[Consensus prevention of hospital infections]

Purpose of this consensus development conference held in Utrecht on 19th May, 1989 was to reach agreement on hygienic hand washing and disinfection procedures, preoperative hand disinfection, isolation procedures, implementation of rules and regulations. A working party had prepared 18 statements on these four subjects, with added explanations. The audience which had received this information in advance, was invited to discuss and possibly modify or reject the statements. Agreement was reached about the following: regular washing of the hands of personnel on the wards is useful to prevent hospital infections; this should be done according to an agreed and feasible protocol defining when and how. Disinfection of the hands of care personnel on the wards should be done with 70-80% alcohol with cetiol; for non-infected patients with normal resistance hand washing and hand disinfection are judged equivalent. Hand disinfection procedures are advocated for personnel caring for immuno-compromised or infected patients. Alcohol (70-80%) with added chlorhexidine (0.5%) and cetiol was chosen for preoperative hand disinfection to be applied after a washing session; brushes should be used sparingly. A category specific isolation system was preferred to a disease specific system. Except for air transmitted infections, barrier nursing is usually adequate. It was deemed important to register practical problems before trying to implement the regulations.