Doctors: Wash your hands!

No conditions are so adverse that doctors and nurses cannot sanitize their hands.

March 10, 2007 21:49
3 minute read.
Doctors: Wash your hands!

washing hands 88. (photo credit: )


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To judge from the banner headlines on newspaper front pages and interminable chatter on the airwaves, Israel is in the grips of an unprecedented outbreak of an antibiotic-resistant microbe. The blame for its predations, moreover, is invariably ascribed to inadequate health budgets. The inevitable conclusion is that more money (NIS 2.5 billion for now and more subsequently) must urgently be prescribed to combat bacteria eruptions - in this case the Klebsiella pneumonia germ. Prime Minister Ehud Olmert has seized the prospect for good press by promising to "investigate the matter and find a solution." It's doubtful, though, that Olmert, despite his credentials as a former health minister, can really eradicate opportunistic infection from hospitals. Media presentations notwithstanding, it's hardly a local problem but one that plagues all hospitals throughout the developed world, as researchers constantly strive to stay one step ahead of bacteria, which develop resistance to certain antibiotics. Such bacteria proliferate in hospitals not only because that's where they come into contact with antibiotics, but also because that's where the most compromised immune systems are to be found. Premature babies, chronically ill geriatric patients and critical patients in intensive-care units are ubiquitously at risk. Fit individuals are unlikely to be affected. This phenomenon is no worse here than in comparable medical environments abroad. Health experts' nightmare everywhere is the evolution of microorganisms into hardier strains as speedily as labs turn out new antidotes. It's an unending contest, not only in Israel. Not every commonplace and predictable medical predicament - from hospital infections to expected seasonal flu outbreaks - is a justified cause for an uproar about finances. Not everything is about money. While overcrowding and manpower shortages do aggravate conditions, and while Israel would be undeniably well served by overdue new hospital construction, the situation here isn't the Western world's worst. Israel's health budget has risen steadily in recent years, even during recessions. In 2003, for instance, annual spending was NIS 21 billion, while in 2007 it stands at NIS 27b. In any case, no budgetary allowances can supplant elementary precautions which every medical institution must take. All hospitals, no matter how cash-strapped, can alleviate some of the hazards with the simplest and most remarkably inexpensive means - like making sure that staffers wash their hands. In this case no excuses will do. No conditions are so adverse that doctors and nurses cannot sanitize their hands. But, as surveys in most Western states show, many physicians and care givers are frighteningly negligent of this basic first-line defense against infection. Some hospitals oblige doctors to don surgical gloves before examining patients, as their hygienic habits cannot be fully trusted. The sad fact of the matter is that medical personnel are themselves the most significant disseminators of hospital-based contagion. All the advances of modern medicine, and all the sophisticated innovative instrumentation at its disposal, will never do away with the need to maintain elementary safeguards like scrubbing hands. Where this is done, rates of opportunistic hospital infections decline. However, where discipline is lax, greater numbers of severely weakened patients will fall prey to contamination. This accounts for differences among hospitals even within Israel - though no single hospital is free of the menace. More unique to Israel are lackadaisical visiting regulations. Israeli hospitals are swarmed with outsiders at all hours of the day. Often entire extended families throng small rooms where patients other than their relative are also lying. Additionally, children - notorious carriers of germs - are allowed to visit too freely in all too many hospitals. Changing exceptionally bad habits can make a much more dramatic difference than is generally admitted. Indeed, all the funds funneled into the system will be of no use if fundamental preventative measures are disregarded. We have no right to expect miracles from the medical profession, though sometimes its accomplishments seem nothing short of miraculous. We do have a right to expect that hospitals take basic measures to ensure that they are not responsible for making patients even less healthy than when they enter their doors.

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