Part 1 of 2. Patients have been told for a long time to ask their doctor or nurse if they have washed their hands, but not enough may be doing so because healthcare hand washing happens less frequently than it should.
One estimate indicates that proper hand washing by healthcare workers could save some 20,000 lives a year, David A. Hyman, University of Illinois at Urbana-Champaign professor of law and of medicine, wrote in the Cornell Law Review.
"The bottom line we know from several hand-hygiene studies: Less than 50 percent of those in healthcare wash their hands before touching patients -- the number we use is under 50 percent, but some individual studies found 20 percent to 30 percent," Maryanne McGuckin, of the University of Pennsylvania Medical Center in Philadelphia, told UPI's Caregiving.
"Gloves may have given people a false sense of security," she said. "You must wash your hands before putting on gloves and after taking them off because the hands get contaminated as the gloves come off -- many in healthcare think of gloves for protecting themselves, not for protecting the patient."
Since the 1840s it has been known that hand washing can prevent healthcare-associated infections.
Personally, I think hand washing is a habit -- some acquire the habit early as children and some never do.
My grandmother died before I was born, but her memory was kept very much alive by my mother, who made it very clear that her mother required -- and so did she -- hand washing after using the bathroom, before touching food, before eating, after coming home, after touching a pet, after touching money, after gardening, after opening or closing the front door, after sneezing, before caring for a baby, after diapering a baby, after using mass transit and after reading library books.
My grandmother wasn't privy to the research on the number of germs found on money, doorknobs or telephones, but she had the moral authority on hand washing because she survived the worst pandemic of the last century, flu in 1918, which killed more than half a million Americans and 20 million people worldwide.
I learned the lesson early, and to this day I cannot touch money or ride the subway without washing my hands -- it just doesn't feel right.
Not only would increased hand washing lower the infection rates in medical facilities, hand washing with soap could halve the incidence of diarrhea and lower respiratory infections in children in developing countries, according to a study published in The Lancet.
In the study, 150 households in squatter neighborhoods in Karachi, Pakistan, were given antibacterial soap and 150 were given plain soap, while 300 were a control.
The researchers found that hand washing with soap reduced the incidence of pneumonia by 50 percent in children under age 5 when compared with the control. Hand washing also reduced the incidence of diarrhea by 53 percent and the bacterial skin infection impetigo by 34 percent in children younger than 15 years. There was no difference in disease incidence between households given antibacterial soap and those given plain soap, according to researcher Stephen Luby.
Not only does hand washing reduce the incidence of disease in the developing world, researchers at Johns Hopkins University in Baltimore report potentially life-threatening hospital infections could be stopped with one of medicine's oldest and most powerful antibacterial treatments: hand washing.
Antibiotic management expert Dr. Xiaoyan Song, a research associate at Hopkins, said the best way to avoid these life-threatening infections is for doctors and nurses to wash their hands before touching a patient and for patients to tell their caregivers to wash their hands before touching them.
In a study of 2,279 patients admitted to Hopkins between 2000 and 2002, none of the patients had a history of methicillin-resistant Staphylococcus aureus, known as MRSA. But after hospital stays averaging 19 days, 3.4 percent (77 patients) acquired the infection.
"Some 40 percent of patients have colonized MRSA in the hospital, and although most do not have any symptoms, the infection can be spread to other patients via the unwashed hands of medical personnel," said McGuckin.
Compared with patients who didn't have MRSA at hospital discharge, patients with MRSA tended to have additional medical problems, such as chronic respiratory illness and/or liver or kidney disease. The Hopkins researchers suspect that unclean hands among healthcare workers were the likely cause of the MRSA.
Next: Part 2: A program increases healthcare hand washing
