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Wash your hands

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14 pointsadamo12 comments

Am I missing something or is this study about hand washing before patient contact, not hand washing after using the toilet? I realize this isn't the main point, but to me it suggests that the author didn't actually bother to read the study they're citing. I wonder what percent of the time the author would estimate they read the studies they cite...

I don't accept that doctors believed they washed their hands 73% of the time. I think simply lied when asked that question since, as doctors, they knew full well that they should have washed their hands.

Pilots solved this a long time ago. We call it a checklist. Anything that might kill you if you miss it is on there. It works ridiculously well.

That might be useful if you had something complicated to remember, but wouldn't you tend to ignore a checklist that had as a single point "Wash your hands"?

Not if you have to sign & date it every time.

Been there, done that.

"The [Michigan Keystone ICU Project] targeted a specific type of infection that ICU patients can get while in the hospital – catheter-related bloodstream infections.

These infections are expensive and potentially lethal. They add approximately $18,000 to the cost of care when a patient contracts them, and cause 24,000 deaths per year.

The Keystone Project sought to change clinicians’ behaviors when inserting catheters into ICU patients. To do so, the team made a checklist, measured infection rates, and changed hospital culture. The checklist’s components consisted of hand washing; using a cap, gown, and mask; cleaning the patient’s skin with a disinfectant; avoiding placing catheters near the groin; and removing unnecessary catheters.

These five steps were associated with a 66-percent reduction in these infections throughout the state, saving over 1,500 lives and $200 million in the first 18 months alone."

Source: http://www.healthreform.gov/reports/success/michigan.html

I'd like to see the paper that shows medical doctors only wash their hands 9% of times after going to the bathroom.

The number is mind-blowingly low, especially since when I'm in public restrooms myself, the number of people who wash their hands seems to be in the majority.

Of course, my sampling could be off because people could be self concious of being watched, doctors could be in more of a rush, etc. But 9%? That's an incredible data point and needs incredible evidence.

Edit: Went back and read the original study. First of all, the study isn't about washing hands after the /toilet/ at all, but rather about washing hands after /patient contact/. Second, nowhere obvious in the study does it say that doctors believe they washed hands 73% of times. In fact, there is no mention of any survey whatsoever...

Not that it was easy to find, but it was there:

""Fourteen of these 19 subjects subsequently participated in the remain- ing phases of the program. Among this cohort, the mean self-estimated handwashing rate was 73% (range, 50%-95%), compared with the covertly observed rate for this cohort of 8.6% before and 10.8% after patient contact, with an individual mean rate of 10% (range, 0-33%)."

This is shockingly widespread:

http://raisethehammer.org/article/868

I think physicians learn in their studies that washing one's hands does not help all that much. They do actual experiments testing how long you would have to rinse your hands to get a significant amount of bacteria off it - it is a very long time.

Recently I read a study (or talked with a doctor who told me about it, can't remember) saying that it is actually more efficient to use disinfectants occasionally (ie on demand) instead of washing one's hands all the time. People tend to be wary of disinfectants because they tend to sting on the skin, but apparently the stinging is only a sign that the skin is already damaged. Apparently the disinfectants also contain stuff that is good for the skin, so using them is not as bad as it seems.

Not true. A quick hand wash gets rid of almost all the bacteria. Fungi take a bit more scrubbing to get rid of.

I found this out in first year university biology. We swabbed and cultured our hands before and after washing with plain soap. Almost no colony forming units of bacteria are left after a short wash. A reasonable amount of the fungi is still there though.

I heard different things from various physicians, is all I can say.

Maybe that experiment should be done at school with all children.

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