Latest blog post:Handing better patient care
We’ve all been there – from furiously scrubbing our hands at a dreaded clinical exam station and thinking ‘at least I can easily get a good mark on this station’ to being rushed on ward rounds and feeling irritated at wasting valuable time to scrub our hands raw. Is it really necessary to focus all this time and energy on washing my hands? I am sure many medical students have thought this very thing as yet another clinical session focused on the importance of frequent hand washing and using the ‘Five Steps.’ Even the signs throughout the hospitals I have worked at declared adamantly: ‘Save Lives: Clean Your Hands’ and seemed to fill up every modicum of blank space on the ward walls.
As of this December, more than 15,500 hospitals from 168 countries around the globe have signed up to participate and actively promote the World Health Organization’s (WHO) campaign to promote hand hygiene – thus bringing down infections and provide better patient care. It is estimated that proper hand hygiene can help reduce dreaded hospital acquired infections, such as Methicillin-resistant Staphylococcus aureus (MRSA) or clostridium difficile (C. difficile), by more than 50%. Therefore, it is likely that your hospital or country has implemented this programme encouraging all healthcare professionals to engage in clean hands – especially medical students.
Although we constantly hear in the news of these ‘superbugs’ invading our hospitals, how big of a problem are they really? Some of the statistics may surprise you, for instance there are five million cases of hospital acquired infections that occur annually in Europe. And especially in the current financial climate when hospitals are trying to save every penny possible, it is estimated that these infections cost Europe €13-24 billion. No wonder hospitals around the world are stressing such an easy and low cost solution as handwashing to combat this problem.
But how consistently will you be washing your hands when you are rushed and have been on your feet all day running from patient to patient as a newly appointed doctor? We all like to think we will be vigilant when this time comes and will wash our hands in between patients (or at least use alcohol gel) no matter how many times our pagers go off. I have seen several doctors run from patient to patient without engaging in this practice. Research published by the WHO shows that this is not an isolated incidence and that a shockingly low rate of handwashing compliance exists among doctors, around 40%.
As time goes on, we all hope to become better doctors – having gained valuable experience and expertise as time goes by. Unfortunately, research by van de Mortel et al. (2000) showed a disturbing trend in handwashing compliance between professions with registered nurses complying 71%, junior doctors 50%, and specialist doctors complying a shockingly low 25% of the time. So why are doctors not washing their hands? It seems as though doctors are rushed, handwashing is inconvenient and when medical students were interviewed by researchers, Hunt, Mohammudally, Stone, & Dacre (2005), they stated their main reason for not washing their hands as: ‘No one else is does it.’ Time should teach us ways to serve our patients better but this research certainly makes us take note of these highly specialised healthcare professionals who are not carrying out such a simple step to better their patients’ wellbeing.
Although the principles of handwashing and antiseptic procedures were introduced to medicine by Ignaz Semmelweis (1 July 1818 – 13 August 1865), a Hungarian physician, more than a century and a half ago; it still seems as though our profession has advanced in the simple art of putting our hands together and rubbing them with a little soap (or alcohol rub). Certainly Dr.Semmelweis who is described as the ‘saviour of mothers’ and the ‘pioneer of antiseptic policy’ would be baffled at the continuing spread of disease among patients – all of which could be reduced drastically with his simple insight into better patient care.
Ultimately, sometimes it’s not learning complicated procedures or memorising every medication known to man, but it’s the simple things that can truly save lives: I always remember to wash my hands no matter how rushed I am. I know patients will thank me for it.