- PHILADELPHIA - Doctors and nurses are least likely to wash their hands in
that part of the hospital where patients are often at their most vulnerable
- the intensive care unit, a study published on Monday showed.
- The study, conducted at Switzerland's
University of Geneva Hospital, also found that compliance with recommended
hand-washing guidelines was lowest before high-risk procedures and that
among hospital staff, doctors were far less likely to wash their hands
than were nurses.
- Published in Tuesday's edition of the
American College of Physicians' Annals of Internal Medicine, the findings
are important because hand washing is a basic safeguard against hospital-acquired
infections that cause 90,000 deaths a year in the United States alone.
- An Annals of Internal Medicine editorial
that accompanied the study said the results confirm generally low hand
hygiene in the medical world, even as hospitals struggle to control new
- Swiss researchers observed staff on 48
wards at the University of Geneva Hospital during all shifts over the course
of two weeks in December 1994, witnessing more than 2,800 "opportunities"
for hand washing.
- Health-care workers were expected to
wash their hands before and after contact with a patient, after touching
potentially infected substances and after removing gloves.
- But hospital workers complied only 48
percent of the time " 30 percent if the worker was a doctor, 52 percent
if a nurse, 47 percent if a nursing assistant and 38 percent if another
kind of health-care employee.
- Among hospital wards, intensive-care
unit staff complied with handwashing guidelines only 36 percent of the
time, compared with 59 percent for staff in the pediatric ward and a rate
of 52 percent for the generic medical ward.
- But the study said it may be impossible
for ICU workers to wash their hands at every opportunity, because the process
of walking to a sink, washing and returning to the patient literally takes
a full minute.
- "If 40 opportunities to wash the
hands occur per hour of care, the total amount of time spent washing hands
becomes prohibitive," the study concluded.