Page 1650 - Week 06 - Tuesday, 12 May 2015
DR BOURKE (Ginninderra) (4.34): Modern infection control started with the story of Dr Ignaz Semmelweis, who in 1847 at Vienna General Hospital dramatically reduced the deaths of mothers after childbirth by simply getting doctors to wash their hands after delivering babies. Nowadays the World Health Organisation recommends five moments for handwashing: before and after touching a patient, before and after a procedure, and after touching the patients’ surrounds. However, this most basic of safety procedures is frequently ignored by hospital staff.
Astonishingly, Australian hospital staff only meet the set standards for handwashing 70 per cent of the time. And this is when the staff know they are being checked. Having unwashed hands for 30 per cent of the time seems to be okay for health authorities.
It gets worse still. When observations are broken down by staff category, it is the doctors who fail the most. Some studies have found that doctors in hospitals wash their hands as little as 60 per cent of the time. In contrast, hospital dental clinics record the highest rates of handwashing, with 88.7 per cent compliance, well ahead of emergency departments, neonatal intensive care units and renal units. Dentists could be proud of this achievement, but a failure rate of 11.3 per cent is still not good enough.
The US Centers for Disease Control and Prevention estimate that poor hygiene results in a whopping one in 25 patients with hospital-acquired infections. In Australia only the most deadly of hospital-based infections, golden staph, is reported on the MyHospitals website. There are 1.35 staph infections for 10,000 patient bed days for major hospitals across the country. One estimate for hospital-acquired infection in Australia is 180,000 cases per year, causing an extra two million additional days in hospital. Yet some hospital managers still want to debate whether handwashing noncompliance constitutes a patient safety error.
Here in Canberra the story is a little different to the rest of the country. The most recent audit, reported on the MyHospitals website, shows an estimated handwashing rate of 76.4 per cent for the October 2014 quarter at the Canberra Hospital. There were 21 cases of golden staph reported last financial year. Whilst these figures have significantly improved on the 2012-13 financial year levels, there is still much more that needs to be done.
ACT Health has responded to these outcomes by working to educate health professionals that handwashing is just as important in preventing the spread of disease and illness as other hygiene practices. However, the most highly educated of hospital staff—doctors—are the worst offenders. It is the failure of doctors to routinely implement their knowledge which is causing this problem and setting a poor example for other staff.
There are plenty of overseas examples of how to get doctors and other health workers to wash their hands. In 2013 the Cedars-Sinai Medical Center in Los Angeles