Doctors and nurses wash their hands one-third to one-half as often as necessary.
Each year, according to the U.S. Centers for Disease Control, two million Americans acquire an infection while they are in the hospital.
Ninety thousand die of that infection.
“This is, embarrassingly, nothing new:
In 1847, at the age of twenty-eight, the Viennese obstetrician Ignac Semmelweis famously deduced that, by not washing their hands consistently or well enough, doctors were themselves to blame for childbed fever.”
Rising infection rates from superresistant bacteria have become the norm around the world.
Infection-control teams have been created to track down causes and build effective procedures, but staff are not following these new rules.
No part of human skin is spared from bacteria. Bacterial counts on the hands range from five thousand to five million colony-forming units per square centimeter. The hair, underarms, and groin harbor greater concentrations. On the hands, deep skin crevices trap 10 to 20 percent of the flora, making removal difficult, even with scrubbing, and sterilization impossible. The worst place is under the fingernails.
Plain soaps do, at best, a middling job of disinfecting.
Today’s antibacterial soaps contain chemicals such as chlorhexidine to disrupt microbial membranes and proteins.
Even with the right soap, however, proper hand washing requires a strict procedure. First, you must remove your watch, rings, and other jewelry (which are notorious for trapping bacteria). Next, you wet your hands in warm tap water. Dispense the soap and lather all surfaces, including the lower one-third of the arms, for the full duration recommended by the manufacturer (usually fifteen to thirty seconds). Rinse off for thirty full seconds. Dry completely with a clean, disposable towel. Then use the towel to turn the tap of. Repeat after any new contact with a patient.
Almost no one adheres to this procedure. It seems impossible.
Less irritating than soap, alcohol rinses and gels have been in use in Europe for almost two decades but for some reason only recently caught on in the United States.
They take far less time to use — only about fifteen seconds or so to rub a gel over the hands and fingers and let it air-dry.