Clean hands, fresh gloves — Not always

Few things curb the spread of infections more than washing your hands and wearing sterile gloves. But how many health care practitioners actually follow that advice? The answer may be frighteningly few — especially if you’re dealing with a long-term care facility.

The Centers for Disease Control and Prevention in Atlanta studied a major nursing home in the Baltimore area to see whether employees were following the facility’s guidelines on hand washing and wearing gloves. The nursing home was of particular interest to the CDC because it had been the site of two bacterial outbreaks: one involving Clostridium difficile, the other, Streptococcus aureus.

In all, the CDC estimated that potential pathogenic transmissions occurred in 83% of observed patient/staff interactions. While gloves were used 82% of the time, they were only changed 16% of the time.

Hand-washing statistics were even more abysmal. The CDC found that in only 4% of cases did employees wash their hands at every mandated point in dealing with a patient. According to the CDC, in 63% of the cases, employees washed their hands after finishing patient care.

The CDC says the glove/hand-washing routine was taken most seriously during wound care procedures and was at its worst when employees were dealing with gastrostomy patients.

More troubling, nursing assistants handled more than half of the wound care interactions in this particular facility; these lower-rung employees may have the least knowledge of infection control.

Still, it’s possible that hand washing and sterile glove regulations may have gone overboard at some institutions, the CDC says, and that employees are simply using common sense when it comes to proper hygiene. Some patient interactions are far less likely to transmit bacteria than others, and the CDC suggests that institutions might concentrate on enforcing sterile procedure rules at only the most important points of patient/staff interaction.