JASPAUL S. JAWANDA, M.D.: Mom Was Right: Wash Your Hands
Most of us grew up with a mother who constantly encouraged (i.e., nagged) us to "Wash your hands." Her commands rang through the house several times a day, but most frequently before meals -- and often with the hurriedly tacked-on suffix, "With soap!"
Well, it seems that Mom, who very often knows best, had science on her side.
From the Centers for Disease Control and Prevention to the Mayo Clinic and other citadels of higher health care, experts in disease prevention routinely extol the virtues of hand hygiene, noting that nothing -- that's right, nothing -- does as much to curb the transmission of infectious disease as the simple application of soap, warm water and friction to the human hands.
FirstHealth of the Carolinas entered the traditional beginning of flu season this year with a campaign designed to increase hand-washing awareness. The program requires the attention of everyone -- patients, visitors, physicians, nurses and other employees, and volunteers -- in all three FirstHealth hospitals.
Called "Save a life, clean your hands," our awareness campaign is designed to make our hospitals safer by combating the source of many infections and encouraging a change in our hand-washing culture. The primary goal is to ensure that everyone who enters a patient's room washes his hands upon entering and leaving. The secondary goal -- and this is where we encounter the change in culture -- involves encouraging patients and visitors to make sure that their caregivers, even their doctors, do just that.
Maybe it's because the act of hand-washing is so easy and the advice so mundane that many of us dismiss it so readily. We're in a hurry, we're hungry, soap and water aren't readily available, or we simply forget. There are plenty of reasons why people don't wash their hands. But not doing so puts us, and everyone around us, at increased risk of disease.
The problem is even (some might say especially) true in hospitals where hand-washing compliance remains low -- sometimes well under 50 percent -- among people who certainly should know better.
Education makes a difference, however, as evidenced by a widely cited Swiss awareness campaign that resulted in a dramatic increase in hand-washing compliance -- from 48 percent in 1994 to 66 percent in 1997 -- after the implementation of a program that included installing alcohol-based hand rub dispensers at patient bedsides.
It should be noted that nosocomial (hospital-originated) infection rates and MRSA (antibiotic-resistant bacteria) transmission rates decreased significantly during the same period.
Because the hands are the main transmitters of germs, you can even make yourself sick if you don't wash your hands often enough and then put them to your eyes, nose or mouth.
You can also spread germs to other people by touching surfaces -- such as doorknobs and telephones -- that they also touch.
Diseases that are spread through simple hand-to-hand or hand-to-object contact include the common cold, flu and any number of stomach bugs. Most people will get over a cold easily, but the flu, especially in combination with pneumonia, can be very serious, even deadly.
There was a time, and not so long ago historically, when most people didn't wash their hands. They didn't believe in it, and they ridiculed people who did. Many times, their number included people who worked in hospitals.
That practice began to change about 150 years ago, when an Austrian physician noted a correlation between patient deaths and the student doctors who had worked on cadavers in an anatomy class before starting rounds in a hospital maternity ward. By insisting that his students wash their hands before touching their patients, this foresighted physician not only produced a drop in patient deaths but also revolutionized health care.
Even then, it would be another 50 years before hand-washing was recognized -- as it is today -- as the health-care worker's most important tool against the spread of infection.
Jaspaul S. Jawanda, M.D., is a board-certified physician who specializes in the diagnosis and treatment of infectious diseases. He received his medical degree from the University of Michigan and did further training at the University of North Carolina at Chapel Hill.
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