Hand hygiene　手の衛生


近年の健康医療分野における変化のうちとりわけ目立つのは、容器に入ったalcohol-hand-rubを病院クリニックに限らず人の集まるところはどこでも見かける事です（出典: Hands Across America by David Owen, The new Yorker March 4 ,2013）。

米国においては毎年、約２百万件の院内感染が報告されていますが、これは患者２０人に一人が院内感染する割合となります（患者数約１５０万人,出典同上）。院内感染はしばしば難治で致命的です（死亡例数約１０万、出典同上）。院内感染の最も効果的な予防法は手の清浄（hand hygiene）にあります。医療分野で働く人は手の清浄に努めなければなりません。更に、患者自身もhand hygiene に心がける必要があります。2002年以降、CDC(the Centers for Disease Control and Prevention)はWHO や他の保険機関と共同でHand Hygiene Guidelineを公表してHand Hygieneの徹底につとめています（出典: CDC web site）。

如何に手の清浄を保つかが重要な点ですが、最良とされる流水と石けんでの手洗いは、忙しい職場ではつい後回しになりがちで、又、水道設備に欠ける所もあり、実行困難な面があります。この欠点を補う方法として注目されてきたのがalcohol-based hand sanitizers or alcohol-hand-rub dispensersです。この清浄剤は最低６０％のアルコールを含み、使用後手の病原菌数を直ちに減少しますが、すべての病原菌を除去するわけではありませんし、手の汚染がひどい場合は、やはり最初に水洗する必要があります(出典: CDC web site)。


One of the most conspicuous changes in health care in recent years has been the proliferation of alcohol-hand-rub dispensers in hospitals and doctors’ offices. (source: Hands Across America by David Owen, The New Yorker March 4, 2013)

In the United States, hospital patients get nearly 2 million infections each year. That’s about 1 infection for every 20 patients (CDC), or more than a million and a half patient illnesses (by D. W. above). Infections that patients get in the hospital can be life-threatening and hard to treat, or nearly a hundred thousand patient deaths (by D. W. above). Hand hygiene is one of the most important ways to prevent the spread of infection. Healthcare providers should practice hand hygiene, and patients can play a role in helping to prevent infection by practicing hand hygiene themselves. Since 2002, the CDC, in conjunction with WHO (2009) and other health organizations, published Guidelines for Hand Hygiene in Healthcare Settings. (source: CDC)

The key is how to maintain hand hygiene. Although washing hands with soap and clean, running water is still the best way, it is often difficult in practice at busy clinical settings and in many parts of the world where clean, running water is not accessible. The hand cleaning method that has attracted attention as a supplement to the soap-and water is alcohol-based hand sanitizer, or alcohol-hand rub that contains at least 60% alcohol to clean hands. Alcohol-based hand sanitizers can quickly reduce the number of germs on the hand, but sanitizers do not eliminate all types of germs. If hands are heavily soiled, they must be washed first with running water. (source: CDC)

What’s new in American Health Field　米国健康事情