Over 150 years ago, a Hungarian physician named Ignaz Semmelweis tried to convince his medical colleagues that hand-washing could prevent infection. His research was rejected, and he was ostracized.
Today’s doctors believe in the germ theory of infectious disease and have embraced the idea of hand-washing to prevent the spread of diseases. They are a lot less concerned about other sources of infection, such as white coats, ties, stethoscopes and cellphones. Although there is good evidence that nasty germs can catch a ride on any of these surfaces, few health care organizations in the Unites States have rules about cleaning them.
We recently had the opportunity to talk to a doctor who works in a hospital. He admitted that there is no policy at his workplace about how often or in what manner white coats and ties should be washed. He observed that some of the residents’ white coats looked like they hadn’t been washed in weeks.
The residents are not the only ones who are careless about cleanliness. A study published in the American Journal of Infection Control (March 2009) noted: “White coats of health-care workers may be contaminated with pathogenic and resistant bacteria. Given that in this study, most of the health-care workers perceived their white coats as being dirty, and two-thirds of them had not washed their coats in more than a week, efforts could be directed at encouraging workers to launder their coats more frequently.”
Another study confirmed that health-care workers wash their white coats infrequently — about every two weeks (American Journal of Infection Control, June 2013). The authors found that only about half of the providers wearing white coats used hot water when washing them. That is disconcerting, since cold water is not very effective in decontaminating uniforms.
White coats are not the only potential sources of contamination. Other studies have found that neckties, stethoscopes, tablets and cellphones may also carry germs (Infection Control and Hospital Epidemiology, November 2016). In some cases, up to one-third of the items tested carried hard-to-treat methicillin-resistant Staphylococcus aureus (MRSA) or gram-negative bacteria.
Computer keyboards are frequently contaminated (BMJ Open, March 8, 2019). Studies don’t show whether or not this contamination has led to patient infections, however.
One area that hasn’t gotten much attention is patients’ hands. According to a study from the University of Michigan, patients who carry multi-drug-resistant organisms on their hands readily contaminate their environments (Infection Control and Hospital Epidemiology, September 2017). Such microbes can’t be killed easily and pose increasing risks for modern health care. People taking immune-suppressing drugs for conditions like cancer, psoriasis, rheumatoid arthritis and ulcerative colitis are more vulnerable.
What can patients do to protect themselves in the hospital? Obviously, they need to be conscientious about washing their own hands. They can and should insist that all health-care workers wash their hands before touching equipment or the patient’s skin. What’s more, they should ask all visitors, whether friends or family members, to wash or disinfect their hands upon entering and leaving the room. This might be socially awkward, but it could help protect both the patient and the visitors from spreading infection.
King Features Syndicate