Handwashing – Shakes and Bumps

fist-bump

Having just returned from SMACC, I’ve been thinking of all of the wonderful people with whom I got to interact. Always a delight is the inestimable Vic Brazil. I remember her gently mocking the EMCrit site for its absence of a single article on handwashing. While this is merely tangential, a search of the site for “handwashing” will now bring up this post saving me from any further shame:

 

Reducing pathogen transmission in a hospital setting. Handshake verses fist bump: a pilot study

Ghareeb PA1, Bourlai T, Dutton W, McClellan WT.

J Hosp Infect. 2013 Dec;85(4):321-3. doi: 10.1016/j.jhin.2013.08.010.

Abstract

Handshaking is a known vector for bacterial transmission between individuals. Handwashing has become a major initiative throughout healthcare systems to reduce transmission rates, but as many as 80% of individuals retain some disease-causing bacteria after washing. The fist bump is an alternative to the handshake that has become popular. We have determined that implementing the fist bump in the healthcare setting may further reduce bacterial transmission between healthcare providers by reducing contact time and total surface area exposed when compared with the standard handshake.

PMID: 24144553 [PubMed – in process]

Update:

Has it always struck you as silly to mandate hand-washing prior to putting on gloves for simple exams? Well, your intuition is quite correct it seems:

Am J Infect Control. 2013 Nov;41(11):994-6. doi: 10.1016/j.ajic.2013.04.007. Epub 2013 Jul 24.

Editorial

Here is a viewpoint on handshakes in the healthcare setting

Is hand hygiene before putting on nonsterile gloves in the intensive care unit a waste of health care worker time?–a randomized controlled trial.

Abstract

BACKGROUND:

Hand hygiene (HH) is recognized as a basic effective measure in prevention of nosocomial infections. However, the importance of HH before donning nonsterile gloves is unknown, and few published studies address this issue. Despite the lack of evidence, the World Health Organization and other leading bodies recommend this practice. The aim of this study was to assess the utility of HH before donning nonsterile gloves prior to patient contact.

METHODS:

A prospective, randomized, controlled trial of health care workers entering Contact Isolation rooms in intensive care units was performed. Baseline finger and palm prints were made from dominant hands onto agar plates. Health care workers were then randomized to directly don nonsterile gloves or perform HH and then don nonsterile gloves. Postgloving finger and palm prints were then made from the gloved hands. Plates were incubated and colony-forming units (CFU) of bacteria were counted.

RESULTS:

Total bacterial colony counts of gloved hands did not differ between the 2 groups (6.9 vs 8.1 CFU, respectively, P = .52). Staphylococcus aureus was identified from gloves (once in “hand hygiene prior to gloving” group, twice in “direct gloving” group). All other organisms were expected commensal flora.

CONCLUSION:

HH before donning nonsterile gloves does not decrease already low bacterial counts on gloves. The utility of HH before donning nonsterile gloves may be unnecessary.

Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

KEYWORDS:

Alcohol hand rub; Handwashing; Health care-associated infection; Infection control; Nosocomial infection

PMID: 23891455

You finished the 'cast,
Now get CME credit

Not a subcriber yet? Why the heck not?
By subscribing, you can...

  • Get CME hours
  • Support the show
  • Write it off on your taxes or get reimbursed by your department

Sign Up Today!

.

Subscribe Now

If you enjoyed this post, you will almost certainly enjoy our others. Subscribe to our email list to keep informed on all of the ED Critical Care goodness.

This Post was by , MD, published 9 months ago. We never spam; we hate spammers! Spammers probably work for the Joint Commission.

Comments

  1. Thanks Scott, I’ve just shared with the Infectious Disease and Medical Leadership in our hospital, I’m cautiously optimistic!

  2. I reckon I fist bumped 50% of the smaccGOLD delegates …. Shaking hands is SO last year.

Trackbacks

  1. […] EMCrit actually has a post on hand hygiene with Handwashing – Shakes and Bumps […]

Speak Your Mind (Along with your name, job, and affiliation)