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The WHO Advanced Draft Guidelines on Hand Hygiene in Health Care provide healthcare  workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specifc recommendations to improve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specifc group in a population. Therefore, this concept applies to specifc health-care facilities, to community settings and to other settings where health care is occasionally performed, such as home care by birth attendants. Defnitions of health-care settings are proposed in Appendix 1.

The development of the advanced draft guidelines followed the World Health Organization
(WHO) recommended process for guidelines and began in autumn 2004. This process included two international consultations (in December 2004 and April 2005) attended by experts from all over the world and technical experts from WHO. Numerous experts conducted multiple search strategies of available published information by 31 July 2005. A core group of experts coordinated the work of reviewing the available scientifc evidence, writing the document, and fostering discussion among authors; more than 100 international experts contributed to preparing the document. WHO advisers and members of the WHO Consultations and Task Forces on Hand Hygiene who actively participated in the work process up to fnal publication are listed in the Acknowledgements at the end of the document. At present, pilot tests of the guidelines are being conducted in each of the six WHOregions to help provide local data on the resources required to carry out the recommendations and generate information on feasibility, validity, reliability and cost–effectiveness of the interventions concerned. In addition, task forces of experts have been established to foster ongoing discussion on some crucial topics included in the guidelines – candidates for further development and practical solutions. The work of these groups is planned to continue until the analysis of the issues has been completed and practical solutions have been identifed. The WHO Advanced Draft Guidelines on Hand Hygiene in Health Care provide a comprehensive review of scientifc data on hand hygiene rationale and practices in health care. This extensive review includes in one document suffcient technical information to support training materials and help plan implementation strategies. The document comprises fve parts:

  • Part I reviews scientifc data on hand hygiene practices in health care and in health-care settings in particular.
  • Part II provides consensus recommendations of the international panel of experts mandated by WHO to summarize the evidence and proposes guidelines that could be used worldwide.
  • Part III discusses outcome and process measurements.
  • Part IV addresses the issue of promoting hand hygiene on a large scale.
  • Part V covers public information.

For convenience, the fgures and tables are numbered to correspond to the Part and the Section in which they are discussed. The tabular presentations are grouped together after the text and the references.

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