[HM2Viking]

Each year, according to the U.S. Centers for Disease Control, two million Americans acquire an infection while they are in the hospital. Ninety thousand die of that infection. The hardest part of the infection-control team's job, Yokoe says, is not coping with the variety of contagions they encounter or the panic that sometimes occurs among patients and staff. Instead, their greatest difficulty is getting clinicians like me to do the one thing that consistently halts the spread of infections: wash our hands.
...
Our hospital's statistics show what studies everywhere else have shown -- that we doctors and nurses wash our hands one-third to one-half as often as we are supposed to. Having shaken hands with a sniffling patient, pulled a sticky dressing off someone's wound, pressed a stethoscope against a sweating chest, most of us do little more than wipe our hands on our white coats and move on -- to see the next patient, to scribble a note in the chart, to grab some lunch.
...
No part of human skin is spared from bacteria. Bacterial counts on the hands range from five thousand to five million colony-forming units per square centimeter. The hair, underarms, and groin harbor greater concentrations. On the hands, deep skin crevices trap 10 to 20 percent of the flora, making removal difficult, even with scrubbing, and sterilization impossible. The worst place is under the fingernails. Hence the recent CDC guidelines requiring hospital personnel to keep their nails trimmed to less than a quarter of an inch and to remove artificial nails.
...
With the gel finally in wide use, the compliance rates for proper hand hygiene improved substantially: from around 40 percent to 70 percent. But -- and this is the troubling finding -- hospital infection rates did not drop one iota. Our 70 percent compliance just wasn't good enough. If 30 percent of the time people didn't wash their hands, that still left plenty of opportunity to keep transmitting infections. Indeed, the rates of resistant Staphylococcus and Enterococcus infections continued to rise. Yokoe receives the daily tabulations. I checked with her one day not long ago, and sixty-three of our seven hundred hospital patients were colonized or infected with MRSA (the shorthand for methicillin-resistant Staphylococcus aureus) and another twenty-two had acquired VRE (vancomycin-resistant Enterococcus) -- unfortunately, typical rates of infection for American hospitals.

http://alternet.org/healthwellness/51949/?page=2

[oramar]

When I work at the bedside I wash my hands 50 to 100 times a shift on average. This has devastating effect on my skin. I am not a compulsive hand washer. The truth is that if you have 8 patients you will need to wash at least 10 times per patient which is 80 times a shift and can be as many as 100 times a shift. If I only had 4-5 it would be 40 to 60 times a shift which is still pretty hard on the hands. Oh by the way, I have taken care of 10 to 12 patients on many occasions. You are looking at 150 hand washing per shift at least. Do these infection control people ever consider the fact that crushing patient loads have something to do with the poor compliance? Or do they just content themselves with finger wagging.

[barbyann]

Originally Posted by oramar

Do these infection control people ever consider the fact that crushing patient loads have something to do with the poor compliance? Or do they just content themselves with finger wagging.

My feelings exactly!

[SuperSleeper]

Take 100 Hand washings a shift....

Performing proper hand washing technique which would basically require a 2 minute session at the sink ends up being....

3.33 HOURS of the shift!

I'm religious about the hand thing (I get sick easily) and luckily we use the foam (but not for C.Diff!). Cuts way down on time!

[sleepwalker]

"With the gel finally in wide use, the compliance rates for proper hand hygiene improved substantially: from around 40 percent to 70 percent. But -- and this is the troubling finding -- hospital infection rates did not drop one iota."


Hmmmm...that's interesting. Do you think they might want to consider whether or not the infections are community-acquired instead of hospital-acquired?

[NBMom1225]

Nosocomial infections are the reason I had an NICU nurse barred from caring for my daughter a few years ago. One of the nurses would NOT wear gloves! She said she washed her hands so much that there was no need for gloves! My daughter started chemo at three weeks old, and ended up with RSV twice, pseudomonas twice, and staph once...even though she was in an isolation room in the NICU! I spoke with the charge nurse about my concerns, and we didn't have her as a nurse after that. I am also proud to say that I maintained great aseptic technique at home when caring for her broviac...she had four different broviac placements inpatient due to infection during her 3mo hospital stay, but the one she was sent home with was the same one they removed permanently 8mos later!

[wensday]

we doctors and nurses wash our hands one-third to one-half as often as we are supposed to. Having shaken hands with a sniffling patient, pulled a sticky dressing off someone's wound, pressed a stethoscope against a sweating chest, most of us do little more than wipe our hands on our white coats and move on -- to see the next patient, to scribble a note in the chart, to grab some lunch.

Speak for yourself! Looking at my hands as I type, they are all dry and cracking from washing my hands so much. Think I will count how many times I wash and gel in a shift.

[CHATSDALE]

this is caused by the hospital providing the cheapest, harshest soap they can buy - very very few have lotion available

Originally Posted by wensday

Speak for yourself! Looking at my hands as I type, they are all dry and cracking from washing my hands so much. Think I will count how many times I wash and gel in a shift.