hand washing in hospitals needs to improve

Device Tracks Hand Washing Adherence In Hospitals

The mere act of washing hands is one of the most important things medical staff can do for their patients. Those ten little fingers can spread a host of pernicious ailments when going from person to person for treatment.

Although not sterile, the act of disinfecting one’s hands saves lives. Yet many medical staff still forgo the practice entirely – either too busy or chronically forgetful.

Ignaz Philipp Semmelweis was a Hungarian physician of German extraction, known as an early pioneer of antiseptic procedures. His findings were published in Etiology, Concept and Prophylaxis of Childbed Fever.

Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics.

Puerperal fever, also referred to as childbed fever, is a bacterial infection contracted by women during childbirth. It can develop into puerperal sepsis, which is a serious form of septicemia (alternately spelled septicaemia).

Sepsis is a potentially deadly medical condition where pathogens infect the bloodstream and symptomatically cause an inflammatory response, fever, fluctuations in blood pressure, and weakens the immune systems. Sepsis is treated with intravenous fluids and antibiotics, otherwise it can be lethal.

Puerperal fever was common in mid-19th-century hospitals and was often fatal, with mortality at 10 to 35 percent. While working in Vienna General Hospital’s First Obstetrical Clinic in 1847, Semmelweis proposed the practice of washing with chlorinated lime solutions for interns who had performed autopsies, urging them to wash before they attended to births.

At the time birthing wards had three times the mortality of midwives’ wards. The action of cleansing hands between autopsies and births immediately reduced the incidence of fatal puerperal fever.

Diseases were inaccurately attributed to several different and unrelated causes. Semmelweis hypothesized there was only one cause and that cleanliness would significantly remedy the problem. This was considered extreme, and was ignored, rejected, and ridiculed by many.

Some seasoned doctors, at the time, were offended at the suggestion that they should wash their hands as Semmelweis was unable to provide a valid scientific explanation. However, Semmelweis’s antiseptic practice earned widespread acceptance years after his death when Louis Pasteur confirmed the germ theory.

The germ theory of disease, established in the late 19th century, states that some infectious diseases are caused by microorganisms, too small to see without magnification, but capable of invading humans, animals, and other living hosts. Their germination can cause disease. A germ refers to a virus, bacterium, fungus, or prion, and microorganisms that cause disease are called pathogens.

For years, hospitals have mulled over the best ways to ensure doctors, nurses, and other medical staff keep their hands clean, but with only limited success, according to CBS News. Now, some are turning to technology, using beepers, buzzers, and tracking systems that remind workers to sanitize and charting those who don’t.

Poor hand cleanliness is a factor in hospital-borne infections, and even today it is attributed to thousands of American deaths each year. The US Centers for Disease Control and Prevention (CDC) estimates that one of every 20 patients in US hospitals gets a hospital-acquired infection each year.

According to Biovigil – a developer of leading-edge hygiene improvement solutions – healthcare associated infections (HAIs) are the fourth leading cause of death in America and cost the U.S. healthcare system between $30 and $40 billion dollars each year.

Hospitals have tried varying ways to promote better hygiene. Signs are posted in restrooms. Some even employ monitors who keep tabs and single out offenders. Experts believe, at best, staff are washing about 50 percent of the time. But hospitals want a 100 percent adherence rate.

Therefore, more and more hospitals are implementing innovative monitoring systems that physically record when soap and hand sanitizer dispensers are used or utilizing technology capable of chemically detecting the topical presence of alcohol. Systems respond by having buzzers sound off or lights blink, alerting and reminding the medical personnel to clean up before handling a patient.

A study published in June in the Journal of Environmental Health showed that 95 percent of people are washing their hands incorrectly. To properly wash your hands, wet your hands with clean, running water and apply soap. Make sure to scrub your fingertips, between your fingers and the front and back of your hands for at least 20 seconds each side. If you’re unsure how long that is, the CDC suggests singing “Happy Birthday” twice.

[Image via Shutterstock]