Hospitals, dirty hands and the risk of disease

Thousands of patients in hospitals each year are at risk of potentially fatal infections because health care workers do not wash their hands on enough occasions, according to researchers from the University of New South Wales (UNSW).

The researchers found that some health care workers washed their hands as little as 15% of the time depending on the type of ward.

"There are a number of conditions which can occur as a result of poor hand hygiene, including Staphylococcus aureus (staph) and drug resistant Staph (MRSA), blood stream infections and surgical wound infections," said Associate Professor Mary-Louise McLaws from the School of Public Health and Community Medicine at UNSW.

"In any large teaching hospital, you can get as many as 500 MRSA infections each year," she said. "It can cause people to die or to stay in hospital for longer – and may lead to intensive care.

"The link between MRSA and poor hand hygiene is well known," said Professor McLaws. "We know that when hand hygiene compliance is up, MRSA falls."

Professor McLaws is one of three authors of a paper "Why Healthcare workers don't wash their hands: a behavioural explanation", which has been published in the Journal of Infection Control and Hospital Epidemiology.

"From a young age, we are taught that we wash our hands to protect ourselves from germs, but we really need to get the message into the community that we wash our hands to protect others too," she said. "It's the same principle with health care workers.

"They often elect not to wash their hands for minor touches, because subconsciously they think it is not placing themselves at risk," said Professor McLaws. "But those minor touches from making a bed to taking a patient's temperature, for instance, may cause a problem for the next patient who is immuno-compromised, is on antibiotics, has just been to surgery, has a tube in place or a breach in their skin.

MRSA and other staph can cause infection by getting into the body through broken skin or into the blood stream.

The work has implications for the winter months and in preparation for any pandemic flu.

"If and when we do get a pandemic flu, hand washing could also help contain the problem," said Professor McLaws. "If it is transmitted via droplets, it will be crucial that people wash their hands with soap and dry them after coughing, sneezing or using a tissue. It's important to get the basics right now."

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