You should listen to your mother: always wash your hands. That’s especially true if you work in health care, where poor hand hygiene can be matter of life and death. By one 2002 estimate, 1.7 million patients were affected by health care-associated infections (HCAI), a number that amount to 4.5% of all patients. Such hospital-based infections are the fourth-leading cause of death in America, and they cost the health system $40 billion a year—nearly all of which would be preventable with better hygiene from health-care workers. Yet very few hospitals are able to get hand-washing rates for doctors and nurses above 50%.
That’s why the World Health Organization (WHO) has chosen May 5 as Save Lives: Clean Your Hands Day, its annual campaign to get health workers to practice better hygiene. The WHO has a simple five-step framework for getting health care workers to ensure they keep their hands clean, but it won’t worker until hospitals get serious about pushing hand washing, before and after a worker sees a patient.
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Admittedly, it’s not as easy as it might seem. For a busy doctor or nurse that might require hand washing dozens to hundreds of times a day, when most health care workers barely have time to breathe. As a result, hygiene tends to be forgotten. One recent study found that doctors and nurses in an intensive care unit—the very area of a hospital where patients are most vulnerable to new infections—only washed their hand a quarter as often as they should have.
Some hospitals have tried having workers wear electronic badges that can detect the alcohol used in most hand sanitizers. The badge displays a green light if the worker has recently washed their hands, so both their colleagues and patients know if they’ve been conscientious. That enables the hospital to gather data on hand-washing compliance, and it serves a visible reminder for the worker themselves about the need to keep clean. (It’s a bit like this cartoon.)
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The drawback, of course, is that such electronic measures are pricey. But those high-tech solutions may not be necessary, though. As Tina Rosenberg writes in the New York Times, some hospitals have found success through a simple checklist:
In 2003, the Michigan Health and Hospital Association began an experiment to see if its members could bring down the rate of infection in central line catheters — one of the deadliest types of hospital-acquired infections.
The intensive care units at nearly every hospital in Michigan participated — 103 I.C.U.’s. What they had to do was use a five-point checklist to prevent infection when inserting the catheters. The steps were: Wash hands. Cover the patient with sterile drapes. Clean the skin with chlorhexidine antiseptic. Do not insert catheters into the groin area. Remove catheters as soon as they are no longer needed.
A paper in the New England Journal of Medicine by Peter Pronovost, the Johns Hopkins University doctor who designed the checklist, set out the results. “Within 3 months after implementation, the median rate of infection was 0, a rate sustained throughout the remaining 15 months of follow-up. All types of participating hospitals realized a similar improvement.”
The point is that with enough willpower, hospitals can enforce proper hygiene—and keep their patients safe from needless infections. A little attention is all that’s really needed—which is one good reason to celebrate Clean Your Hands Day.