Review - Reviewer's Assessment

1. Short summary / abstract
This is an excellent review of the evidence on hand hygiene undertaken by Boyce and Pittet on behalf of HICPAC. These guidlelines supercede the 1995 APIC guidelines and are the gold standard for the USA. They include the evidence for the use of alcohol hand rub. In the first part there is a thorough review of the history of hand hygiene, discussion of materials used, a comprehensive list of definitions, some economic evaluations and a new section on adherence.

2. What question is the document addressing?
The guidelines cover hand hygiene in surgery and normal care actvities. They include when to decontaminate hands, how and what to use the use. There is also guidance on hand lotions and creams.

3. Type of study
A wide variety of studies are considered

4. Methods valid & appropriate?

The methods of developing HICPAC guidleines are not included in the individual guidelines but are available. They differ from those used by NICE and the recommendation categories concern implementation, whereas in the UK recommendations are based on the strength of the evidence.

5. Results / recommendations reliable?
Yes these are considered one of the best hand hygiene guidelines available.

6. Any major problems and biases?
No. Readers should note the differences in guideline development methods

7. Any other important / relevant studies which confirm or contradict?

8. Keywords
hand hygiene alcohol hand rub international guidelines

Reviewer's Details:

Name:Dr Carol Pellowe
Post:Deputy Director
(Society / Organisation / Advisory Committee):
Richard Wells Research Centre,
Thames Valley University

*** Note: These are the views of a professional expert rather than an official statement from his or her society, organisation or advisory committee.

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