27 December 2008

Wash your hands or lose your job

We've been talking the past few days about hospital infection control: Is it as simple as Sir Richard Branson suggests? Or as complex as Paul Levy's commenters make it appear?

The National Health Service of Scotland comes down on the side of simple. It is poised to enact a new, no-tolerance policy: Wash your hands or lose your job.

It is important to add that the Scottish health service (a subset of the National Health Service of the entire UK) has actually done a good job of promoting hand hygiene in its hospitals. A year ago, an audit showed that Scottish hospitals were at 79% compliance, and so the service set a 12-month goal of 90% compliance.

(All of these numbers, by the way, are better than in the United States, where even intensive attention to hand-washing gets even caring hospitals only to about 70%. And yes, it is true that hand hygiene alone does not equal infection control — but it is the basic building block. If you can't establish hand hygiene, what are your odds of accomplishing more complex interventions?)

But now they've decided to go for 100%. In Scotland the move is being applauded. The Glasgow Evening Times editorialized:
If it takes the threat of the sack to make medical staff wash their hands then it is a justified action. It is scarcely credible that up to 10% of doctors, dentists and nurses do not practice this basic hygiene measure.
Anyone want to disagree?


Robyn said...

Wow! Look at Ontario! They are reporting hospital infections. What do you think?


Maryn McKenna said...

Awesome. Will definitely check that out!

Anonymous said...

Basing our salvation from superbugs on forcing people to change their behavior is a long shot, I’m doubtful this would ever happen. Sounds like an act of desperation, to make it look like they are "doing something" about the problem.

What about the community-acquired MRSA; should the government also try to force the public to wash their hands more regularly? How will it be enforced - by the "hand washing" and "laundry" police? More video cameras? And the penalty? Who will disinfect all of the things that people touch on a daily basis?