Is there anybody out there? Physicians and handwashing

Our objectives were to evaluate the utility of electronic hand hygiene counting devices in outpatient settings and the impact of results feedback on physicians’ hand hygiene behaviors.

big-brother-1984We installed 130 electronic hand hygiene counting devices in our redesigned outpatient department. We remotely monitored physicians’ hand hygiene practices during outpatient examinations and calculated the adherence rate as follows: number of hand hygiene counts divided by the number of outpatients examined multiplied by 100. Physician individual adherence rates were also classified into 4 categories.


Two hundred and eighty physicians from 28 clinical departments were monitored for 3 months. The overall hand hygiene adherence rate was 10.7% at baseline, which improved significantly after feedback to 18.2% in the third month. Of the clinical departments, 78.6% demonstrated significant improvement in hand hygiene compliance. The change in the percentage of physicians in each category before and after feedback were as follows: very low (84.3% to 72.1%), low (8.6% to 14.3%), moderate (2.9% to 8.9%), and high (4.3% to 4.6%), from the first to third month, respectively. Based on category assessment, 17.1% of physicians were classified as responders.


Physicians’ adherence to hand hygiene practices during outpatient examinations was successfully monitored remotely using electronic counting devices. Audit and feedback of adherence data may have a positive impact on physicians’ hand hygiene compliance.

Utility of electronic hand hygiene counting devices for measuring physicians’ handwashing

American Journal of Infection Control, DOI:

A Arai, M Tanabe, A Nakamura, D Yamasaki, Y Muraki, T Kaneko, A Kadowaki, M Ito


Doctors fall ill in India as food safety ignored at hospital mess

Doctors at Gandhi Hospital and Osmania General Hospital are regularly falling ill thanks to the poor hygiene at the mess being run at the two hospitals.
Common complaints being made by the duty doctors after having their meals at the mess include vomiting sensation, stomach ache and low grade fever. In rare cases, a few have come down with typhoid too.

scrubs.foodIn fact, the situation is worse at the Gandhi Hospital mess above the emergency block, with the doctors claiming that it is infested with rodents.
“It’s the worst place to have food, but we are helpless as 70-80 duty doctors working for 24 hours at a stretch cannot bring food from home. I have an upset stomach now,” said a senior doctor at Gandhi Hospital on condition of anonymity.

The mess at the hospital neither has a fridge to store vegetables nor proper containers to store cooked food. One can see rotten tomatoes, chillies and other vegetables left to dry on pieces of paper and half-eaten food kept in dirty plastic containers without lids. Leftovers from lunch being served for dinner is also quite common. Adding to the troubles is the fact that the wash basin is situated in the common eating area itself.

However, when contacted, both OGH and Gandhi Hospital authorities denied the allegations. “The hospital food is served to both doctors and patients only after it passes quality tests every day. However, if any individual doctor has any issues, it can be brought to our notice,” said Dr G V S Murthy, superintendent, OGH.

Irony can be ironic: 47 resident doctors suffer food poisoning at hospital in India

About 47 resident doctors were admitted at the Sion hospital after they complained of vomit and diarrhea. Authorities suspect sweets distributed at the hospital’s canteen to be a cause.

dr.mcdreamyThe doctors started fealing uneasy after 12.00 noon on Friday post their breakfast at the canteen. The contractor who is appointed by the BMC gives these doctors breakfast free of cost but since it was Independence Day, there were sweets prepared out of Khava which were brought from Sion Koliwada. About 150 doctors had consumed these sweets out of which 47 complained of health issues.

Study: hand hygiene ‘too complex’ for Australian doctors

Doctors at most public hospitals are failing to follow national hand hygiene guidelines, a new study shows.

This is because the current five-step approach is too complex, says Professor Mary-Louise McLaws, an infectious diseases expert at the University of New South Wales.

handwash_south_park(2) handwash_south_park(2)Her study focused on how regularly health workers wash their hands before seeing a patient, which is the first hand-hygiene opportunity in the five-step plan adopted in Australia in 2009.

The approach should be simplified to focus on washing hands before and after seeing each patient, says Prof McLaws, who has published a report in the Medical Journal of Australia.

Human instinct will take care of other protocols, such as washing after coming into contact with bodily fluids.

“We need to simplify it. Five behaviour changes were thrown at the doctors and nurses all at once.

“The nurses got it. They are exemplary compared with doctors. But they work in teams and support each other.”

Welsh doctors ask, why should I wash my hands?***

Almost half of doctors in south Wales fail to wash their hands properly.

When health council member Alison Morgan claimed to have noticed staff not washing their hands and challenging doctors, they asked "why?"

Mrs Morgan described the situation as abysmal.

Latest figures from a spot check in December showed that only 58 per cent of doctors were complying with guidelines.

Victoria Franklin, Abertawe Bro Morgannwg University Health Board’s director of nursing, confirmed 42 per cent of doctors and consultants had failed to ensure their hands were cleaned properly.

Mrs Franklin said she had heard the issue discussed in a talk and said she believed it was important to ensure that the culture of not washing hands was completely unacceptable.

Doctors work while sick: study

People shouldn’t work preparing or serving food when they are sick because they may spread the illness. That’s become a food safety mantra, and yet outbreaks are repeatedly traced back to sick food workers – like the 300 who got sick with norovirus at the Haaaaarvard faculty club earlier this year after 14 food service employees were discovered to be working while sick. Or the 529 who got sick with norovirus at Heston Blumenthal’s Fat Duck restaurant last year, where again, the presence of sick food workers was cited as a contributing factor to the outbreak.

There’s a difference between saying what should be done – sick workers stay at home – and actually doing it – food service workers may get fired, whether they work with divas or in dives.

Medical doctors are the same.

The Associated Press reports more than half of doctors in training said in a survey that they’d shown up sick to work, and almost one-third said they’d done it more than once.

Dr. Anupam Jena, a medical resident at Massachusetts General Hospital in Boston, developed food poisoning symptoms halfway through an overnight shift last year, but said he didn’t think he was contagious or that his illness hampered his ability to take care of patients.

Jena, a study co-author, said getting someone else to take over his shift on short notice "was not worth the cost of working while a bit sick." He was not among the survey participants.

The researchers analyzed an anonymous survey of 537 medical residents at 12 hospitals around the country conducted last year by the Accreditation Council for Graduate Medical Education. The response rate was high; the hospitals were not identified.

The results appear in Wednesday’s Journal of the American Medical Association.

Nearly 58 percent of the respondents said they’d worked at least once while sick and 31 percent said they’d worked more than once while sick in the previous year.

Better food poisoning awareness amongst docs after E. coli O157 inquiry in Wales

Looks like the E. coli O157 death of 5-year-old Mason Jones, the illnesses of 160 other Welsh schoolchildren and the subsequent inquiry headed by Prof. Hugh Pennington were not entirely in vain.

The South Wales Echo is reporting today that the number of reported foodborne illnesses increased to 631 in June, compared to 234 in January.

The figures highlight the impact the public inquiry into the September 2005 E.coli outbreak in South Wales has had on the willingness of doctors and sufferers to report suspected food poisoning cases.

A spokeswoman for Rhondda Cynon Taf council said,

“The high-profile E.coli court case and subsequent inquiry that has generated increased awareness of food poisoning and, as a result, has driven up the number of cases that are reported to us.

“More GPs are diagnosing cases as food poisoning and not stomach bugs and reporting them to us."

Scottish docs told: wash your hands or you’re fired

My high school friend Dave used to say life is a series of hills and valleys: hills and valleys, Boog (that was my nickname, after Baltimore Orioles baseball great, Miller Lite spokesthingy and mesquite barbecue whiz, John “Boog” Powell).

Dave’s descriptor was insightful, to the point and accurate; or just really dull, I’m never quite sure which. I’m reminded of such adjectives when I find myself saying any approach to modifying food safety behavior requires a mixture of carrots and sticks.

I can be amazingly dull.

The National Health Service in Scotland has decided to focus on the sticks bit to get wayward physicians to wash their damn hands: doctors who don’t wash their hands could be fired.

An aide to Health Secretary Nicola Sturgeon said it was “unacceptable” for medical staff to flout hygiene rules, adding,

“Hand hygiene is an important part of our drive to tackle healthcare associated infection. We are now adopting a zero-tolerance approach to non compliance.”

Would you ask your doctor if she washed her hands?

I’m an advocate for asking questions.

Where was that fresh produce grown? What temperature is medium-rare? Did the cook wash his hands after going to the bathroom?

I also recognize that most people — including me — feel socially awkward asking such questions.

So, would you ask your doctor if he has washed his hands?

That’s what Carmela Fragomeni of The Hamilton Spectator in Canada asked this morning.

Hamilton resident Maria Pimentel says,

"I’m not comfortable to ask him because maybe he’d get upset."

Linda VanRysell believes doctors would always automatically be washing their hands before examining a patient, stating,

"I assume they’re professional."

Dr. David Higgins, chief of staff at St. Joe’s in Hamilton, said if he were to fail to wash his hands, he hopes patients would called him on it, adding,

"I should thank the person for doing it. That’s the ideal culture."