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by Abigail Van Buren

All Hands in Hospitals Should Be Kept Clean

DEAR ABBY: When my father was in the hospital for cancer treatment (surgery and chemotherapy), a doctor examined my father's surgical wound without first washing his hands. When I asked the doctor to please wash his hands, he appeared angry. After that incident, my mother was afraid to ask anyone to wash his or her hands before attending to my father, because she wanted them to be nice to him. We were at their mercy.

I have seen doctors, nurses, technicians and other hospital personnel come into a patient's room and either not wash their hands, or simply run water over their hands before attending to a patient. I have also seen some people come into a patient's room with a cold.

In an article in the Annals of Internal Medicine (Jan. 19, 1999), a study showed that not only do health-care workers wash their hands less frequently than they should, but they do not wash them for even 10 seconds -- even though most protocols require 30 seconds of hand-washing. Studies have shown that washing hands for less than 10 to 15 seconds has limited effectiveness. Hands must be washed before putting on gloves, for just putting on gloves does not protect patients well enough.

An article in The New York Times (Nov. 9, 1999) reported that a study at Duke University found that only 17 percent of physicians treating patients in intensive care units washed their hands appropriately. The Times went on to report that, according to the Centers for Disease Control and Prevention, 5 percent of the people admitted to hospitals, about 1.8 million patients a year, will pick up an infection there, and 20,000 of them will die as a direct result. By contrast, 17,171 Americans died of AIDS in 1998. Hospital-acquired infections will contribute to the deaths of 70,000 more people.

Abby, this is a serious problem. Please help patients and their families speak up when they see a health-care worker failing to wash his or her hands properly. Also, please urge doctors, nurses and other health-care workers to do the right thing and wash their hands with soap for 30 seconds before touching a patient. -- DAUGHTER OF A PATIENT

DEAR DAUGHTER: Your letter is shocking, and I'm pleased to help spread the message. The Mayo Clinic, the world-renowned medical mecca in Minnesota, has sponsored "Infection Awareness Week" programs. Perhaps it's time other hospitals followed suit. Part of the campaign included prominently displaying posters along the corridors of the Mayo hospital complex that depicted a pair of hands under the terse message: "THE 10 MOST COMMON CAUSES OF INFECTION."

Doctors, nurses and other employees of the Mayo Clinic were reminded to wash their hands frequently by other posters bearing a catchy slogan: "A milligram of hand-washing is worth a kilogram of antibiotics."

I urge anyone who encounters a medical professional who fails to adhere to recommended hygiene practices to speak up about it and to report it to the hospital administrator in writing. I am told that instead of hand-washing, some institutions use alcohol-based hand rises and gels containing softeners that remove bacteria and are less irritating or drying to the hands.

Proper hygienic practices are an essential part of high-quality medical care. No one should settle for less.

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