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Hand washing by hospital visitors has never been more important

Hand washing by hospital visitors has never been more important

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By Edward Sutanto

Practicing hand hygiene through hand washing remains one of the simplest, cheapest and most effective measures to prevent infections. Unsurprisingly, hospitals often hold hand washing campaigns aimed at health care providers, but seldom at hospital visitors.

Yet, hospital visitors may have a unique position in disease transmission as they can unknowingly spread infectious diseases from the community to hospitalized patients. Perhaps even more alarmingly, visitors can spread diseases – be it bacterial, viral or fungal – from hospitals to the community.

This issue is especially relevant given the current Covid-19 pandemic that has now spread to every continent, except Antarctica, and all states within the U.S. The state of New York has been hit particularly hard as it currently has the highest number of Covid-19 cases among all U.S. states.

In addition, there is also the silent risk of spreading antibiotic-resistant bacteria from the hospital, a noted breeding ground for such bacteria, to the community. The Centers for Disease Control and Prevention has reported that at least 2.8 million people per year get an antibiotic-resistant infection – among those, more than 35,000 people die – in the U.S.

A recent Johns Hopkins study has shed light on hand hygiene behavior among hospital visitors. It delivered both bad and good news. The bad news is hand washing among hospital visitors remains low, even after all the “clean your hand” signs being put in numerous places within the hospital and general hand hygiene education in public media.

However, the good news is, when visitors are verbally reminded to clean their hands with the ubiquitously available sink or hand sanitizer station, the hand hygiene compliance increases by more than eight-fold (up to 80%). However, health care providers are already busy. It is not impossible, but if they receive the added task of verbally reminding hospital visitors to clean their hands, it will require a modest addition to the number of staff to accomplish this result.

It is unfortunate that many well-intentioned hand hygiene interventions, including educational materials like brochures and posters, along with easily available hand washing stations, have failed to achieve their intended goal for hospital visitors. This stands in contrast with the hand hygiene compliance among health care providers, which consistently surpasses the 90% mark. It is salient that we translate these results to achieve similar compliance with hospital visitors.

When we visit our loved ones in the hospital, the least we want to do is to cause any more harm to them. The 20-second act of hand washing will go a long way in addressing this issue. The current Covid-19 pandemic should serve as a wake-up call for us to start emphasizing the importance of hand hygiene, including for hospital visitors, and perhaps we will be better equipped to deal with the next pandemic.

Dr. Edward Sutanto, MD,  is a postdoctoral fellow in Roswell Park Comprehensive Cancer Center.

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