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I’m not sure how I missed this reference. It appeared in the Morbidity Mortality Weekly Report Recommendations and Reports, October 25, 2002 / 51(RR16);1-44 They provide a glossary, an interesting historical summary, a precís of skin, evaluation of behavioral changes, and more.

Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC / SHEA / APIC / IDSA Hand Hygiene Task Force, Prepared by John M. Boyce, M.D., Didier Pittet, M.D.

The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231–43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251–69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.

Part I. Review of the Scientific Data Regarding Hand Hygiene
Historical Perspective
Normal Bacterial Skin Flora
Physiology of Normal Skin
Definition of Terms
Evidence of Transmission of Pathogens on Hands
Models of Hand Transmission
Relation of Hand Hygiene and Acquisition of Health-Care–Associated Pathogens
Methods Used To Evaluate the Efficacy of Hand-Hygiene Products
Review of Preparations Used for Hand Hygiene
Irritant Contact Dermatitis Resulting from Hand-Hygiene Measures
Factors To Consider When Selecting Hand-Hygiene Products
Hand-Hygiene Practices Among HCWs [health care workers]
Adherence factors
Lessons Learned from Behavioral Theories
Methods Used To Promote Improved Hand Hygiene
Other Policies Related to Hand Hygiene (fingernails, gloves, jewelery)
Web-Based Hand-Hygiene Resources
Part II. Recommendations
Part III. Performance Indicators

see also
Hands washing, sanitizers
Song to time hand washing for hygiene and disease prevention
Clean Hands Week: How will you celebrate?
Give germs the boot, not our babies: unwashed hands make everyone sick

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