Subscribe to RSS
DOI: 10.1055/s-0031-1280757
© Georg Thieme Verlag KG Stuttgart · New York
Händehygiene – einfach, aber nicht trivial
Hand Hygiene: Basic, but not TrivialPublication History
Publication Date:
28 June 2011 (online)

Zusammenfassung
Händehygiene gilt als Schlüsselelement der Infektionsprävention. Nosokomiale Infektionen beeinflussen maßgeblich die Mortalität des Patienten sowie die Länge und die Kosten des Krankenhausaufenthaltes. Die hygienische Händedesinfektion gilt als wichtigste Einzelmaßnahme zur Prävention nosokomialer Infektionen als auch zur Vermeidung der Transmission (multiresistenter) Bakterien. Die WHO hat die 5 Indikationen zur Händehygiene definiert und vor dem Hintergrund der niedrigen Compliance die Notwendigkeit der Implementierung dieser Maßnahme in die tägliche Praxis herausgestellt. Non-Compliance ist multifaktoriell bedingt: Verhaltenstheoretische Ansätze, religiöse und soziokulturelle Aspekte müssen bei der Ausarbeitung von Interventionsprogrammen berücksichtigt werden. Trotz aller Schwierigkeiten sollten geeignete Maßnahmen zur Compliancesteigerung mit dem Ziel der Qualitätsverbesserung in der Krankenversorgung und der Patientensicherheit ergriffen werden.
Abstract
Hand hygiene is considered as the pillar of infection control and prevention. Healthcare-associated infections have a great impact on morbidity, length of hospital stay, and treatment costs. Hand disinfection is considered to be the single most effective tool to prevent healthcare-associated infections and cross-transmission of multi-drug resistant bacteria. The WHO defined “5 moments” for hand hygiene and highlighted the need for new strategies to improve everyday hand hygiene practices on the basis of the current low compliance. Reasons for non-compliance are multifaceted and behavioural, religious, and sociocultural aspects have to be considered when designing intervention programs. Despite all these barriers it is worth the effort to aim at quality of care improvement.
Schlüsselwörter
Händehygiene - Infektionskontrolle - Compliance - Überwachung - Infektionen durch Gesundheitspflege
Key words
hand hygiene - infection control - compliance - surveillance - healthcare associated infection
Literatur
- 1
Pittet D, Allegranzi B, Boyce J.
WHO guideline: The World Health Organization guidelines on hand hygiene in health
care and their consensus recommendations.
Infect Control Hosp Epidemiol.
2009;
30
611-622
MissingFormLabel
- 2
World Health Organization (WHO)
.WHO Guidelines for Hand Hygiene in Health Care.. Geneva: WHO; 2009
MissingFormLabel
- 3
Kampf G, Kramer A.
Epidemiologic background of hand hygiene and evaluation of the most important agents
for scrubs and rubs.
Clin Microbiol Rev.
2004;
17
863-893
MissingFormLabel
- 4
Pittet D, Hugonnet S, Harbarth S.
et al
Effectiveness of a hospital-wide programme to improve compliance with hand hygiene.
Lancet.
2000;
356
1307-1310
MissingFormLabel
- 5
Best M, Neuhauser D.
Ignaz Semmelweis and the birth of infection control.
Qual Saf Health Care.
2004;
13
233-234
MissingFormLabel
- 6
Dharan S, Hugonnet S, Sax H.
et al
Comparison of waterless hand antisepsis agents at short application times: raising
the flag of concern.
Infect Control Hosp Epidemiol.
2003;
24
160-166
MissingFormLabel
- 7
Stutz N, Becker D, Jappe U.
Nurses’ perceptions of the benefits and adverse effects of hand disinfection: alcohol-based
hand rubs vs. hygienic handwashing: a multicentre questionnaire study with additional
patch testing by the German Contact Dermatitis Research Group.
Br J Dermatology.
2009;
160
565-572
MissingFormLabel
- 8
Löffler H, Kampf G, Wischnewski N.
How irritant is alcohol?.
Br J Dermatology.
2007;
157
74-81
MissingFormLabel
- 9
Kampf G, Löffler H, Gastmeier P.
Händehygiene zur Prävention nosokomialer Infektionen.
Dtsch Ärztebl Int.
2009;
106
649-655
MissingFormLabel
- 10
Arbeitskreis Viruzidie beim Robert Koch-Institut, Fachausschuss
„
Virusdesinfektion” der Deutschen Vereinigung zur Bekämpfung der Viruskrankheiten,
Desinfektionsmittelkommission der Deutschen Gesellschaft für Hygiene und Mikrobiologie
.
Prüfung und Deklaration der Wirksamkeit von Desinfektionsmitteln gegen Viren.
Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz.
2004;
47
62-66
MissingFormLabel
- 11
Allegranzi B, Memish ZA, Donaldson L, Pittet D.
Religion and culture: Potential und recurrents influencing hand hygiene promotion
in health care.
Am J Infect Control.
2009;
37
28-34
MissingFormLabel
- 12
Ahmed QA, Memish ZA, Allegranzi B, Pittet D.
Hand hygiene and the Muslim healthcare worker.
Lancet.
2006;
367
1025-1027
MissingFormLabel
- 13
Whitby M, Mc Laws ML, Ross MW.
Why healthcare workers don’t wash their hands: a behavioral explanation.
Infect Control Hosp Epidemiol.
2006;
27
484-492
MissingFormLabel
- 14
Kramer A, Below H, Bieber N.
Quantity of ethanol absorption after excessive hand disinfection using three commercially
available hand rubs is minimal and below toxic levels for humans.
BMC Infectious Diseases.
2007;
7
117
MissingFormLabel
- 15
Miller MA, Rosin A, Crystal CS.
Alcohol-based hand sanitizer: can frequent use cause an elevated blood alcohol level?.
Am J Infect Control.
2006;
34
150-151
MissingFormLabel
- 16
Reinhardt A, Johnscher I.
Herausforderung Händehygiene.
Krankenhaushyg up2date.
2009;
4
209-221
MissingFormLabel
- 17
Boyce JM.
Using alcohol for hand antisepsis: dispelling old myths.
Infect Control Hosp Epidemiol.
2000;
21
438-441
MissingFormLabel
- 18
United States Department of Health and Human Services
.
Fire safety requirements for certain health care facilities; amendment.
Federal Register.
2005;
70
15229-15239
MissingFormLabel
- 19
Larson EL, Eke PI, Wilder MP, Laughon BE.
Quantity of soap as a variable in handwashing.
Infect Control.
1987;
8
371-375
MissingFormLabel
- 20
Kampf G, Reichel M, Feil Y.
Influence of rub-in technique on required application time and hand coverage in hygienic
hand disinfection.
BMC Infect Dis.
2008;
8
149
MissingFormLabel
- 21
Trick WE, Vernon MO, Hayes RA.
Impact of ring wearing on hand contamination and comparison of hand hygiene agents
in a hospital.
Clin Infect Dis.
2003;
36
1383-1390
MissingFormLabel
- 22
Reichardt C, Hansen S, Gastmeier P.
Hygienische Händedesinfektion.
Intensivmed up2date.
2009;
5
93-105
und Krankenhaushyg up2date 2009; 4:297–308
MissingFormLabel
- 23 Schwarzer R, Luszczynska A. Compliance als universelles Problem des Gesundheitsverhaltens. In: Birbaumer N, Frey D, Kuhl J, Schneider W, Schwarzer R, Hrsg. Enzyklopädie der
Psychologie Series X, Vol. 1: Gesundheitspsychologie. Göttingen Hogrefe; 2005: 585-601
MissingFormLabel
- 24
Erasmus V, Daha TJ, Brug H.
Systematic review of studies on compliance with hand hygiene guidelines in hospital
care.
Infect Control Hosp Epidemiol.
2010;
31
283-294
MissingFormLabel
- 25
Pittet D.
Improving compliance with hand hygiene in hospitals.
Infect Control Hosp Epidemiol.
2000;
21
381-386
MissingFormLabel
- 26
Hugonnet S, Perneger TV, Pittet D.
Alcohol-based handrub improves compliance with hand hygiene in intensive care units.
Arch Int Med.
2002;
162
1037-1043
MissingFormLabel
- 27
Pittet D, Simon A, Hugonnet S.
Hand hygiene among physicians: performance, beliefs, and perceptions.
Ann Int Med.
2004;
141
1-8
MissingFormLabel
- 28
Larson E, Killien M.
Factors influencing handwashing behavior of patient care personnel.
Am J Infect Control.
1982;
10
93-99
MissingFormLabel
- 29
Gould DJ, Chudleigh J, Drey NS.
Measuring handwashing performance in health service audits and research studies.
J Hosp Infect.
2007;
66
109-115
MissingFormLabel
- 30
Scheithauer S, Haefner H, Schwanz T.
Compliance with hand hygiene on surgical, medical, and neurologic intensive care units:
Direct observation versus calculated disinfectant usage.
Am J Infect Control.
2009;
37
835-841
MissingFormLabel
Korrespondenzadresse
Simone Scheithauer
Zentralbereich für
Krankenhaushygiene und
Infektiologie
Universitätsklinikum Aachen
RWTH Aachen
Pauwelsstraße 30
52074 Aachen
Email: sscheithauer@ukaachen.de