The World Health Organization, says handwashing and providing alcohol-based handrub at the point of care can go a long way in preventing the spread of HAIs, yet compliance with proper hand hygiene standards is still quite low. Healthcare providers have cited a number of reasons why they do not wash their hands, including forgetfulness, loss of concentration, interruptions, lack of knowledge of specific hand hygiene standards, and skin irritation. To help providers remember and understand hand hygiene standards, the WHO’s “My Five Moments” program has been implemented in thousands of hospitals worldwide, teaching the importance of handwashing and providing alcohol-based handrub at the point of care. Healthcare providers can also reduce skin irritation associated with handwashing by using colder water. A new study found that water as cold as 40 degrees Fahrenheit reduced bacteria on hands just as well as warmer water.
A study in Mayo Clinic Proceedings found that stethoscopes are more contaminated than certain parts of physicians’ hands.
The researchers took samples from physicians’ hands and stethoscopes following patient visits and found that the stethoscope’s diaphragm and tube had a higher total bacterial count than either side of the palm and the back of the hand. Only the fingertips had a higher average bacterial count. Didier Pittet, MD, lead physician on the World Health Organization’s Global Patient Safety Challenge initiative and researcher in the study, suggested the high levels of stethoscope contamination may stem from hand hygiene practices. “Physicians forget to clean their hands quite frequently, even in the best places,” said Didier Pittet. “When they forget to clean their hands, they certainly forget to disinfect their stethoscope. And from my experience, even those who are really good models of hand hygiene likely forget to clean their stethoscopes most of the time.”
Common bacteria found on mobile devices include staphylococci and micrococci, yet a 2009 survey found that of the healthcare workers who carried a mobile device, 80% of the PDAs, 85% of the mobile phones, and 96% of the pagers had never been cleaned by the owner. Researchers at the Hannover Medical School found that when devices are cleaned with a standardized cleaning procedure, microbes were reduced by 98.1%.
New guidance released by the Society for Healthcare Epidemiology of America (SHEA) recommends physicians and NPs hang their coats on hooks while examining patients and wash their coats at least once a week using hot water and bleach. Providers typically push back against such wardrobe restrictions, saying more casual dress would reduce patients’ confidence in their provider. SHEA acknowledges that patients express a preference for formal attire, including a white coat, but says, “patient comfort, satisfaction, trust, and confidence in their physicians is unlikely to be affected by the practitioner’s attire choice”. The association also says patients who understand the infection risks of certain attire are more willing to change their preferences.