Hand-washing heedless in healthcare
By Michal Tellos
News Editor
September 23, 2009
You may be tired of hearing every nurse, doctor and pharmacist telling you to constantly wash your hands even though they may not be practising what they preach.
A recent study conducted by a UWindsor researcher could indicate that healthcare providers might be speaking hypocritically.
Maher El-Masri, a research chair at UWindsor’s nursing faculty, recently conducted an observational study at an oncology unit in Miami that revealed some disappointing results.
In his study, which involved three nursing research assistants observing 47 healthcare providers for a total of 612 observations, El-Masri found that hand washing compliance rates were as low as 42 per cent before medical procedures, and 72 per cent after procedures.
Furthermore, a fully proper compliance, which necessitates washing before and after any medical procedure, only occurred 34 per cent of the time.
According to El-Masri, there are a number of variables involved in this low rate, but ignorance is not one of them.
“Some people think it is due to a lack of knowledge, but the truth of the matter is that healthcare providers know they have to wash their hands. This is the first thing they learn when they come to medical school, or pharmaceutical school,” said El-Masri.
Factors affecting this rate, according to El-Masri, include understaffing and prioritizing, but mostly the issue of micro-organisms being invisible.
“If I see blood on my hands, I’m likely to go and wash my hands. If I touch urine, I’m likely to go wash my hands. But if I just move a patient from a chair back to bed, for instance, or I changed the IV bag for the patient, the assumption is that I did not do something that contaminated my hands,” he said.
Also affecting the rates of hand washing were the risks involved with the procedure, with healthcare providers much more likely to comply with proper hygiene if conducting a high-risk procedure.
El-Masri further notes the effects that over-washing can have on skin, particularly that of females, who generally have more sensitive skin.
“[Healthcare providers] don’t want their hands to dry, and they don’t want their hands to crack. And it’s known that if you over-wash your hands they dry, and they don’t want to do that,” he said, noting that manufacturers of hand sanitizer and soap are beginning to address this.
El-Masri has studied predictors of infection in many different ways, but this was the first time that he was able to study hand hygiene as a factor, because it is such a difficult statistic to quantify in a survey.
He admits that every study could have a limitation or a possible margin of error, but he notes that this was taken into account in his study’s adjusted analysis.
Despite the grave results of this survey, El-Masri continues to stress the strong need for hand washing. He notes that it is the absolute strongest prevention method for disease and infection, including the H1N1 virus.
El-Masri adds it is always a safe precaution for students to wash their hands even if they feel like their hands may be clean.
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