Cleaner Hands, Fewer Infections? Maybe Not

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Either you as a consumer patient or an advocate in your room..require everyone to wash their hands thoroughly 15 secs plus.A Study has shown that doctors when not being watched will only wash their hands 44% of the time, and if they knew they were being watched 61% of the time did they wash up..this is still way too low.
A wonderful new book for us consumer patients is worth getting to note all the practical tips to help you survive the healthcare system. Navigating the Healthcare Maze-Jeff Knott..certainly emphasises that we have to take back the empowerment of our care.
Infection of patients every year kills upwards of 100,000 people a year..handwashing might prevent some of those deaths by more handwashing. Amazing!!

Charles William of FL 8:14AM September 03, 2008

Dear Editor,
Your article pertaining to hand washing and reducing infections makes a good point. Even the most effective intervention of hand hygiene cannot solve the problem of healthcare associated infections. However, I agree that it is one of the most important means of preventing the spread of infections. As a nurses aid I have been taught that there is a proper technique to hand washing. I t must be done with soap, water and friction using a scrubbing motion for at least 20 seconds. I believe that hospitals and care facilities are becoming too lax in the correct procedure and too dependent on simply using hand sanitizers. From working as a health care provider I have seen that only a percentage of care givers are actually using the proper hand washing technique. All health providers need to make this a priority thus reducing the risk of infection and protecting people who come into and out of healthcare facilities. Professionals need to know their hospital and risk of infection in all areas such as emergency rooms, operating rooms, equipment, instruments, rest rooms, patients’ rooms and which areas are at high risk for infection.
Health providers need to work as a team to help prevent infections in their work areas. I believe that visitors need to be instructed not to visit if they are not well. Posted signs can create reminders of this and will remind staff and visitors about washing hands. People also need to be reminded to get their flu shots. Each person needs to be responsible to stop the spread of infections in day to day activities.
In closing I agree that the infection rate would not drop if facilities focused only on proper hand washing as there are just too many other areas that need to be considered. I believe this article will get the readers' attention on the importance of decreasing infection and realizing it is each health care provider and visitor's responsibility.
Katie

Katie of MN 6:04PM March 16, 2008

Well-used stethoscopes, bp cuffs, etc., have a role in this too. But one biggie that I've noticed in a couple of hospitals and several nursing homes is that there is no place to put bed linens, gowns, towels, washcloths, pillows, except in the visitor chairs, because the food tray (which isn't big enough anyway) usually holds other supplies. Even then, the pillows (which will get re-used with the same pillowcase if it is not bath/bed-changing time but just toilet hygiene) often fall to the floor. Plastic leathery chairs seems to be just as dirty as the fabric-covered filthy-looking chairs. Guess where else visitors' butts have sat before they visited; and take a stab at what is on the floor.
Also, the above-mentioned supplies, in anticipation of a later bath, are often stored on the floor of the patient's closet where shoes, dirty clothes, overnight bags and other stuff from previous patients have been. Viruses and germs survive longer than given credit.
Most rooms have space for a foldable pull-down table from a wall. Close it up when not in use.
Hand-washing is primary of course, but let's look at other obvious infectious sources.

J. Heatwole of MD 3:24AM February 15, 2008

Excerpt from my blog:
From one of our Emergency Department doctors comes this very sensible and simple approach that could be used by doctors in almost every setting -- both to remind themselves to practice correct hand hygiene and to reassure patients that they have done so:
After much personal trial and error, I finally came up with a successful solution to the hand-washing issue. The key for me is incorporating a preset routine into my introduction whenever I walk into a room to meet a patient, much like the pre-shot routine of a golfer or a basketball player shooting a free throw. My routine is...”Hello, I am Dr. Jones. I am going to wash my hands as we get to know each other. What brings you to the ER today?” I teach this type of routine to my residents as well.

Paul Levy of MA 6:15AM February 04, 2008

A complex, ongoing problem, complicated by the preponderance of antibiotic-resistant infections that are now upon us.
In my realm, giving anesthesia in the Operating Room, not only do we wear gloves ALL THE TIME, but I probably change gloves dozens of times an hour. Not only do I not want to contaminate my patient, I don't want to dirty my workspace, either.

Counting Sheep of PA 12:44PM February 03, 2008

Visitors, equipment and medical charts etc., are called "fomites" and have been implicated in infection transmission; as with most other improper toilet activities .. and always perform true hand-washing .. skip the puny wipes and gels .. it's really cost effective.
Fraternally,
Dr. David E. Marcinko; MBA
www.HealthcareFinancials.wordpres.com
www.MedicalBusinessAdvisors.com

Dr. David E. Marcinko of GA 6:01PM January 27, 2008

Interesting article.
But, I am not sure that "hand washing" is the same as using hand-sanitizers. So, perhaps it is the sanitizers that don't work?
Of course, the author rightly concludes that this is only one part of the equation—one element in a multi-package that wraps in other elements, such as meticulous care of IVs and urinary catheters and thorough room cleaning; etc. [ie., the traditional basics].
Nevertheless, if you don't wash your hands - with soap, H20 and friction - you will never touch me as a patient, and my in-hospital advocate will tell you exactly why.
I sure hope folks just wash their hands, and stop spending so much time and RD money on this "debate."
I just don't see the downside, and can only imagine how a good plaintiff's attorney will use such info - and maybe rightly so!
Best.
Ann
Ann Miler
www.HealthcareFinancials.wordpress.com
www.MedicalBusinessAdvisors.com

Ann Miller of GA 5:53PM January 27, 2008

What can the patient do to improve her odds of not contracting infections while hospitalized?
Can she ask any medical person to please wash her hands before an examination? How would that be received? Should she ask visitors to refrain from hugging and kissing? I would think the absence of that kind of comforting contact would have its own consequences.
So, what can a patient do to protect herself?

Barbara K. of CA 2:01PM January 27, 2008

Has anyone noticed how many people working in hospitals are wearing glvoes when they touch patients? Maybe the effect of more handwashing isn't as dramatic because of the glove use? And what about the patient's own germs causing infections? Even with bathing, patients still carry lots of bacteria in their bodies and on their skin.

Sharri of PA 6:35PM January 25, 2008

I am not so convinced that the infection rate would not have dropped if you had actually investigated "proper hand washing" as opposed to doubling the use of hand sanitizers. We have become far too dependent on using hand sanitizers in-place of proper hand washing with soap, warm water, scrubbing for 20 seconds and using a disposable towel to dry. According to the CDC " "Hand washing is the single most important means of preventing the spread of infection." Using hand sanitizers are not part of the equation! It would be interesting to repeat your two-year study with the doctors, nurses, and other caregivers using the traditional method of hand washing! Looking forward to more results.

Marti Breau of MA 5:58PM January 25, 2008