By: Rosemary Stephen, Elements: Environmental Health Intelligence
Article:
“ Let Me See You Wash Your Hands!”
Author: Ian Ayres, Freakonomics, The Hidden Side of Everything.
http://freakonomics.blogs.nytimes.com/2009/11/11/let-me-see-you-wash-your-hands/
When I was young, I was fascinated by a science show on TV. One episode particularly affected me – a program, of all things, about the history of hand washing. I still remember the black and white image of a doctor urging his maternity staff and doctors to wash their hands before delivering babies. I still see the sad face of a new, young mother being told that she had puerperal fever, an often fatal infection. I still recall an older doctor handing out hand washing pamphlets to hospital staff as they came to work and their laughing, mocking response. The show ended by saying that thanks to this doctor, hand washing policies were put in place in many hospital maternity wards, decreasing the number of acquired infections to below 1%. This doctor was Ignaz Philipp Semmelweis [1].
When I was taking care of patients, the hospital where I worked was very firm about its hand washing practices. I assumed that hospital policies about compulsory hand washing still existed, but when reading public health articles on the web, I realized that this may not actually be the case. Then, an Elements team member sent me this article by Ian Ayres titled “Let Me See You Wash Your Hands!”. Clearly, others also noticed a lapse in this simple and basic sanitation practice.
This seemingly lighthearted article touches briefly on Dr Semmelweis’ effort to encourage doctors to wash their hands. By starting with Sammelweis, the author put us into the right mood to read on. He explains the failure of voluntarism in hand washing programs in medical facilities and then relates how the Cedars-Sinai Medical Center manages to achieve 100% compliance to their Clean Hand program. The center’s program used visual impact to entice medical staff to comply. Their approach was in line with “ a picture is worth a thousand lectures and in-services”.
The author continues by telling us that voluntarism is also failing in schools. He suggests that hand washing should be made compulsory, achieving compliance using an approach similar to Cedars-Sinai Clean Hand program. Mr. Ayres supports his suggestion by citing a 2002 study done in 18 elementary schools in the United States. Hand washing was made compulsory and students were instructed how, and when, to use hand sanitizer during the school day. The results of the study showed a 19.8 % drop in absenteeism for students and 10.1% for teachers.
I highly recommend reading this article for the information it provides and for showing us what is, and what is not, working when dealing with hand sanitation.
Read the article here: http://freakonomics.blogs.nytimes.com/2009/11/11/let-me-see-you-wash-your-hands/
Reference:
[1] Ignaz Semmelweis (2009) Wikipedia, The free encyclopedia. (On-line) Available: http://en.wikipedia.org/wiki/Ignaz_Semmelweis. Cited 2009 Nov 19.
