John Davis Bell‚MD, President
John Davis Bell‚MD President

“We”  includes physicians as well – often the most egregious offenders.

The answer is not “education”, but a change in attitude and culture within our staff actively in contact with patients. Use of alcohol based cleaners are fine – as long as they are used properly. Soap and warm water scrubs are needed after a few uses in order to remove the film left by these cleaners  in order for the cleaner to reach the skin. Please be aware that these cleaners is may injure your skin ,making it more susceptible to abnormal flora growth. Is it theoretically possible to produce “super” strains in the hospital setting which are resistant to these cleaners? We are all aware that surgical scrub products have changed over the years because of the evolution of resistance in the bacterial population. Is this use of alcohol hand cleaners another inappropriate use of antibiotics? Does it really save time since the cleaner must be massaged into the hands and allowed to dry to be effective?

On the other hand..(joke)…Warm soap and water mostly sends bacteria down the drain instead of attempting to cause cell lysis through dehydration. It probably does not take much more time if any to wash your hands and sing “Happy Birthday ” to yourself twice…silently in my case!Many hand soaps contain bactericidal agents . Studies show that there is very little difference in the effectiveness of these soaps on bacteria over those that contain nothing but pure soap.

Use of gloves does not solve the problem if one contaminates the gloves. Often they can become more hazardous to the patient because of a sense of germ free confidence  built by the provider – ” I have gloves on!!” We often un-consciously touch  dirty surfaces…computer keyboards…charts…stethoscopes, etc. …not to mention face, nose, hair, and mouth ! Humans touch their face approximately 3000 times per day, not really noticing that they have done so. When you do, your hands are potentially contaminated–gloves or not.

Please be aware of these issues. 100% compliance is likely impossible, and many different methods are effective in hand hygiene efforts. Being aware of the responsibility to promote compliance is the most important weapon in dealing with this aspect of patient care. It is a cultural responsibility. Do not be hesitant to kindly ask your fellow workers to wash their hands for their own and their patient’s benefit. We can all help each other in this simple but most difficult task.

Our patients benefit.