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When it comes to hand-washing, not all hospital workers are created equal

October 19, 2009 |  9:59 am

Hospital When a relative of mine was in the hospital recently, I was amazed by how many people came in and out of her room -- and appalled by how few of them washed their hands on their way in and out.

Turns out I'm not the only one who's been thinking about hospital hygiene.

French researchers were sufficiently concerned about this that they created a model of an intensive care unit with 18 patients and three kinds of healthcare workers. The first type spent a lot of time with just a handful of patients, like nurses. The second type saw more patients but spent less time with each of them, like doctors. The third type, which the researchers dubbed "peripatetic" workers, interacted with every patient each day, like therapists. Then they assumed one of the patients was sick with methicillin-resistant Staphylococcus aureus -- better known as MRSA -- and measured how fast it spread when various types of workers failed to wash their hands.

It wasn't good when any of the healthcare workers skipped the soap, but it was definitely worse when the peripatetic workers failed to wash their hands, the researchers found. If a single peripatetic worker flunked the hygiene test, the spread of disease was three times worse than if a nurse or doctor did. In fact, they calculated that if just one peripatetic worker refused to wash his or her hands, the effect was the same as if ALL healthcare workers washed their hands only 77% of the time, they wrote in a study published online today in Proceedings of the National Academy of Sciences.

The degree to which an infectious disease spread through this hypothetical ICU depended on the virulence of the pathogen and on how easily it can spread from person to person. But no matter what values they used, the peripatetic  workers were always the most dangerous. In an ideal world, all healthcare workers would wash their hands all the time. But in the real world, it makes the most sense for hospitals to focus on getting the peripatetic workers to comply with common-sense hygiene measures, the researchers concluded.

-- Karen Kaplan

Photo: Sometimes, hospital rooms may only look clean -- especially if healthcare workers fail to wash their hands.

Credit: Canterbury District Health Board (New Zealand) via Bloomberg

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