It might be hard to believe that there is more to learn about hand hygiene, but the World Health Organization1 has issued new guidelines for hand hygiene in any healthcare-delivery setting (including the home) to improve practices and reduce transfer of pathogenic microorganisms. The recommendations specify when soap and water is preferable for handwashing and when alcohol-based handrubs should be used. The guidelines cover indications and techniques for hand washing, surgical hand-washing procedures, selection of hand-hygiene products, and the use of gloves.

A few of the recommendations are as follows:

* Wash hands with soap and water when visibly dirty, when soiled with blood or other body fluids, when Clostridium difficile is present, or after using the toilet. In other clinical situations, use an alcohol-based handrub.

* Wash hands before and after touching the patient; before touching an invasive device used for patient care; after contact with body fluids or excretions, mucous membranes, nonintact skin, or wound dressings; if moving from a contaminated body site to another body site on the same patient; after touching inanimate surfaces and objects in the immediate vicinity; and after removing gloves.

* Soap and alcohol-based handrub should not be used together.

* Provide alternative hand-hygiene products for healthcare workers with confirmed allergies to standard products, and provide healthcare workers with hand lotions or creams to reduce the risk for irritant contact dermatitis.

The complete document is available at http://www.who.int/patientsafety/information_centre/ghhad_download_link/en/.

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