I had to laugh when I saw FDA was warning consumers in Puerto Rico that some hand sanitizers had high levels of bacteria (Burkholderia cepacia) that can cause serious infections. It’s not really funny of course, except that one of the hand sanitizers was called ?MD Quality Hand Sanitizer? (the other one was “Bee-Shield Hand Sanitizer?). Most appropriate, considering that a persistent problem with hospital infections is that we doctors are insufficiently conscientious about washing our hands between patients, A study in 2004 showed that doctors washed their hands only about half the times when it was indicated. Five years later, things hadn’t improved:
Only one in four doctors wash their hands between patients on some wards within the McGill University Health Centre, an internal audit has found.
Nurses do a better job, but their rate of compliance is still 40 to 50 per cent – a factor that’s blamed for the spread of germs and deadly infections in hospitals.
What’s more, results from the audit taken last year show little progress since a study was conducted at the MUHC in 2001. That study found that fewer than one in four doctors and less than 40 per cent of nurses took hand-hygiene precautions. (The Gazette [Montreal])
A hundred years before I was born, Oliver Wendell Holmes, Sr. (father of the later Supreme Court Justice) observed that doctors were responsible for transmitting childbed fever (puerperal fever) from one pregnant woman to another. Since disease was caused by God and not God-fearing doctors, he his opinions weren’t looked upon kindly. A few years later Ignaz Semmelweiss noticed the vast difference in puerperal fever rates in two maternity wards at the Vienna Lying-In hospital, one staffed by midwives and one by medical students and supervising doctors. He blamed the difference on contagion from the autopsy room where students were dissecting bodies. Use of a strong antiseptic brought the rates in line. All this was before the germ theory of disease, and the cry, “Doctors wash your hands” was controversial if not heretical.
Now we know better. So when we don’t wash out hands, we are committing malpractice. Unless, of course, we are washing our hands with “MD Quality Hand Sanitizer.” Then we are just carrying on a grand old tradition.