By now everyone knows doctors and nurses are supposed to wash their hands before medical procedures. We’re even told to ask our clinicians if they’ve washed up before they touch us. That’s something I find hard to do, and I’m sure I’m not alone. A new study shows why this advice may be needed, though, as a last line of defense. From MedPage Today (Hand Hygiene in Hospitals Not Up to Par)
Nurses and other healthcare providers complied with hand hygiene guidelines less than half of the time before participating in medical procedures, results of a new study showed.
Compliance was better after procedures, with 72% following guidelines after procedures compared with 41.7% before procedures, according to a report published in the May issue of Applied Nursing Research.
Overall compliance with hand hygiene guidelines was just 34.3%.
“It is important to note that preprocedure hand hygiene intends to protect patients against infections and maximize risk reduction, whereas postprocedure hand hygiene intends to protect the healthcare provider and other patients who may contract patient-to-patient infections,” wrote Denise M. Korniewicz, PhD, RN, of the University of Miami, and Maher El-Masri, PhD, RN, of the University of Windsor, in Ontario, Canada.
“Thus,” they wrote, “these findings may suggest that healthcare providers are probably driven to wash their hands by their need to protect themselves more than their patients.”
This is pretty bad news. In the past I’ve held open the possibility that hand hygiene guidelines were excessive, and that clinicians were keeping patients safe even if they weren’t adhering to the letter of the law. I’ve heard some senior physicians criticize the emphasis on hand hygiene as overblown. And yet this study suggests providers do believe hand hygiene is a good idea, but aren’t as concerned about their patients as they should be.
I don’t have any great solutions in mind, but the findings reinforce some of my existing convictions:
- Avoid the hospital if possible
- Bring an advocate –preferably an MD or at least someone assertive– if you have to be there
- Try to hold out till the arrival of robot caregivers, who don’t have a problem following protocols consistently