Cleaner Hands, Fewer Infections? Maybe Not
Reader Comments
Infections
I'm wondering if a study has ever been conducted focusing on how often an infection has been introduced by 'visitors' of the patients. It seems to me that this could be just as important as cleanliness of doctors and caregivers.
Great story
Yes I am not an epidemiologist but it makes sense to me that a small core of "bad-habit carriers" who resist efforts to increase compliance could be responsible. Good luck designing a study for that which does not run afoul of the hospital workers' unions.
Not discounting visitors, but there have always been visitors and there has been some progress in infection rates.
Is it also possible that modern personnel practices have increased the number of different people who handle a given patient, which gives those core bad-habit carriers exposure to more patients?
Not So Convinced
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.
Cleaner hands
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.
What Can A Patient Do To Protect Herself?
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?
Hand Washing
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
Fomites
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
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.
A simple routine
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.
U.S. News's Avery Comarow has been editor of the America's Best Hospitals annual rankings since their debut in 1990. In his reporting on all aspects of clinical medicine from the latest cholesterol guidelines to robotic surgery, he has kept one question in the front of his mind: What does this mean to patients? That perspective uniquely qualifies him to observe and comment on the efforts by hospitals and other healthcare providers to improve care and patient safety.
