The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Hand Hygiene—Of Reason and Ritual

Robert A. Weinstein, MD
[+] Article, Author, and Disclosure Information

From John H. Stroger Jr. (Cook County) Hospital, Rush Medical College, Chicago, IL 60612.

Potential Financial Conflicts of Interest: None disclosed.

Current Author Address: Robert A. Weinstein, MD, Division of Infectious Diseases, John H. Stroger Jr. (Cook County) Hospital, 1901 West Harrison Street, Chicago, IL 60612; e-mail, rweinste@rush.edu.

Ann Intern Med. 2004;141(1):65-66. doi:10.7326/0003-4819-141-1-200407060-00016
Text Size: A A A

Modern infection control is grounded in the work of Ignaz Semelweis, who in the 1840s demonstrated the importance of hand hygiene for controlling transmission of infection on an obstetric ward. Although hand hygiene is the most important activity for preventing health care–associated infections, scores of observational studies demonstrate poor adherence by health care workers. The often-cited drawbacks to hand hygiene are the time required, a perception that the recommended frequency of hand cleansing is excessive, fear that frequent washing will lead to dermatitis, and limited access to sinks and hand hygiene products. To overcome these objections, an expert panel recently issued revised national recommendations that promote sinkless alcohol-based hand-rub solutions for degerming hands that are not grossly soiled (1). This recommendation seemed like excellent advice because these solutions are as effective as traditional hand-washing with an antimicrobial soap, can be applied when needed from dispensers conveniently located throughout health care facilities, and can be rubbed on within seconds as health care workers move from patient to patient. In addition, the emollients in alcohol-based hand-rub solutions actually improve the condition of the skin, so repeated application is beneficial.


washing hands

First Page Preview

View Large
First page PDF preview





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.