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CDC Telebriefing Transcript

CDC Release New Hand Hygiene Guidelines for Healthcare Settings

October 25, 2002

I would now like to turn the conference call over to your host, Chair of CDC's Health Infection Control Practices Advisory Committee, Dr. Robert Weinstein. Please go ahead.

DR. WEINSTEIN: Good morning and welcome. Today we're holding a press conference and telebriefing to announce new CDC guidelines for hand hygiene in the health care setting. I want to especially thank the Infectious Disease Society of America for allowing us to announce these important guidelines at their annual meeting and a special thank you to the staff that made this possible.

Before I introduce my colleagues and Dr. Gerberding, I'd like to take care of some housekeeping items. When we get to the question and answer portion of today's briefing, we will alternate questions from the room and from the phone, taking our first question from the room. If you need to verify anything that was said today, it will be available by transcript on the CDC website,, by the end of today.

If you have any additional questions not covered in this press conference, you can follow up with Nicole Coffin, C-o-f-f-i-n, by contacting CDC's office of communication at 404-639-3286.

Now let me introduce my colleagues. To my far right, Dr. William Shaffner representing the Infectious Disease Society of America. Next to him is Dr. Elaine Larson, a member of the Hand Hygiene Task Force and is representing the Association of Professionals in Infection Control and Epidemiology. Next to her is Dr. John Boyce, lead author of the guidelines and the Chair of the Hand Hygiene Task Force, representing Society for Healthcare Epidemiology of America. I would like introduce Dr. Julie Gerberding, Director of the Centers for Disease Control and Prevention.

DR. GERBERDING: Thank you for all of you participating in the panel. I appreciate you getting up in the morning and providing your scientific expertise. Congratulations on a great guideline. It was quite a heroic effort and I think one of the most scientific efforts at defining hand hygiene we have ever seen so it is just a terrific effort. My comments this morning are going to put hand hygiene into context. I think we recognize in the broadest sense of the word that there is a growing need to take actions within the health care setting to promote patient safety and protect patients. CDC has strong stake in this mission under the rubric of our overall goal of providing safer healthier people, that certainly translates to safer healthier patients. And we know that hand hygiene is a critical component of safe and healthy health care.

Our agency has a whole division that's dedicated to promoting patient safety and that is the Division of Healthcare Quality Promotion and that is within CDC's National Center for Infectious Diseases under the leadership of Dr. Steve Solomon and Dr. James Hughes and it's really their effort to expand the notion of prevention of infection in hospitals and the whole health care delivery system that allows us to put this specific guidelines in context of the overall environment of care, which includes the hospital, clinics and non-hospital settings like dialysis centers and so forth.

We have seven challenges, at CDC, for promoting a safety in the health care setting. The first four of them have specifically to do with preventing either specific types of infection or antimicrobial resistance. Those additional three challenges are included in your press packet but hand hygiene is essential to at least accomplishing these four challenges. So it is really an integrated strategy that protects patients across the board.

Let me say a few specifics about the guidelines before we open it up for questions.

First of all, what the new guideline says is that hand hygiene is a critical component of patient safety and really saves lives in health care settings. I think we've known that since the (inaudible)time of more than 106 years ago, but it's something that all too often has not been practiced.

What's new about the current guidelines is that we've taken the knowledge that hand hygiene is important and we've coupled that with the observation that health care providers are traditionally not 100% adherent with hand washing regimens because we've learned now that using alcohol-based hand products in the health care setting improves adherence to hand hygiene practices and we'll end up with more people doing the right things to clean their hands more of the time and ultimately a better impact for patient safety.

But this is not to be interpreted that alcohol preps alone are the stated issue. What we're advocating is a comprehensive approach to hand hygiene. Certainly if hands of health care workers are soiled with blood or other materials, they need to wash with soap and water, and alcohol preps are not going to deal with that aspect of hand hygiene. And, likewise, gloves are still recommended for situations where people have contact with blood or other body fluids or when they're conducting sterile procedures and so forth.

So the addition of alcohol preps is an expansion of a comprehensive approach to hand hygiene not a substation for practices we have known for a long time that are important. I think what this guideline does is very clearly delineate the appropriate role of each of these components of a comprehensive approach and put them in the context of a scientific basis that really allows some degree of confidence to recommend the addition of alcohol preps to the overall hand hygiene methods.

Now, the trick here is that we're talking about health care settings. Health care settings are different from kitchen or bathroom or the kinds of environments in the non-health care world where hand hygiene is also relevant and important. In health care settings, health care personnel acquire pathogens that become part of their residential flora on their hands and they also come in contact with very virulent organisms, many of which are antimicrobial resistant. So if they pick up a pathogen like that and move it to a vulnerable patient and we know there a lot of vulnerable patients it creates a very special risk. Therefore, we might use measures in that environment that are especially effective at removing those pathogens. And it's not the kind of situation that exists in the kitchen or in the home where soap and water still remains a very sensible strategy for cleaning the hands. If people don't have access to soap and water or a sink at hand than alcohol-based hand products can have a role there, too. But it is not the kind of situation that we're dealing with in the health care setting.

So these guidelines address health care settings, and they include the recommendations about adding alcohol-based products because of the special vulnerability of the patients in that environment and the special pathogens that exist there, including those that are highly and multiple drug resistance. So these are for this very, very special environment.

I'll let others discuss in fine detail the scientific basis of the recommendations. I think at this point I would open it up for questions and ask for the experts to chime in.

AT&T OPERATOR: Ladies and gentlemen, if you do have any questions, please press the 1 on your touch-tone phone. You'll hear a tone indicating you've been placed in queue and may remove yourself from queue by pressing the pound key. If you're using a speakerphone, we ask that you please pick up your handset before pressing any numbers.

Also, I would like to take this opportunity to let the host location know that we're having some difficulty hearing the presentation for the conference call as well.

DR. WEINSTEIN: Okay. The first question from the room. Would the speaker identify yourself?

QUESTION: Hi, I'm Maryn McKenna from the Atlanta Journal Constitution. Dr. Gerberding, you said that this was a scientifically-based effort, so could you or one of the panel discuss the evidence for--that you have for hand washing with soap and water not occurring sufficiently in health care settings and the evidence for alcohol preps being more attractive or more efficient for health care personnel?

DR. WEINSTEIN: John Boyce will answer that who is the author.

DR. BOYCE: Well, there are over 30 studies that have been done in about the last 20 years that show that health care workers have just not been able to wash their hands as often as recommended. So this is very well documented, and it's not a new problem.

The news is that there are several recent studies that have shown that in health care settings, where they have promoted the use of the alcohol-based hand rubs that they have demonstrated that there's increased adherence of health care workers to recommended hand-washing policies.

DR. WEINSTEIN: Next question from the phone.

AT&T OPERATOR: We have no questions in queue from the telephone lines, but I will take this opportunity to remind the telephone participants that if you have a question, press 1 at this time.

DR. WEINSTEIN: A question from the room.

QUESTION: Ed Sussman from UPI. Dr. Boyce while you're showing that there are studies that show an increase of adherence to hand-washing practices and policies, do you have any data that would indicate that it decreases disease?

DR. BOYCE: Yes, there is. There's a large study that was conducted at the University of Geneva Hospital in Switzerland where they demonstrated significant improvement in the adherence of health care workers to hand hygiene practices and they also showed that they incidence of antibiotic resistance to staph infections went down and that the overall prevalence of health care-acquired infections went down as adherence to hand hygiene went up.

Dr. Larson, who's with us today, also did a study that demonstrated some reductions in antibiotic-resistant organisms, like vancomycin, enterrococci when adherence to hand hygiene was improved.

So there are at least these two and actually another more recent study that suggest that we are able to reduce infections in health care facilities by improving hand hygiene.

DR. WEINSTEIN: Let me point out that the study at the University of Geneva was by Dr. Diddea Pettit who was the co-author of the current guideline. He's not able to join us today. He's in Switzerland.

A question from the phone?

AT&T OPERATOR: We have a question in queue from the line of Adam Marcus with Health Scout. Go ahead, please.

QUESTION: Two questions. The first is for Dr. Gerberding. I'm wondering if you can't--as you may know, there's terrible audio here. Can you repeat the sort of nut of this very loudly? And the second is: Is Geneva really a fair test considering how at least the stereotype of Switzerland being so clean for U.S. hospitals?

Thank you.

DR. WEINSTEIN: Okay. The first one, Dr. Gerberding, would you repeat your entire presentation?

QUESTION: Just the 25-word-or-less version.

DR. GERBERDING: Hand hygiene saves lives. We're recommending a comprehensive evidence-based approach in hospitals that consists of handwashing with soap and water when the goal is to remove unsightly debris; hand alcohol preps for enhancing appearance and reducing bacterial counts; and gloving when people have contact with blood or other body fluids in accordance with universal precautions.

Health care settings are not the same as community settings, and in community settings washing with soap and water remains a very sensible strategy for hand hygiene.

QUESTION: Thank you.

DR. WEINSTEIN: Dr. Larson, would you care to opine on the cleanliness of hospitals in Geneva versus Chicago?

DR. LARSON: (inaudible) No, I think that if you're going to show a difference in infection rates, the least likely place to find it is in the cleaner places. So if you find a difference in the cleanest places, you're more likely to find even more difference in dirtier places. I'm not commenting on where things are cleaner or dirtier. I'm just saying that the fact that this difference was found in relatively clean places, if that's the case, is actually strong evidence.

DR. WEINSTEIN: So you can make good even better.

QUESTION: Thank you.

DR. WEINSTEIN: There's a question from the room.

QUESTION: Dan Haney from AP. Do the gels actually do a significantly better job of killing germs by themselves, or is this mainly the main advantage the convenience pack?

DR. WEINSTEIN: Dr. Boyce, why don't you answer that?

DR. BOYCE: Well, I think that the main advantage of the alcohol-based products is that they're faster, more convenient, and they're easier on your hands than traditional handwashing.

But to answer your question directly, there are about 20 published studies that have compared the alcohol-based products to various soap products. In every study, the alcohol-based products were more effective at reducing the number of bacteria on hands than using plain soap, and in 18 of the 20 studies, the alcohol reduced bacterial counts on the hands to a greater degree than the antimicrobial soaps tested.

So the bottom line is that the alcohol preps are effective.

DR. WEINSTEIN: If you look at Table 4 on page 12 of the guidelines that were just released today, there's a nice demonstration of those results surrounding efficacy.

A question from the phone?

AT&T OPERATOR: Yes, we have a question in queue from the line of Delphia Riggs (ph) with Newsday. Go ahead, please.

QUESTION: There is a study that was reported--this is either for Dr. Boyce or Dr. Gerberding. There was a study that was reported not too long ago in the Journal of the American Medical Association out of France which showed no difference whatsoever between hand washing and alcohol-based scrubs. And I never got a good answer from anyone in the medical community here as to why that was so.

Do you have any thoughts on it, either of you?


DR. BOYCE: I'm aware of that study, and I think the important message was that the investigators knew that surgeons have traditionally washed their hands with an antimicrobial soap before performing surgery. What the investigators wanted to do was to determine if cleaning their hands with an alcohol-based solution was as effective as the traditional hand-washing procedures. And what their study demonstrated was that there was no significant difference in the frequency of surgical site infections in patients whose surgeons washed their hands with soap and water versus those who used the alcohol rubs.

So what they demonstrated was that it is safe from the patient's standpoint for surgical personnel to clean their hands with an alcohol-based hand rub, and the guideline specifically states that for surgical personnel, cleaning their hands with either antimicrobial soap and water or an alcohol-based hand rub, both of those are acceptable alternatives.

DR. WEINSTEIN: A question in the room?

QUESTION: Greg Myers from the Chicago Tribune. I just wanted to ask, what is the current level of compliance for handwashing? And what level of compliance do you project with these new guidelines? And, finally, how will these guidelines be enforced?

DR. WEINSTEIN: Dr. Larson, do you want to help with that?

DR. LARSON: I think the first part, which is what is the current level of adherence or compliance with current guidelines, the studies that Dr. Boyce mentioned over the last couple of decades show that if health care personnel wash their hands about 50--somewhere between 40 and 70 percent of the time that the guideline--the current--previous guideline recommended, and researchers in Europe have calculated that if health care workers were to wash their hands as frequently as the previous guideline recommended, it would take about 16 hours of nursing time per 20-bed--I think this is right--per 20-bed intensive care units. And, therefore, they concluded that it wasn't really possible or practical to do that. In addition, the damage to the skin with hand washing that frequently would have been pretty significant.

In that same study, they calculated that by using an alcohol hand product, you could reduce the time that was required to follow the current guideline to about--wasn't it two hours--four hours versus--yeah. So there's a huge benefit to the new guidelines recommending alcohol-based hand products in terms of the ability to actually have the time to do what the guidelines suggest.

DR. WEINSTEIN: Dr. Schaffner?

DR. SCHAFFER: In addition to this hard science, there are also observations that are being made constantly. For example, in our own institution, Vanderbilt University Hospital, watching this literature develop, we have several years ago introduced these hand rubs, these alcohol-based hand rubs, throughout our institution, first in the intensive care unit and then now located outside of every patient door.

Our infection control team has watched very carefully, not in the hard science fashion that the studies have done, but in their everyday infection control activities, they have looked at compliance with hand washing, and it soared. The convenience and the ease with which one can perform hand hygiene is so much easier than waiting in line at the sink and then having to do something with the towel afterward. And the ease of the location as well as a general educational activity throughout the institution has resulted in very substantial enhancement of compliance with hand-washing guidelines. We're very pleased with these [inaudible] products.

DR. WEINSTEIN: A question from the phone?

AT&T OPERATOR: Yes, that will come from the line of John Lauerman with Bloomberg News. Go ahead, please.

QUESTION: Thanks for taking my question. My question is: Where do you think you'll see the biggest changes from this? We've talked a little bit about scrubbing in the OR. Do you think people will be more likely to use hand rubs before surgery? Are there other--how many hospitals have actually adopted this already? Do you expect to see big changes?

DR. WEINSTEIN: Dr. Larson?

DR. LARSON: As Dr. Shafner mentioned, there are a number of hospitals that have already adopted these new practices, particularly in high-risk areas, intensive care units, and so forth, and I think that's really important because, sort of related to the last question. One of the other things that's interesting is that in the past there has been an inverse correlation between the frequency of adherence to hand hygiene and the level of risk of the procedure.

In other words, during high-risk procedures, or in intensive care units, there was actually less adherence to the guidelines than in lower-risk areas, which clearly has to do with priorities and how busy one is.

So I think the other thing that's advantageous about these new guidelines is that it will be possible, in emergency situations, or in higher-risk situations, to not have to line up at a sink and make a choice between doing hand hygiene and doing a high-risk emergency kind of a procedure.

CDC MODERATOR: What about in ORs?

DR. LARSON: Oh, in the OR, now this guideline does not make specific recommendations for surgery, although it does recommend not using a scrub brush, because scrub brushes have been shown to increase shedding, and--but this recommendation is not for surgery.

There are studies out there, like the one that was just discussed, that do show that there may be in the future some use for this; but this guideline doesn't address it. [Correction: Surgical hand antisepsis using either an antimicrobial soap or an alcohol-based hand rub with persistent activity is recommended before donning sterile gloves when performing surgical procedures. The guidelines do not recommend against using a scrub brush.]

Is it fair to say--I wonder if my colleagues would agree, that the most immediate impact of this guideline will be in the intensive care units and in regular ward practice.

Mind you, today, hospitals are full of very, very sick patients. They are quasi buildings that are really intensive care units, and so implementing these guidelines in the wards, and in the intensive care units ought to have a substantial impact.

DR. GERBERDING: It's important to recognize that we're not just talking about hospitals, and our nursing homes and long-term care facilities are places where often you have multiple people in a room and even less access to soap and water, handwashing. So our hope is that these products will also have a very important role to play in the nonhospital setting where it's even more difficult to achieve adherence with the old guidelines.

Clinics and physicians' offices, dialysis units, any place where you've got a lot of patients in a small area, and many steps to take to get to the sink, it's just really difficult to adhere, and so having this product on hand, no pun intended, I think these products will make a difference in those environments.

CDC MODERATOR: Mr. Mark [ph], you have a follow-up question?

The other question is is there a projected adherence rate for the future? Dr. Gerberding?

DR. GERBERDING: We always want perfect adherence to our guidelines. We don't know what the incremental improvement in patient will be for any given improvement in adherence, but it's one of the things that we hope to be able to monitor, and this guideline does include performance indicators that we're hoping health care facilities will pick up on as part of their patient safety promotion programs, or infection control programs, that they will actually evaluate adherence to the guideline and we may be able to understand better what is good enough hand hygiene to accomplish the stated goal.

But for training and purposes of educating health care personnel, of course we expect them to do this right all the time.

CDC MODERATOR: A question from the phone.

AT&T MODERATOR: That'll come from the line of Margo Kissel with Dayton Daily news. Go ahead, please.

QUESTION: Yes. I appreciate you taking my call. Do you see a point in the near future when these alcohol rubs will replace the need for surgical scrub rooms?

CDC MODERATOR: Dr. Larson, did you hear that? The question was do you foresee a time in the future when alcohol rubs will replace surgical scrub? I think that was the question as I heard it. Dr. Boyce?

DOCTOR: You know, I think that hospitals will want to keep both anti-microbial soaps and alcohol-based products available for surgical personnel. I think that if you have both types of products, individuals will choose the one that works best for them and they're most comfortable with, and I suspect that over the next few years, that the alcohol-based product will be used a lot more by surgical personnel, and this is already true in some parts of Europe, where they're quite popular.

I wouldn't guess that they would completely replace anti-microbial soap.

DR. GERBERDING: The kind of surgery also requires the use of sterile gloves, so we're getting the real advantage here from the barrier protection, but because we know the barriers aren't perfect, and again, I keep underlining that--it's important.

CDC MODERATOR: Would it be fair to say that in ORs, adherence, actually, right now, is probably superb, and we're not looking to improve it here as an OR is actually already probably a 100 percent. We just want to use the product that people find most easy to use there.

MAN: Yes.

CDC MODERATOR: Question from the room. Why don't you go up to the microphone.

QUESTION: Dan Haney again from AP. Are there situations outside of the health care setting where these products to make sense? You mentioned it won't replace soap and water in the kitchen, but what are some settings where these might be useful?

CDC MODERATOR: Dr. Gerberding?

DR. GERBERDING: There are situations where people don't have easy access to soap and water, for example, in the medical context outside of the actual delivery environment, if you're riding in an ambulance it's very difficult, sometimes, to access the sink, and so that can be extended into other occupations where people are providing, for example, emergency services, and they may have human to human contact, and hand hygiene is relevant in those environments.

I think we also are aware of some of our field stations, and some sort of "in the trenches" public health environments where hand hygiene is relevant but people don't have easy access to sinks and soapy water, and so these products have a role to play there, and the environment, even within the home, where we know these are popular, they're being heavily marketed to the community at large, the data are not there to suggest that there are any benefits to personal health by using these alcohol products. But many people prefer them and find that they give them an extra margin of comfort.

DOCTOR: I'd just add to that, be a bit more specific. Hand hygiene is very important in food preparation and if you're on a picnic, you may not be near a sink and running water. These are wonderful products to use in that circumstance. My wife always carries a small bottle in her purse because she may be in a public restroom circumstance where she's a little squeamish. These work very nicely in the circumstance. Otherwise, soap and water, out in the world, is more than sufficient. The trick is do it and do it vigorously.

CDC MODERATOR: I won't identify the last speaker in case his wife was listening.

Okay. Do we have a question from the room?

QUESTION: Marilyn Marchion [ph] from the Milwaukee Journal-Sentinel. Can you talk at all about child care settings or the food industry. I know this is not [inaudible] but--

CDC MODERATOR: John, do you want Dr. Boyce, or maybe Dr. Gerberding?

DOCTOR: I think we need to keep in mind that the evidence that was used to support this guideline dealt exclusively with health care settings. So this guideline does not replace recommendations by the Food and Drug Administration that relate to food processing or food service establishments.

This guideline deals with health care settings. And also, we don't have any specific recommendations that relate to child care settings.

CDC MODERATOR: A question from the phone.

AT&T MODERATOR: Yes, sir. That'll come from the line of Michelle Merrill with Hospital Employee Health. Go ahead, please.

QUESTION: I wanted to know, since this is a significant change in habit, do you anticipate that it will be difficult to convince health care workers that this is in fact better than using soap and water? Hello? Hello? Did you hear my question?

AT&T MODERATOR: Your line is open and your question was heard. However, we don't seem to be getting any response from the host location.

Dr. Weinstein, are you there?

[No response.]

AT&T MODERATOR: Once again from the host location, we're not hearing any sound.


AT&T MODERATOR: We can hear you now.

CDC MODERATOR: Okay. We heard the question and Dr. Boyce is about to answer it.

DR. BOYCE: Changing behavior I think is always difficult, so I wouldn't anticipate that we would be able to change everybody's behavior overnight. This is something we've been dealing with for years. But as Dr. Shafner already mentioned, a number of institutions have already noted improved adherence to hand hygiene procedures, once they've adopted the alcohol-based hand rubs, and I think that as more and more health care workers are educated appropriately, and motivated, that they will find that these are easy to use, they're easier on their hand, and so I think we will be successful at modifying behavior.

CDC MODERATOR: Dr. Shafner wanted to say something, and Dr. Gerberding.

DR. SHAFNER: Dr. Gerberding first.

DR. GERBERDING: What I wanted to add was that there has been some debate in health care facilities about the cost-effectiveness of these products, meaning they are, up front, sometimes more expensive to purchase than soap and water. But I think what we have now is some empowerment because we have the evidence base to say that the cost is worth it, if there is an incremental up-front cost, the efficacy of the products and their adherence, and their impact on patient safety make them appropriate purchases, and so we need to engage the purchaser and the administrators of health care facilities to become knowledgeable about what the criteria are, so that when they do purchase the products they're purchasing the kinds of products that people will use, and there are big differences in how they smell, how they feel, user-friendliness of the various preparations, and so it has to be a process that engages the workforce in the selection and the choice of the specific materials that work for them.

DR. SHAFNER: That certainly sounds wonderfully familiar. It's exactly the process we used at Vanderbilt a few years ago and we began, as I said, in our intensive care units, where of course the risk of transmission and the most sick patients are located.

What we found, very quickly, is that it's analogous, if you build it they will come. As Dr. Boyce has said, these are acceptable and our health care workers were indeed involved in choosing the specific products, and we found that they were so acceptable and were used so readily, that we rather quickly, I must say, cost notwithstanding, extended these products throughout the institution.

So as I say they are now outside, located outside each of our patient care rooms, and as I'm the "handwashing hawk" in our institution, as we go around, there is no doubt that compliance has increased.

CDC MODERATOR: A question from the room.

QUESTION: Does anyone have any estimate of what percentage of hospitals in the United States have already made the switch?

DOCTOR: There was, I think, a survey of a number of hospitals at one of the recent meetings, but it was before the guidelines I think were in the Federal Register, and I think the numbers were in the low double digits. Do you remember, John?

DOCTOR: You know, I don't have a good feel for this. It's pretty clear that since the proposed guideline was published almost a year ago, that many health care facilities are aware of the recommended strategies, and so there are a number of hospitals that have already adopted this but I can't give you a percent.

CDC MODERATOR: Dr. Gerberding?

DR. GERBERDING: I don't want to nit-pick words, but I want to be precise, that we're not recommending a substitution. We're recommending an addition of these products to a comprehensive hand hygiene program. So that soap and water still has a role to play in certain situations. Gloving still has a very important role to play, but we're adding them to the hand hygiene armamentarium.

CDC MODERATOR: Last question from the phone.

AT&T MODERATOR: That'll be a follow-up question from Adam Marcus with Health Scout. Go ahead, please.

QUESTION: Hi. A two-part question. The first is is it impossible for an alcohol prep to stimulate resistance in bacteria? And is there any probability that one of the reasons these products are effective is that they're much easier for patients to use, too, so they're more likely to not infect themselves, or not be infected by relatives who come to visit, if they have these things in the room?

CDC MODERATOR: So Dr. Boyce, the first one is resistance of, developing to alcohols.

DR. BOYCE: I think it's important to point out that there's no known mechanism by which bacteria become resistant to alcohol, and I think another point is is that alcohol has been around in various forms for centuries. Alcohol has been used as an antiseptic for probably 60 or 70 years, and there is no evidence that bacteria are becoming more resistant to alcohol. So this should not be a problem.

CDC MODERATOR: The second part of the question was patients using these themselves, does it make them less susceptible to infection?

DR. BOYCE: I think in the health care setting, one of the other recommendations in the guideline is that we have encouraged hospitals and other health care settings to remind patients and patient family members, that they can ask their health care providers if they've cleaned their hands when they come into the room, so that we think that this is also something where patients and the families can get involved in their own health care.

CDC MODERATOR: Last question from the room.

QUESTION: Ed Sussman, UPI. Is there any indication that these new guidelines, or to you expect that these new guidelines will become part of the hospital accreditation process?

CDC MODERATOR: Dr. Gerberding?

DR. GERBERDING: You know, CDC is not a regulatory agency but when we publish a guideline like this, it becomes a de facto standard of care, and I think the Joint Commission has a number of ways of encouraging facilities to follow accepted infection control practices, and so we would hope that this would be one of those things that they might look at, either by accepting these performance measures as part of a quality promotion program or patient safety program in health care facilities, or some of the other ways of supporting good infection control.

Of course the list of interventions in hospitals and other facilities for patient safety is growing and we will make our voice heard in emphasizing the importance of this particular aspect of patient safety because it is so cross-cutting and it affects so many areas of risk.

CDC MODERATOR: Okay. Thank you.

I want to thank you all for having joined us for this press conference and telebriefing to announce the release of CDC's new guideline for hand hygiene.

I want to thank Dr. William Shafner, Dr. Elaine Larson, Dr. John Boyce, and Dr. Julie Gerberding for being here to answer questions. They'll be available shortly after this briefing to answer individual questions. Thank you very much.

AT&T MODERATOR: Ladies and gentlemen, that concludes your conference call for today. Thank you for your participation and for using AT&T's executive teleconference service. You may now disconnect.

Listen to the telebriefing

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