{"id":"https://openalex.org/W7225796817","doi":"https://doi.org/10.3390/hygiene6040082","title":"Healthcare-Associated Infections and Resource Limitations: A Bioethical Perspective on the Enforceability of Hand Hygiene","display_name":"Healthcare-Associated Infections and Resource Limitations: A Bioethical Perspective on the Enforceability of Hand Hygiene","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7225796817","doi":"https://doi.org/10.3390/hygiene6040082"},"language":"en","primary_location":{"id":"doi:10.3390/hygiene6040082","doi":"https://doi.org/10.3390/hygiene6040082","is_oa":true,"landing_page_url":"https://doi.org/10.3390/hygiene6040082","pdf_url":null,"source":{"id":"https://openalex.org/S4210235442","display_name":"Hygiene","issn_l":"2673-947X","issn":["2673-947X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hygiene","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/hygiene6040082","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5084625462","display_name":"Esteban Cruz-Arenas","orcid":"https://orcid.org/0000-0003-0238-9518","observed_orcids":["https://orcid.org/0000-0003-0238-9518"]},"institutions":[{"id":"https://openalex.org/I4210124243","display_name":"Instituto Nacional de Rehabilitaci\u00f3n","ror":"https://ror.org/03734cd59","country_code":"MX","type":"facility","lineage":["https://openalex.org/I4210124243"]}],"countries":["MX"],"is_corresponding":false,"raw_author_name":"Esteban Cruz-Arenas","raw_affiliation_strings":["Hospital Epidemiological Surveillance Unit, National Rehabilitation Institute (INR-LGII), Mexico City 14389, Mexico"],"raw_orcid":"https://orcid.org/0000-0003-0238-9518","affiliations":[{"raw_affiliation_string":"Hospital Epidemiological Surveillance Unit, National Rehabilitation Institute (INR-LGII), Mexico City 14389, Mexico","institution_ids":["https://openalex.org/I4210124243"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5006504014","display_name":"Mar\u00eda Guadalupe S\u00e1nchez-Bringas","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I8961855","display_name":"Universidad Nacional Aut\u00f3noma de M\u00e9xico","ror":"https://ror.org/01tmp8f25","country_code":"MX","type":"education","lineage":["https://openalex.org/I8961855"]}],"countries":["MX"],"is_corresponding":false,"raw_author_name":"Mar\u00eda G. S\u00e1nchez-Bringas","raw_affiliation_strings":["Department of Embryology and Genetics, National Autonomous University of Mexico, Mexico City 04510, Mexico"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Embryology and Genetics, National Autonomous University of Mexico, Mexico City 04510, Mexico","institution_ids":["https://openalex.org/I8961855"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5134853974","display_name":"Mar\u00eda Guadalupe Franco Herrera","orcid":"https://orcid.org/0009-0000-4303-5076","observed_orcids":["https://orcid.org/0009-0000-4303-5076"]},"institutions":[{"id":"https://openalex.org/I193181351","display_name":"Universidad de Guadalajara","ror":"https://ror.org/043xj7k26","country_code":"MX","type":"education","lineage":["https://openalex.org/I193181351"]}],"countries":["MX"],"is_corresponding":false,"raw_author_name":"Mar\u00eda G. Franco-Herrera","raw_affiliation_strings":["Department of Medical and Life Sciences, University of Guadalajara, Guadalajara 44100, Mexico"],"raw_orcid":"https://orcid.org/0009-0000-4303-5076","affiliations":[{"raw_affiliation_string":"Department of Medical and Life Sciences, University of Guadalajara, Guadalajara 44100, Mexico","institution_ids":["https://openalex.org/I193181351"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161494890","display_name":"Kennia De Paz-Duque","orcid":"https://orcid.org/0009-0008-3293-1041","observed_orcids":["https://orcid.org/0009-0008-3293-1041"]},"institutions":[{"id":"https://openalex.org/I4210124243","display_name":"Instituto Nacional de Rehabilitaci\u00f3n","ror":"https://ror.org/03734cd59","country_code":"MX","type":"facility","lineage":["https://openalex.org/I4210124243"]}],"countries":["MX"],"is_corresponding":false,"raw_author_name":"Kennia De Paz-Duque","raw_affiliation_strings":["Burn Care, National Rehabilitation Institute (INR-LGII), Mexico City 14389, Mexico"],"raw_orcid":"https://orcid.org/0009-0008-3293-1041","affiliations":[{"raw_affiliation_string":"Burn Care, National Rehabilitation Institute (INR-LGII), Mexico City 14389, Mexico","institution_ids":["https://openalex.org/I4210124243"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5114275618","display_name":"Sandra Elvia Hern\u00e1ndez-Valencia","orcid":"https://orcid.org/0000-0001-8232-1585","observed_orcids":["https://orcid.org/0000-0001-8232-1585"]},"institutions":[{"id":"https://openalex.org/I4210124243","display_name":"Instituto Nacional de Rehabilitaci\u00f3n","ror":"https://ror.org/03734cd59","country_code":"MX","type":"facility","lineage":["https://openalex.org/I4210124243"]}],"countries":["MX"],"is_corresponding":false,"raw_author_name":"Sandra E. Hern\u00e1ndez-Valencia","raw_affiliation_strings":["Sports Medicine Division, National Rehabilitation Institute (INR-LGII), Mexico City 14389, Mexico"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Sports Medicine Division, National Rehabilitation Institute (INR-LGII), Mexico City 14389, Mexico","institution_ids":["https://openalex.org/I4210124243"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5107814774","display_name":"Araceli Guerra-Grajeda","orcid":"https://orcid.org/0000-0003-3442-1826","observed_orcids":["https://orcid.org/0000-0003-3442-1826"]},"institutions":[{"id":"https://openalex.org/I4210124243","display_name":"Instituto Nacional de Rehabilitaci\u00f3n","ror":"https://ror.org/03734cd59","country_code":"MX","type":"facility","lineage":["https://openalex.org/I4210124243"]}],"countries":["MX"],"is_corresponding":true,"raw_author_name":"Araceli Guerra-Grajeda","raw_affiliation_strings":["Socio-Medical Research Unit, National Rehabilitation Institute (INR-LGII), Mexico City 14389, Mexico"],"raw_orcid":"https://orcid.org/0000-0003-3442-1826","affiliations":[{"raw_affiliation_string":"Socio-Medical Research Unit, National Rehabilitation Institute (INR-LGII), Mexico City 14389, Mexico","institution_ids":["https://openalex.org/I4210124243"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5107814774"],"corresponding_institution_ids":["https://openalex.org/I4210124243"],"apc_list":{"value":1000,"currency":"CHF","value_usd":1207},"apc_paid":{"value":1000,"currency":"CHF","value_usd":1207},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"6","issue":"4","first_page":"82","last_page":"82"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11000","display_name":"Infection Control in Healthcare","score":0.9951000213623047,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11000","display_name":"Infection Control in Healthcare","score":0.9951000213623047,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13147","display_name":"Ethics and bioethics in healthcare","score":0.0038999998942017555,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14396","display_name":"Healthcare Regulation","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C188084074","wikidata":"https://www.wikidata.org/wiki/Q194294","display_name":"Bioethics","level":2,"score":0.9101999998092651},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.6355999708175659},{"id":"https://openalex.org/C206345919","wikidata":"https://www.wikidata.org/wiki/Q20380951","display_name":"Resource (disambiguation)","level":2,"score":0.5496000051498413},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.5210000276565552},{"id":"https://openalex.org/C12713177","wikidata":"https://www.wikidata.org/wiki/Q1900281","display_name":"Perspective (graphical)","level":2,"score":0.5045999884605408},{"id":"https://openalex.org/C547646559","wikidata":"https://www.wikidata.org/wiki/Q162297","display_name":"Hygiene","level":2,"score":0.4763000011444092},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.4758000075817108},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3495999872684479},{"id":"https://openalex.org/C65414064","wikidata":"https://www.wikidata.org/wiki/Q484105","display_name":"Autonomy","level":2,"score":0.33230000734329224},{"id":"https://openalex.org/C143299363","wikidata":"https://www.wikidata.org/wiki/Q900584","display_name":"Attribution","level":2,"score":0.30869999527931213},{"id":"https://openalex.org/C124056412","wikidata":"https://www.wikidata.org/wiki/Q3320364","display_name":"Scientific evidence","level":2,"score":0.30790001153945923},{"id":"https://openalex.org/C2776035688","wikidata":"https://www.wikidata.org/wiki/Q1606558","display_name":"Affect (linguistics)","level":2,"score":0.3041999936103821},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.2888999879360199},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.2777999937534332},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.27559998631477356},{"id":"https://openalex.org/C108827166","wikidata":"https://www.wikidata.org/wiki/Q175975","display_name":"Internet privacy","level":1,"score":0.27219998836517334},{"id":"https://openalex.org/C2775941552","wikidata":"https://www.wikidata.org/wiki/Q25212305","display_name":"Isolation (microbiology)","level":2,"score":0.27059999108314514},{"id":"https://openalex.org/C55587333","wikidata":"https://www.wikidata.org/wiki/Q1133029","display_name":"Engineering ethics","level":1,"score":0.26840001344680786},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.2680000066757202},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.26589998602867126},{"id":"https://openalex.org/C2781083858","wikidata":"https://www.wikidata.org/wiki/Q17327049","display_name":"Scientific literature","level":2,"score":0.25369998812675476}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3390/hygiene6040082","doi":"https://doi.org/10.3390/hygiene6040082","is_oa":true,"landing_page_url":"https://doi.org/10.3390/hygiene6040082","pdf_url":null,"source":{"id":"https://openalex.org/S4210235442","display_name":"Hygiene","issn_l":"2673-947X","issn":["2673-947X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hygiene","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3390/hygiene6040082","doi":"https://doi.org/10.3390/hygiene6040082","is_oa":true,"landing_page_url":"https://doi.org/10.3390/hygiene6040082","pdf_url":null,"source":{"id":"https://openalex.org/S4210235442","display_name":"Hygiene","issn_l":"2673-947X","issn":["2673-947X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hygiene","raw_type":"journal-article"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":64,"referenced_works":["https://openalex.org/W1494847897","https://openalex.org/W2032003447","https://openalex.org/W2032750238","https://openalex.org/W2040402741","https://openalex.org/W2049247856","https://openalex.org/W2061356704","https://openalex.org/W2062362292","https://openalex.org/W2101754925","https://openalex.org/W2113701842","https://openalex.org/W2116072599","https://openalex.org/W2119417456","https://openalex.org/W2146192072","https://openalex.org/W2157117527","https://openalex.org/W2165128313","https://openalex.org/W2179056879","https://openalex.org/W2264181637","https://openalex.org/W2517779411","https://openalex.org/W2897529890","https://openalex.org/W2901222459","https://openalex.org/W2919584253","https://openalex.org/W2922577842","https://openalex.org/W2948508195","https://openalex.org/W2952347145","https://openalex.org/W2957046606","https://openalex.org/W3078562891","https://openalex.org/W3098496013","https://openalex.org/W3154762453","https://openalex.org/W3173418848","https://openalex.org/W3173850690","https://openalex.org/W3184556731","https://openalex.org/W3185691993","https://openalex.org/W3204698875","https://openalex.org/W4200159894","https://openalex.org/W4213348448","https://openalex.org/W4214646122","https://openalex.org/W4233997546","https://openalex.org/W4293826397","https://openalex.org/W4308257028","https://openalex.org/W4361225624","https://openalex.org/W4378389877","https://openalex.org/W4383709947","https://openalex.org/W4386046796","https://openalex.org/W4389815532","https://openalex.org/W4392267146","https://openalex.org/W4392362230","https://openalex.org/W4393282156","https://openalex.org/W4399914408","https://openalex.org/W4400026419","https://openalex.org/W4402067336","https://openalex.org/W4402926927","https://openalex.org/W4403949399","https://openalex.org/W4404860149","https://openalex.org/W4405464312","https://openalex.org/W4405536887","https://openalex.org/W4406616788","https://openalex.org/W4406753966","https://openalex.org/W4409318829","https://openalex.org/W4409978686","https://openalex.org/W4413363488","https://openalex.org/W7116965716","https://openalex.org/W7155074094","https://openalex.org/W7161556663","https://openalex.org/W7165484460","https://openalex.org/W7168243906"],"related_works":[],"abstract_inverted_index":{"Healthcare-associated":[0],"infections":[1],"(HAIs)":[2],"pose":[3],"a":[4,17,37,153],"safety":[5],"risk":[6],"to":[7,27,53,59,86,89,165,223],"patients":[8],"and":[9,35,48,55,75,119,134,142,146,175,200,219],"healthcare":[10,41,98,211],"personnel.":[11],"Although":[12],"hand":[13],"hygiene":[14],"(HH)":[15],"is":[16,197],"fundamental":[18],"preventive":[19],"measure,":[20],"insufficient":[21],"availability":[22],"of":[23,46,64,69,72,83,97,121,205],"the":[24,61,70,80,87,129,135,192,202],"resources":[25,127,218],"required":[26,96],"perform":[28],"HH":[29,56,84,170,196],"properly":[30],"may":[31,93,190],"limit":[32],"its":[33,91,186],"effectiveness":[34],"create":[36],"bioethical":[38,62,81,154],"conflict":[39],"in":[40,67,114,126],"delivery.":[42],"A":[43],"documentary":[44],"review":[45],"national":[47,141],"international":[49,143],"scientific":[50],"literature":[51,110],"related":[52],"HAIs":[54],"was":[57,112,150],"conducted":[58,113],"examine":[60],"enforceability":[63,82],"this":[65,78],"practice":[66],"light":[68],"principles":[71],"beneficence,":[73],"non-maleficence,":[74],"justice.":[76],"In":[77],"study,":[79],"refers":[85],"extent":[88],"which":[90,195],"performance":[92],"reasonably":[94],"be":[95],"personnel":[99,212],"under":[100,194],"specific":[101],"circumstances,":[102],"including":[103],"those":[104],"involving":[105],"institutional":[106,180],"resource":[107,157],"limitations.":[108],"The":[109,148],"search":[111],"PubMed,":[115],"Google":[116],"Scholar,":[117],"Scopus,":[118],"Web":[120],"Science,":[122],"as":[123,125],"well":[124],"from":[128,152,215],"World":[130],"Health":[131,138],"Organization":[132,139],"(WHO)":[133],"Pan":[136],"American":[137],"(PAHO),":[140],"regulatory":[144],"instruments,":[145],"textbooks.":[147],"information":[149],"analyzed":[151],"perspective.":[155],"Greater":[156],"availability,":[158],"by":[159],"itself,":[160],"has":[161],"not":[162],"been":[163],"shown":[164],"improve":[166],"health":[167],"outcomes.":[168],"Effective":[169],"depends":[171],"on":[172],"individual,":[173],"institutional,":[174],"organizational":[176],"factors.":[177],"Therefore,":[178],"when":[179],"limitations":[181],"objectively":[182],"hinder":[183],"or":[184],"prevent":[185],"effective":[187],"implementation,":[188],"they":[189],"modify":[191],"conditions":[193],"bioethically":[198],"enforceable":[199],"affect":[201],"proportional":[203],"attribution":[204],"individual":[206],"responsibility,":[207],"without":[208],"implying":[209],"that":[210],"should":[213],"refrain":[214],"using":[216],"available":[217],"adopting":[220],"reasonable":[221],"measures":[222],"protect":[224],"patients.":[225]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-11-12T00:00:00"}