Cape Gazette

People's Pharmacy

Washing hands saves lives and money in the long run

By Joe and Teresa Graedon | Sep 29, 2011

Hundreds of years ago people feared going to hospitals. These were places of last resort because they were often ill equipped and unsanitary. Patients too often died.

Even childbirth was hazardous. Childbed fever claimed the lives of many women shortly after delivery. That's because doctors didn't know about the germ theory of disease.

Dr. Ignaz Semmelweis was a physician in Vienna in the middle of the 19th century. He noted that there was a huge difference in maternal mortality between two teaching clinics associated with the Vienna General Hospital.

The one teaching medical students had a much higher death rate than the one teaching midwives.

After analyzing all the differences, Semmelweis realized that the medical students were dissecting cadavers in a laboratory adjacent to the maternity wards. They did not wash their hands after their dissections or between deliveries. Dr. Semmelweis believed that the students should disinfect their hands after anatomy labs and between patients.

When he instituted this practice, maternal mortality rates dropped dramatically.

Dr. Semmelweis was not a popular man with his colleagues. What seemed so clear to him was rejected and ridiculed by other physicians. He was eventually forced into an insane asylum where he died.

Eventually, Dr. Louis Pasteur discovered germs and provided an explanation for the protection hand washing could provide. Despite our understanding of the germ theory, however, too many patients still catch infections in the hospital. Experts estimate that roughly 100,000 people die each year as a result.

One reader reported: "A close friend just barely recovered from a MRSA infection acquired during the course of a knee replacement. The whole episode lasted months and on two different occasions she almost lost her life." (MRSA, methicillin-resistant Staphylococcus aureus, is difficult to treat and often deadly.)

Another reader noted, "A dear relative of mine died from a staph infection received from a heart cath. It was a terrible way to go."

A heart cath is a tube that is inserted directly into a chamber of the heart.

A central line catheter goes into a large vein through the neck, chest or groin. It is used to administer medications such as chemotherapy, take blood samples or measure the pressure in the vein. But while this technology can be life saving, it has inherent dangers. One is that bacteria can get into the body and cause a life-threatening infection.

Following a set of common-sense guidelines can reduce this risk significantly. The first of these is hand hygiene. But just as in Semmelweis' day, it is difficult to get all healthcare providers to wash every time they should. Some studies suggest that health professionals follow hand hygiene guidelines only half the time.

When hospitals embrace teamwork and the use of practical interventions that include hand washing, they are able to reduce their rates of central-line infections and ventilator-associated pneumonia (Health Affairs, Sept. 2011). These interventions save lives and also save hospitals millions of dollars (American Journal of Medical Quality, Sept./Oct., 2011).

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