【柳叶刀】Evidence-based model for hand transmission during patient

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这篇文章的作者大家很熟悉，就是在上海年会作报告的WHO官员，Didier Pittet,

Didier Pittet, Benedetta Allegranzi, Hugo Sax, Sasi Dharan, Carmem Lúcia Pessoa-Silva, Liam Donaldson, John M Boyce; on behalf of the WHO
Global Patient Safety Challenge, World Alliance for Patient Safety
Hand cleansing is the primary action to reduce health-care-associated infection and cross-transmission of
antimicrobial-resistant pathogens. Patient-to-patient transmission of pathogens via health-care workers’ hands
requires fi ve sequential steps: (1) organisms are present on the patient’s skin or have been shed onto fomites in the
patient’s immediate environment; (2) organisms must be transferred to health-care workers’ hands; (3) organisms
must be capable of surviving on health-care workers’ hands for at least several minutes; (4) handwashing or hand
antisepsis by the health-care worker must be inadequate or omitted entirely, or the agent used for hand hygiene
inappropriate; and (5) the caregiver’s contaminated hand(s) must come into direct contact with another patient or
with a fomite in direct contact with the patient. We review the evidence supporting each of these steps and propose a
dynamic model for hand hygiene research and education strategies, together with corresponding indications for hand
hygiene during patient care.

Lancet Infect Dis 2006; 6:641–52