Insights

Why is this even a problem at all? There cannot be a single trained health care worker, anywhere in the world, who is unaware of the importance of hand-washing. Yet 2 million patients in America acquire an infection in the hospital every year — about one in 20 patients — and 100,000 people die of them. This is the fourth leading cause of death in America. Few families don’t have some horror story that started with a hospital-acquired infection. And hand-washing rates in other wealthy countries are not much different.
Why can’t hospitals get health care workers to wash their hands?

Hospitals in the United States enjoy access to running water. Virtually all of them have alcohol-rub dispensers, hundreds of them, in the hallways. Using one takes a few seconds. Yet health care workers fail to wash hands a good percentage of the times they should. Doctors are particularly bad.

A health care worker’s hands are the main route infections take to move from one patient to another. One recent study of several intensive care units — where the patients most vulnerable to infection reside — showed that hands were washed on only one quarter of the necessary occasions.

It’s not that hospitals are ignoring the problem — indeed, they are implementing all kinds of strategies to promote hand-washing. Nevertheless, it is rare to find a hospital that has been able to keep the hand-washing rate above 50 percent.

Readers of Fixes know our skepticism about relying on things that beep in health care. In general, the American health care system depends too much on technology and not enough on human connection. But in the case of hand-washing, the opposite may be true. Improving hand-washing rates is not simple – if it were, we wouldn’t have a problem. It requires many steps that take into account human foibles. But for measuring compliance — one of the most important and difficult steps — we may have been relying too much on people to do a machine’s job. There is a new technological fix available that — when accompanied by other changes — may be key to reducing dangerous infections.

Why is this even a problem at all? There cannot be a single trained health care worker, anywhere in the world, who is unaware of the importance of hand-washing. Yet 2 million patients in America acquire an infection in the hospital every year — about one in 20 patients — and 100,000 people die of them. This is the fourth leading cause of death in America. Few families don’t have some horror story that started with a hospital-acquired infection. And hand-washing rates in other wealthy countries are not much different.

Hospital-acquired infections cost the American health care system between $30 and $40 billion annually. Simple division puts the rough average cost of treating of a hospital-acquired infection at $15,000 to $20,000. One study that gathered data from other studies found the average cost of treating an infection with MRSA, a staph bacteria resistant to many antibiotics, is $47,000.

Read the complete column here.

Acknowledgment

Better Hand-Washing Through Technology From the New York Times April 25, 2011, 9:00 pm By TINA ROSENBERG