July 6, 2004 -- Upwards of one-half of doctors don't wash their hands between visits with hospital patients, a new study shows. It's a big infection control concern in hospitals because dirty hands transmit germs to other patients.
Why don't doctors wash their hands -- a seemingly simple procedure? Hospitals routinely promote good hygiene to doctors and other health-care workers, alerting them of the risks of dirty hands after examining different patients or after examining various infected and uninfected sites on a single patient. Yet doctors are frequently observed breaking the rules.
In this study, researchers sought to better understand doctors' attitudes. They secretly tracked 163 doctors to monitor their hand washing during the day. Each doctor also completed a survey about their attitudes on hand hygiene.
They observed just 57% of doctors washing their hands between patients, writes lead researcher Didier Pittet, MD, MS, an infection control expert with the University of Geneva Hospitals. Pittet's report appears in the latest Annals of Internal Medicine.
Internists and medical students were the most diligent about washing their hands, Pittet reports. Surgeons and anesthesiologists washed their hands least often.
On days when doctors had a busy workload, they were less likely to wash, the report shows. If they thought they were being watched, they were more likely to wash.
If doctors carried hand-wipe packets with them, or if hand-rub solutions were at the patient's bedside, they were more likely to use them. These solutions don't require water and a sink.
In fact, an expert infection-control panel recently issued a national recommendation promoting the use of these hand-rub solutions for disinfecting hands that are not grossly soiled, writes Robert A. Weinstein, MD, with Chicago's Cook County Hospital, in an accompanying editorial.
It's "excellent advice," he writes. Doctors "must use these products as a matter of ritual on entering and leaving every patient's room." Also, doctors must act as role models for medical students to ensure that each generation of doctors follows good hand hygiene -- and infection control -- practices.