Why a hand wash will keep the doctor away

ASKING someone to wash their hands after visiting the toilet or before eating food may come off as belittling, yet ignoring this seemingly simple practice of hygiene is stifling the fight against microbial infections.

The results are evident especially due to the soaring cases of faecal contamination. More concerns are now growing about similar negligence from health workers.

While hospital regulations globally stipulate that one must clean up before handling any medical procedures, health workers must ensure sterility from germs.

For surgical rooms, safety standards should even be higher and this necessitates surgeons, nurses and aesthetics to take a shower, put on disinfected gear and keep washing hands regularly between breaks of operations. For one reason or another, proper hand washing may not happen even in the hospital setting and the results are grave.

Dr Emile Rwamasirabo, a senior surgeon and chief executive officer of King Faisal Hospital, Kigali, says that poor hand hygiene by health workers is promoting the spread of infections to patients who come to hospitals seeking treatment.

“They visit hospitals to treat illnesses only to end up contracting other infections just because of poor hygiene practices. Sometimes it is realised upon discharge and this is a worldwide problem as most of the micro-organism are picked up by the hands,” he says.

Dr Rwamasirabo adds that the use of antibiotics within the hospitals worsens the situation since on exposure, most germs acquire infections and later develop into more resistant strains.

“This is why we are emphasising cleanliness and mostly within surgery rooms. Hand-washing is well known for limiting the number of infections that are passed to patients through contact.

“This means that when these infections are acquired in the hospital, they are passed to the patients through the health care providers despite the fact that washing hands would have been the cheapest and most effective way of fighting antimicrobial contamination,” he says.

In fact most of these hospital-acquired infections (nosocomial infections) are transmitted to patients from other patients or staff members who practice poor hand-washing techniques.

Research shows that if hospital staff members don’t wash hands between patients, they carry bacteria and viruses from one patient to another.

Some of the micro-organisms that are difficult to eradicate include methcillin-resistant staphylococcus aureus clostridium difficile and vancomycin-resistant enterocci, contaminant escherichia coli.

The burden is huge and in some cases, patients can die. For instance, a study carried out in the US found that approximately 10 percent of hospitalised patients are infected with a nosocomial infection during their stay and 20 000 people in the US die from them each year. Hands pick dirt from all surfaces Louise Ingabire, a nurse from Masaka District Hospital, explains that the biggest roadblock in ensuring proper hygiene remains in the practice of handling equipment and materials with a perception that all appear clean because they are micro-biologically safe.

“You may be working from a place that appears clean but it may not be safe from germs. People ignore the fact that every time they touch their body, clothes or shoes, their hands leave with micro-organisms. In case such a person seeks access to a patient, then chances are high that they will contaminate them with the acquired infections,” she explains.

According to Mayo Clinic, as one touches people, surfaces and objects throughout the day, they accumulate germs on hands. In turn, they can infect themselves by touching their eyes, nose or mouth.

Mayo Clinic goes ahead to suggest that the best ways to avoid getting sick and spreading illness is through hand-washing that requires only soap and water or an alcohol-based hand sanitiser — a cleanser that doesn’t require water.

A 2014 study carried out by the World Health Organisation in Uganda involving more than 650 surgical patients found that the rate of infections halved after the new measures of hand washing were introduced.

As a result, patients started spending less time in hospital, resulting in a cost saving both to them and the hospital.

Besides the surgical areas, one of the most sensitive places where good hygiene is needed is the nursery.

In the paediatrics section Globally, about 3,5 million children die before the age of five due to diarrhoea diseases, which can be prevented through effective hand-washing practices.

Dr Tharcise Ngambe, a paediatrician at King Faisal Hospital, says that hand-washing within the paediatric department is a necessity for the caretakers, nurses and doctors since young ones do not have fully developed systems to fight the germs.

“There is easy contamination during nursery care; even with feeding every contact, be it in food preparation for the little ones, some other person has to be involved and once those helping come with infections, the life of the young ones can be compromised. Hand-washing is just one simple thing that can prevent such infections,” says Dr Ngambe.

The other problem the paediatrician points out is that most respiratory infections that affect young people are caused by contamination and without frequent hand-washing; these contagious infections find their way into the body.

“If you clean one baby and you don’t clean yourself properly there is a risk and we have seen some cases. When someone comes with diarrhoea and does not maintain proper hand hygiene, spreading this to the whole unit won’t take time. For the premature babies, that would mean extra costs in trying to deal with these infections,” he adds.

Lack of effective hand washing is a problem in most communities and while several studies have concluded that good hand-washing saves lives, many people continue living recklessly despite the fact that proper disinfection using ordinary soap could be enough even to save a person from contracting infections as deadly as cholera. — Agencies.