Agencies Question Safety of Hand Cleaners

The Washington Post ^ | January 19, 2004 | Avram Goldstein

[neverdem]

Doctors and nurses aren't surprised anymore when they walk into isolation rooms at Inova Fairfax Hospital and sick patients ask them whether their hands are clean.

Years ago, such patients might be regarded as troublemakers, but now Inova's chief infection fighter, hospital epidemiologist Allan J. Morrison Jr., uses brochures to encourage patients to protect themselves by challenging caregivers' hand hygiene.

"Anything that gets you talking about hand washing, anytime or anywhere, is music to the ears of an infectious disease professional," Morrison said.

Medical experts at the federal Centers for Disease Control and Prevention enthusiastically agree with Morrison, and they have called on the nation's 5,700 hospitals to push workers to faithfully use alcohol-based, waterless hand sanitizers in the fight against infections.

But their campaign has met with resistance from officials at CDC's sister agencies within the Department of Health and Human Services. They worry the sanitizers may be too dangerous because they are at least 62 percent alcohol -- and therefore flammable.

In some parts of the country, including the District, fire departments have ordered hospitals to remove dispensers from exit corridors because the fire code forbids the use of the dispensers there, hospital industry officials say.

Each year, Americans contract 2 million infections in U.S. hospitals and clinics, and 90,000 people die as a result, according to federal officials. Experts are certain that the microbes that cause most of those infections are inadvertently delivered to vulnerable patients on health care workers' hands.

Hand sanitizers kill germs without irritating the skin, even after 100 applications a day. Washing so frequently with soap and water would take much longer and cause painful, severe dermatitis, doctors say.

But many hospitals have yet to fully adopt the new hand hygiene approach and are not equipped with enough sanitizer dispensers, said Michele L. Pearson, an infectious disease specialist who is leading the CDC hand hygiene effort. And health workers don't always use those that are available because they say they are too busy to stop between patients.

Pearson said dispensers should be installed wherever possible in hospitals and nursing homes, especially in public corridors. "Obviously there are some potential advantages to having it in a place where the health care worker sees it as they go in the door, as a passive reminder," Pearson said.

[neverdem]

FWIW

[relee]

Doctors and nurses aren't surprised anymore when they walk into isolation rooms at Inova Fairfax Hospital and sick patients ask them whether their hands are clean.

They still give those patients substandard care, however.

IIRC, 100% of the people in the DC area that got anthrax AND went to Inova Fairfax Hospital lived, while 100% of the people in the DC area that got anthrax AND DID NOT go to Inova Fairfax Hospital died.

YMMV.

[relee]

Well, I've never been at Inova Fairfax Hospital even though I drive by it frequently. If I ever get anthrax, I'll make a beeline for Inova Fairfax Hospital.

[Marie]

I gave birth to my second child in Germany. They do not use gloves when performing... a-hem... female examinations. And it wasn't just one doctor, either. My friends warned me before I went in.

[neverdem]

Congratulations for your family and surviving German obstetric techniques. Look at the 4th paragraph of the following link:

http://www.histmedindia.org/obgyn.htm

[CJ Wolf]

Not true, I was born there, My son and Daughter were born there, my son spent a month in the NICU. My friend spent two months in the ICU after a car crash in a coma for a while. I would say, from personal experience care at INOVA is exceptional for a hospital, The nurses are good the doctors are good as well. As with any human endevour there are some bad eggs that cause problems, But INOVA is a model for many hospitals around the country and people in the region here think it's the best of many choices.

[CJ Wolf]

Going into the NICU, it was incredible the sterilization process. Between baby handlings you would see the nurse stop and wash after each patient was checked.