDC's New Guideline
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FRANK MYERS
SUE PARINI
$7.95
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Nursing Management
April 2003
Volume 34 Number 4
Pages 3 - 14
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Supported by an educational grant from
 GOJO Industries
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ABSTRACT
LAST YEAR, THE CENTERS FOR DISEASE CONTROL and Prevention (CDC) released a guideline on hand hygiene that's changing the way clinicians protect their patients-and themselves-from infections. No longer is the mantra 'Wash your hands'; according to the CDC, 'Practice good hand hygiene' makes more sense.
The revolution in hand hygiene isn't limited to which products clinicians use to clean their hands. It also encompasses a change in how long we wash our hands with soap and water, whether we can wear artificial fingernails, and issues surrounding surgical scrub.
For managers, this revolution will provide many challenges in terms of reeducating clinicians, ensuring that they change old habits, and evaluating how these changes have affected patient care. Managers will also be challenged to comply with safety codes and other federal and local laws, sometimes in the face of conflicting interests. Remember that the CDC's guideline doesn't carry the weight of law, although some recommendations listed are the law and therefore are codified elsewhere. That doesn't mean the guideline should or even can be ignored; instead, managers must find ways to follow the law and implement the guideline, for the sake of patient and staff safety.
Indications for hand washing
The CDC guideline hasn't declared hand washing obsolete. In fact, the first recommendation describes when hands should be washed with soap and water. Given the high profile alcohol-based hand rubs have recently attained, staff may forget that hand washing still has a crucial role in the armamentarium of disease prevention. If hands are visibly soiled, the only option recommended by the CDC is hand washing with nonantimicrobial or antimicrobial soap and water for 15 seconds (recommendation 1A, category IA; see What the Categories Mean ).
The reason for this is simple, and it reflects the old saying 'There is no sterilization without cleaning.' Although hands aren't technically sterilized, ...
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