# 4547
One hundred and sixty-three years ago, a Hungarian physician named Ignaz Semmelweis published a controversial medical book called Etiology, Concept and Prophylaxis of Childbed Fever.
Childbed, or puerperal fever, was a major cause of mortality and morbidity among postpartum women, and Semmelweis demonstrated in his Viennese hospital that its incidence could be greatly reduced by having doctors wash their hands before performing gynecological exams.
His theories were considered radical (Pasteur wouldn’t come up with his `germ theory’ for another 17 years), and went against all currently accepted medical science. Diseases, as everyone knew, were caused by imbalances in one of the `four humours’ in the body, to be cured by bloodletting, and had nothing at all to do with washing one’s hands.
Besides, it was outrageous to suggest that doctors might actually be causing disease and death among their patients.
Semmelweis was ridiculed, ostracized and eventually forced to leave his hospital post. He moved to Pest, and frustrated by the lack of acceptance of his theories, often denounced the medical community.
His fortunes and reputation suffered greatly due to his unrelenting advocacy of hand hygiene.
Eventually, he was committed to an asylum, a broken man, where he died at the age of 47. It was only in the years after his death, with the addition of Pasteur’s findings, that his theories became universally accepted.
Incredibly, and despite 150 years of evidence of proven efficacy, doctors and health care professionals around the world are still not as diligent with hand washing as they should be.
And those lapses cost thousands of lives, and billions of dollars in additional medical expenses, every year.
This from the CDC on HAI’s (Hospital Acquired Infections)
CDC strives to understand how healthcare-associated infections happen and to develop appropriate interventions. A new report from CDC updates previous estimates of healthcare-associated infections. In American hospitals alone, healthcare-associated infections account for an estimated 1.7 million infections and 99,000 associated deaths each year. Of these infections:
- 32 percent of all healthcare-associated infection are urinary tract infections
- 22 percent are surgical site infections
- 15 percent are pneumonia (lung infections)
- 14 percent are bloodstream infections
And this is just the United States, globally the numbers are much, much higher. Sadly, many of these complications could have been prevented by more stringent hand hygiene.
A point driven home again and again by Maryn McKenna in her book, Superbug: The Fatal Menace of MRSA which I reviewed here.
Remarkably, Maryn points out that 50% of health care workers fail to consistently wash their hands between patients.
Lisa Schnirring at CIDRAP has a good overview of the WHO’s (World Health Organization’s) and CDC’s push for better hand hygiene among health care workers.
An excerpt, and then I’ll return with more.
CDC joins WHO push for better hand hygiene in healthcare
Lisa Schnirring
Staff Writer
May 4, 2010 (CIDRAP News) – A day before the May 5 call to action from the World Health Organization (WHO) to improve hand hygiene practices in healthcare workers, the Centers for Disease Control and Prevention (CDC) held a clinicians teleconference on the topic and said it would unveil a new online resource tomorrow as part of the day's events.
The WHO is in its second year of a "Save Lives: Clean Your Hands Campaign," a global effort to help clinicians improve hand hygiene to reduce the number of healthcare-associated infections (HAIs). To build support for the campaign, the WHO has said it hopes to register 10,000 healthcare facilities to participate in the movement by May 5. As of Apr 23, 8,173 had registered, according to the WHO.
Katherine Ellingson, PhD, an epidemiologist with the CDC, told clinician participants at today's teleconference that the WHO is holding the event on May 5 to symbolize five fingers on the hand as well as the campaign's "My Five Moments for Hand Hygiene" list, which urges healthcare workers to clean their hands:
- before touching a patient,
- before clean/aseptic procedures,
- after body fluid exposure/risk,
- after touching a patient, and
- after touching patient surroundings.
Whether you work in a healthcare setting or not, today would be a good day to visit the CDC’s hand hygiene website, where you will find many resources, including a link to a new iPad/iPhone application called iScrub.
The World Health Organization’s Save Lives: Clean Your Hands" initiative hoped to enroll 10,000 health-care facilities by today. They have exceeded that by a considerable margin.
5 May 2010: an incredible achievement!
Over 11 500 health-care facilities have registered!
Awareness is important, of course. But we’ll have to see whether that translates to better compliance, and lower infection rates.
To round out this entry, some oldies but goodies from the AFD archives.
Doing The Hand Jive
Referral: Maryn McKenna On Hand Hygiene
Gonna Wash Those Germs Right Off Of My Hands
A collection of Hand Washing posters can be found at:
And lastly, a return engagement by that consummate entertainer, one that Maryn McKenna introduced me to a year ago . . . the one you all know and love . . give it up for GERMY, in the award winning all singing, all dancing production of Soapacabana!
Stick around for the outtakes!
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