Aussie Doctors Neglect Washing Hands Before Touching Patients

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By Athena Yenko | April 29, 2014 2:40 PM EST

Mary-Louise McLaws, a professor of epidemiology in healthcare infection and infectious diseases control at the University of NSW found it unsettling when her study on hand hygiene found doctors neglect washing hands before touching patients one after another. She said that the poor hygiene among doctors expose the patients to high risk of infectious bugs.

Dr McLaw's study found that hand hygiene among doctors in hospitals failed the accepted threshold ranging only at 61 per cent to 68 per cent. In comparison, nurses passed the threshold at 77 per cent to 84 per cent.

"Compliance for medical staff was 17 to 18 PPs lower than that for nursing staff regardless of hospital size. After adjusting for the effect of differential sampling of high-performing nursing staff in 82 hospitals, the average adjusted total compliance fell by 5 PPs from 76% to 71%. The adjusted rate for the two largest hospital sizes (> 400 beds and 301-400 beds) fell 4 PPs to 71%," the report said.

The report also found that compliance at 56 of the 82 hospitals also failed below the national threshold of 70 per cent for before touching a patient.

"The lowest compliance rate for > 400-bed hospitals was 55% and for 301-400-bed hospitals was 49%. When hospitals performed at or above the national threshold, the compliance were well above the national threshold. The highest compliance rates were 81% for > 400-bed hospitals, 78% for 301-400-bed hospitals, 87% for 201-300-bed hospitals, and 86% for 101-200-bed hospitals. A small number of hospitals with high compliance rates inflated the average compliance rates for each hospital size to reach or surpass the threshold."

With her study, McLaws believed that it is necessary to have a routine through which every hospital staff be trained to ask a doctor to wash his or her hand when the latter neglects. This routine may be done in discreet by asking a doctor if he or she can "have a moment."

In an interview with ABC, McLAws said that through this routine the doctors will always be reminded respectfully.

"Reminded, exactly. So we've come up with a little slogan of you know, 'Doctor, do you have a moment?' - which could also be Nurse, do you have a moment? - where quite respectfully, they're asking the doctor to step back and clean their hand either before touching a patient or after leaving the patient or the patient's zone."

McLaws believed that the poor hygiene among doctors sprang from the lack of education session for doctors among hospitals.

"I believe it's because doctors work often alone, they don't work with other doctors and they don't have the support that the nurses have been able to get over the years where each day they have an education session, they have handovers where they talk about issues and they're quite happy to correct each other. So doctors need to be given the permission and the opportunity to help each other and to be helped by other health care professionals, which is never done."

However, Hand Hygiene Australia director Lindsay Grayson disagreed with Professor McLaws saying that hospitals failed to have education session with doctors blaming the neglect to doctor' part-time employment.

"Most of the doctors employed in hospitals are actually not full-time ...so the amount of time we have to teach them about hand hygiene is much less," he told Sydney Morning Herald.

Program manager of healthcare-acquired infection at the Clinical Excellence Commission, Paul Smollen, said that although with education sessions, no positive effect was observed among doctors' behaviour.

 "There is no positive spin. NSW has for a long period of time been leading the way on this issue," he said.

Australian Medical Association NSW president Brian Owler, on the other hand, believes that younger doctors value hand hygiene more nowadays.

 "There is probably some cultural change needed among some of the older doctors, but that really varies from hospital to hospital and doctor to doctor," he said.

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