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Why Don't Doctors Wash Their Hands?

By Ross Pomeroy

Hand washing: This quintessential hygiene practice has been hammered home by kindergarten teachers, bathroom notices, public health officials, Elmo, and your mother. But despite the consistent peppering, the majority of people probably don't wash their hands as often as they should. Unfortunately, doctors are no different.

In the last two decades, a host of studies have found that less than 50% of health care workers wash their hands as often as they're supposed to, and compliance among physicians is routinely lower. This is problematic, because hand washing is the single most successful and cost-effective means of preventing healthcare-associated infections (HAIs), and HAIs, which include the notorious superbugs, are growing more frequent.

At this time, the World Health Organization ranks HAIs as one of the top ten causes of hospital deaths worldwide. Additionally, the CDC claims that 1.7 million people contract infections in hospitals each year, and that estimate might be low.

Past studies have looked into why doctors don't wash their hands, and they've uncovered a host of different reasons. Lack of access to sinks, time constraints, lack of soap, lack of towels, and skin irritation were frequently cited reasons. (If you found the final reason to be a weak excuse, remember that doctors are urged to wash their hands dozens of times per day. That makes for some cracked, dry, irritated skin, and a potentially grumpy doctor.)

In order to remedy this dirty situation and ensure that doctors worldwide are washing their hands, a team of Canadian physicians has proposed a large study with the aim of finding a sweeping solution to the problem.

First, they plan to identify barriers and enablers to hand hygiene compliance via interviews, nonparticipant observation, and focus groups. Then, they will develop an intervention strategy. Finally, they will pilot their program in four patient care units in a large urban hospital in Canada.

The physicians hope to utilize the results of their pilot study to spearhead a multi-site randomized controlled trial.

Source: Squires et. al (2013) Improving physician hand hygiene compliance using behavioural theories: a study protocol. Implementation Science, 8:16 doi:10.1186/1748-5908-8-16

Steven Ross Pomeroy is the assistant editor of Real Clear Science. Follow him on Twitter @SteRoPo.

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