Not all doctors want hand-washing reminders

NEW YORK (Reuters Health) - Many doctors and nurses don’t like the idea of patients reminding them to clean their hands, a new study from Switzerland suggests.

A surgeon washes his hands at a hospital in Berlin February 29, 2008. REUTERS/Fabrizio Bensch

So-called hand hygiene has become a major goal of health care facilities around the world, and patients are often encouraged to become involved in system-wide changes to promote hand washing, researchers said.

“Hand hygiene is the primary measure to prevent infections and cross-transmission (of bacteria and viruses) at the point of care,” said Dr. Didier Pittet, the senior researcher on the new study from the University of Geneva Hospitals and Faculty of Medicine.

The findings shouldn’t discourage patients from bringing up the topic, he added.

“Patients should know and ideally should remind their health care workers about the importance of hand hygiene, especially right before they are going to touch them,” said Pittet, who also leads a hand hygiene campaign at the World Health Organization.

Previous research has shown doctors and nurses are much more likely to wash up when video systems monitor their compliance and send them feedback (see Reuters Health story of November 30, 2011.)

Switching from soap and water to an alcohol-based hand rub also makes regular hand hygiene much more feasible, as long as hand-sanitizing stations are located in patient rooms and not only in the hallway, Pittet said.

For the new study, he and his colleagues sent surveys to 700 doctors and nurses at the University of Geneva Hospitals - and got responses back from 227 of them.

Just under one-third of the health care workers said they didn’t like the idea of being reminded to wash their hands by patients, because they thought it could be upsetting or humiliating. And 37 percent said they wouldn’t consent to wearing a badge encouraging patients to ask them about hand hygiene.

Still, most of the doctors and nurses agreed that patients can play a role in preventing infections transmitted in the hospital, the researchers reported Monday in the Archives of Internal Medicine.

The data were also presented in part at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Boston in September 2010.

The low response rate to the survey is one limitation of the study, Pittet and his colleagues noted. And it’s unknown whether the results would be the same for other hospitals.

“It’s clear that in some places around the world it would be easier to get patients to remind their health care workers, and health care workers to accept that they will be reminded by patients,” Pittet told Reuters Health.

Even when it comes to Geneva hospitals, he said he’s “not pessimistic at all” about the findings. He expects the culture in hospitals will continue to change to make hand hygiene more second nature and patient participation more accepted.

“There will be a day when it will be so automatic for health care workers to clean their hands,” Pittet said. “It will be a lot easier at that time for patients, in case health care workers forgot, to remind them.”

SOURCE: Archives of Internal Medicine, online September 3, 2012.