Washing Our Hands Of Hospital Infections

Came across this Yahoo story about how gowns and gloves aren’t convincingly keeping down infections from antibiotic resistant strains of bacteria. There are a bunch of bad bugs running around out there, and for some strange reason we can’t seem to keep them away.

Washing would seem to be a good approach, and washing our hands would be the first thing we should look at. Reading the comments in the article, I see that many older nurses and doctors were trained rigorously in hand washing. In fact, the Centers for Disease Control and the World Health Organization both recommend old-fashioned hand washing using soap. There is some mention of the alcohol based rubs, but when it comes to really getting your hands clean, there is only soap.

Here’s where our study of behavior comes in. Washing hands takes a bit of work, especially if you do it correctly. You have to find a sink, run water, apply the soap, rub your hands together both in and out of the water, sing “Twinkle Twinkle Little Star” three times, and then dry off your hands. Very exhausting. If you’re in a hurry, you will want to take shortcuts.

Worse yet, if you make the outcome of the hand wash routine unpleasant, then you increase the chances of a nurse or doctor wanting to skip the whole sterilization thing. And that’s also bad, because, well, it’s important! And that is what has happened over the years. Because of cost cutting and industrial efficiencies, we’ve seen gentle, hand friendly soaps like Physohex (find it) disappear and be replaced by industrial detergents that do more damage to skin than help.

At the same time, the management of the hospital must bow to pressures from their owners, we need profits! The best way to increase profit is by decreasing expenses; and one big expense is the time doctors and nurses spend washing their hands. Imagine, if you will, a doctor washing her hands 60 times a day. In a normal world, one minute each time means an entire hour has been ‘wasted’ by hand washing. Now, being the enterprising manager you are, what if that hour could be reduced to 10 minutes? You’ve just added 50 minutes of reduced expenses for every doctor in your hospital, per day! You’re a genius. How did you do this great thing?

You placed alcohol dispensers every few feet in the hallways, and in every room throughout your hospital. They are everywhere. And even though there isn’t a whole lot of research saying alcohol is better for halting transmission of MRSA [2] than soap and water, they are still everywhere. Why? Because they save TIME. By the way, the alcohol still damages their skin! So everyone hates using the alcohol as well.

And there you have it. Because of the need for profits and saving time, the quality of soap has gone downhill and nurses are forced to spend less time getting sterile. As a result, a few more people contract opportunistic diseases. How many? Not really sure about that. The CDC website is down because the government is currently shut down.

So, going to the hospital? Take your own good soap and make everyone WASH THEIR HANDS! Twinkle, twinkle, little star, how I wonder what you are …

[1] http://news.yahoo.com/gloves-gowns-don-t-stop-spread-infections-hospitals-152223468.html

[2] Methicillin-resistant staphylococcus aureus (MRSA) is one of the more popular super bugs that we are worried about in opportunistic hospital infections. There are many others. If you happen to know of solid academic peer-reviewed research showing that alcohol based rubs are equally effective at reducing rates of MRSA transmission, let me know. I haven’t been able to find a single one.