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How To Minimize Your Chances Of Catching Infections
How To Minimize Your Chances Of Catching Infections
By: Herb Denenberg, Special To The Evening Bulletin
http://www.theeveningbulletin.com/site/news.cfm?newsid=17369742&BRD=2737&PAG=461&dept_id= 576361&rfi=6
By: Herb Denenberg, Special To The Evening Bulletin
http://www.theeveningbulletin.com/site/news.cfm?newsid=17369742&BRD=2737&PAG=461&dept_id= 576361&rfi=6
If you want to learn how to wash your hands, visit a hospital. But If you want to learn how not to wash your hands, you should also visit a hospital. There you will see some of the best and worst of hand washing techniques.
I recently had the occasion to visit someone at a hospital, and again I noted that despite the hundreds of thousands of infections and deaths caused by bad hand washing and other related practices, and all the talk of the importance of hand washing, nurses, doctors and other health care providers still don't get it when it comes to hand washing. Some do it right but far too many don't, so that's why you can easily observe both good hand washing techniques at a hospital or wherever health care workers do their job. You can see the violation of every principle of hand washing formulated in the last century and a half since the great Hungarian physician, Ignaz Philipp Semmelweis (1818-1865), discovered in 1847 that deadly infections of the blood stream of pregnant women (the infection was then called childbed fever) were transmitted to them by medical students going from cutting up cadavers in cadaver rooms to delivering babies without washing their hands in between.
The most fundamental mistake, of course, is not washing hands before patient contact. But even more common are bad hand washing techniques. For example, on my recent visit I noticed at least a half a dozen nurses and others washing their hands and then turning off the faucet with their hands. You have to assume the faucet is completely contaminated, as every one who washes their hands has used it. For that reason, you are supposed to wash your hands, dry them with paper towels, and then use one of the towels to touch the faucet in turning it off.
What about restaurants and hand washing? If you want to learn to wash your hands, go to a restaurant, or if you want to see the bad examples, you should also go to a restaurants. My experience is that servers and others handling food rarely wash their hands correctly, if at all, and typically provide bad examples. That could explain in large measure why hundreds of thousands of Americans end up with food poisoning every year.
Before proceeding with some ways to protect yourself from preventable infections, I have one little statistic that may capture your attention to the matter at hand. So I'll put it in the form of a question: What would weigh more - the total weight of all the bacteria in the world, or that of all the elephants in the world? Answer that and then consider another question: What would weigh more - all the bacteria in the world or the weight of all other living organisms in the world combined? The answer to both questions is the same - all the bacteria in the world.
In the fifth edition of a book, The Biology of Plants, by Peter H. Raven, Ray F. Evert and Susan E. Eichhorn, this statement appears: "Even though individual bacteria are quite small, the total weight of all the bacteria in the world is estimated to exceed that of all other living organisms combined; in the seas, for example, bacteria make up an estimated 90 percent of the total combined weight of all organisms. In a single gram of fertile agricultural soil, there may be 2.5 billion bacteria, 400,000 fungi, 50,000 algae, and 30,000 protozoa! About 2,500 species of bacteria are currently recognized, but many more await discovery."
I found that statistic about the weight of all bacteria in the world to be both incredible and instructive - incredible for obvious reasons but instructive because we often tend to discount or even ignore what we don't see. The statistic brings home with force the notion that what you can't see is still all about us in considerable quantity, and is a force both for doing good and bad. When dealing with the principles of hospital safety, restaurant safety, or even home safety, you can't forget the all-pervasive character of the bacteria and other microscopic creatures that can cause infection and death.
This brings us back to the question of how to protect yourself. In the hospital or other locations within the health care delivery system, you should insist that providers wash their hands before touching you. You should also insist that they sanitize stethoscopes or other equipment before it touches you. For example, a nurse should use an alcohol pad to run over the part of the stethoscope that will come into contact with you. The same goes for oximeters (those devices that you put your finger into to measure oxygen saturation) and blood pressure cuffs. While on that visit to a hospital, a so-called patient-care technician came into the room to take a blood pressure reading of the patient. I asked, "Have you sanitized the blood pressure cuff?" She said, "No." So I said please do so, and then I asked how many people have ever made that request to her. She said, "You're the first one." I said, "How long have you been working here?" She said, "Since 2000." That's a long history of potential for infection, but at least that one patient escaped one avenue of infection.
Here are some other self-defense measures to prevent infection that you can employ at home, at work, or anywhere else.
Wash Your Hands Often: This is often described as the single most important way to prevent hospital infections, in particular, and all other infections, in general. One study carried out on naval personnel, found that hand washing dramatically cuts the rate of respiratory infections. The specific advice from the University of California, Berkeley Wellness Letter (November 2006) is as follows: "Wash your hands often - before eating, before and after handling food, particularly raw meat or fish; after having sex; before putting in contact lenses or treating a wound; after using the toilet; after sneezing, coughing, or blowing your nose (particularly when you have a cold); after changing a diaper; after playing with a pet or cleaning a litter box; and after gardening or any other task that leaves hands grimy. Covering your mouth and nose when you cough or sneeze is another important preventive."
Wash Your Hands Correctly: Use soap and water. Hot water is most effective, but cold water will get the job done, too. Be sure and wash parts of the hands most often missed - the back of the hands and back of the thumbs. Web hands when washing to get between the fingers. The whole process should take at least 15 or 20 seconds. Rinse thoroughly and then dry, preferably with paper towels. Turn the faucet off with the towels. The University of California notes that soap and water don't kill microorganisms, but just make them slide off into the sink. However, the friction or washing and drying can kill bacteria, so that is why it makes sense to do both vigorously. Those popular alcohol washes do in fact kill bacteria.
Keep Your Hands Off Of Your Face: This is often omitted advice, but it is as important as washing your hands. You don't want to transport bacteria or other microorganisms from your hands for easy entry into your system through your nose, mouth, or eyes. So keep track of where your hands are and keep them off of your face. Watch doctors and nurses in hospitals for constant violation of good practice. They may wash their hands before dressing a wound or otherwise dealing with the patient. But in between, they might touch their hair or face, run their hands over the clothing, or otherwise contaminate hands right after washing them. I've coined a term of knowing where your hands are and being sure you don't recontaminate them before patient contact, food preparation, etc. The term is "hand discipline." You have to develop it, and know where your hands are and should be at all times, and should avoid recontaminating hands after washing.
The Wellness Letter says that ordinarily antibacterial soaps, sponges and cleansers aren't necessary, but alcohol sanitizers are useful as they are so convenient and don't require a sink or towels. The Wellness Letter also says that ordinarily masks aren't necessary, and there's no evidence that household products impregnated with antibacterial chemicals cut the risk of infection.
MOISTURIZE YOUR HANDS. Here's another piece of advice rarely given. If you are actually washing your hands as often as you should, chances are they will get dry. That can lead to cracking, and openings for infection. So to avoid that scenario, it makes sense to frequently moisturize your hands during the day, especially in the winter when dry skin is most common.
However, you should not moisturize before doing what you washed your hands to do, as that might recontaminate your hands. If you are preparing food, for example, wash your hands, prepare the food, wash your hands again and then moisturize them. Health care providers sometimes use dry hands as an excuse for not hand washing washing.
MAINTAIN HEALTH. You want a healthful diet, an exercise program, enough sleep, good control of stress, and all the rest to stay healthy. That means you will have a strong immunity system and will be best equipped to fight off infection. But no matter how careful you are, you still should get the flu vaccine as soon as possible, and a pneumonia shot as well, unless contraindicated.
The Wellness Letter offers some closing advice. You don't have to wrap yourself in a plastic envelope. However, those who are especially susceptible to infection should be extra careful. "But a healthy immune system (including the skin) is good at protecting against most microbes. Usually all that's needed is commonsense precautions like hand washing and not sharing intimate objects such as toothbrushes."
Herb Denenberg, a former Pennsylvania insurance commissioner and professor at the Wharton School, is a longtime Philadelphia journalist and consumer advocate. His column appears daily in The Evening Bulletin.
I recently had the occasion to visit someone at a hospital, and again I noted that despite the hundreds of thousands of infections and deaths caused by bad hand washing and other related practices, and all the talk of the importance of hand washing, nurses, doctors and other health care providers still don't get it when it comes to hand washing. Some do it right but far too many don't, so that's why you can easily observe both good hand washing techniques at a hospital or wherever health care workers do their job. You can see the violation of every principle of hand washing formulated in the last century and a half since the great Hungarian physician, Ignaz Philipp Semmelweis (1818-1865), discovered in 1847 that deadly infections of the blood stream of pregnant women (the infection was then called childbed fever) were transmitted to them by medical students going from cutting up cadavers in cadaver rooms to delivering babies without washing their hands in between.
The most fundamental mistake, of course, is not washing hands before patient contact. But even more common are bad hand washing techniques. For example, on my recent visit I noticed at least a half a dozen nurses and others washing their hands and then turning off the faucet with their hands. You have to assume the faucet is completely contaminated, as every one who washes their hands has used it. For that reason, you are supposed to wash your hands, dry them with paper towels, and then use one of the towels to touch the faucet in turning it off.
What about restaurants and hand washing? If you want to learn to wash your hands, go to a restaurant, or if you want to see the bad examples, you should also go to a restaurants. My experience is that servers and others handling food rarely wash their hands correctly, if at all, and typically provide bad examples. That could explain in large measure why hundreds of thousands of Americans end up with food poisoning every year.
Before proceeding with some ways to protect yourself from preventable infections, I have one little statistic that may capture your attention to the matter at hand. So I'll put it in the form of a question: What would weigh more - the total weight of all the bacteria in the world, or that of all the elephants in the world? Answer that and then consider another question: What would weigh more - all the bacteria in the world or the weight of all other living organisms in the world combined? The answer to both questions is the same - all the bacteria in the world.
In the fifth edition of a book, The Biology of Plants, by Peter H. Raven, Ray F. Evert and Susan E. Eichhorn, this statement appears: "Even though individual bacteria are quite small, the total weight of all the bacteria in the world is estimated to exceed that of all other living organisms combined; in the seas, for example, bacteria make up an estimated 90 percent of the total combined weight of all organisms. In a single gram of fertile agricultural soil, there may be 2.5 billion bacteria, 400,000 fungi, 50,000 algae, and 30,000 protozoa! About 2,500 species of bacteria are currently recognized, but many more await discovery."
I found that statistic about the weight of all bacteria in the world to be both incredible and instructive - incredible for obvious reasons but instructive because we often tend to discount or even ignore what we don't see. The statistic brings home with force the notion that what you can't see is still all about us in considerable quantity, and is a force both for doing good and bad. When dealing with the principles of hospital safety, restaurant safety, or even home safety, you can't forget the all-pervasive character of the bacteria and other microscopic creatures that can cause infection and death.
This brings us back to the question of how to protect yourself. In the hospital or other locations within the health care delivery system, you should insist that providers wash their hands before touching you. You should also insist that they sanitize stethoscopes or other equipment before it touches you. For example, a nurse should use an alcohol pad to run over the part of the stethoscope that will come into contact with you. The same goes for oximeters (those devices that you put your finger into to measure oxygen saturation) and blood pressure cuffs. While on that visit to a hospital, a so-called patient-care technician came into the room to take a blood pressure reading of the patient. I asked, "Have you sanitized the blood pressure cuff?" She said, "No." So I said please do so, and then I asked how many people have ever made that request to her. She said, "You're the first one." I said, "How long have you been working here?" She said, "Since 2000." That's a long history of potential for infection, but at least that one patient escaped one avenue of infection.
Here are some other self-defense measures to prevent infection that you can employ at home, at work, or anywhere else.
Wash Your Hands Often: This is often described as the single most important way to prevent hospital infections, in particular, and all other infections, in general. One study carried out on naval personnel, found that hand washing dramatically cuts the rate of respiratory infections. The specific advice from the University of California, Berkeley Wellness Letter (November 2006) is as follows: "Wash your hands often - before eating, before and after handling food, particularly raw meat or fish; after having sex; before putting in contact lenses or treating a wound; after using the toilet; after sneezing, coughing, or blowing your nose (particularly when you have a cold); after changing a diaper; after playing with a pet or cleaning a litter box; and after gardening or any other task that leaves hands grimy. Covering your mouth and nose when you cough or sneeze is another important preventive."
Wash Your Hands Correctly: Use soap and water. Hot water is most effective, but cold water will get the job done, too. Be sure and wash parts of the hands most often missed - the back of the hands and back of the thumbs. Web hands when washing to get between the fingers. The whole process should take at least 15 or 20 seconds. Rinse thoroughly and then dry, preferably with paper towels. Turn the faucet off with the towels. The University of California notes that soap and water don't kill microorganisms, but just make them slide off into the sink. However, the friction or washing and drying can kill bacteria, so that is why it makes sense to do both vigorously. Those popular alcohol washes do in fact kill bacteria.
Keep Your Hands Off Of Your Face: This is often omitted advice, but it is as important as washing your hands. You don't want to transport bacteria or other microorganisms from your hands for easy entry into your system through your nose, mouth, or eyes. So keep track of where your hands are and keep them off of your face. Watch doctors and nurses in hospitals for constant violation of good practice. They may wash their hands before dressing a wound or otherwise dealing with the patient. But in between, they might touch their hair or face, run their hands over the clothing, or otherwise contaminate hands right after washing them. I've coined a term of knowing where your hands are and being sure you don't recontaminate them before patient contact, food preparation, etc. The term is "hand discipline." You have to develop it, and know where your hands are and should be at all times, and should avoid recontaminating hands after washing.
The Wellness Letter says that ordinarily antibacterial soaps, sponges and cleansers aren't necessary, but alcohol sanitizers are useful as they are so convenient and don't require a sink or towels. The Wellness Letter also says that ordinarily masks aren't necessary, and there's no evidence that household products impregnated with antibacterial chemicals cut the risk of infection.
MOISTURIZE YOUR HANDS. Here's another piece of advice rarely given. If you are actually washing your hands as often as you should, chances are they will get dry. That can lead to cracking, and openings for infection. So to avoid that scenario, it makes sense to frequently moisturize your hands during the day, especially in the winter when dry skin is most common.
However, you should not moisturize before doing what you washed your hands to do, as that might recontaminate your hands. If you are preparing food, for example, wash your hands, prepare the food, wash your hands again and then moisturize them. Health care providers sometimes use dry hands as an excuse for not hand washing washing.
MAINTAIN HEALTH. You want a healthful diet, an exercise program, enough sleep, good control of stress, and all the rest to stay healthy. That means you will have a strong immunity system and will be best equipped to fight off infection. But no matter how careful you are, you still should get the flu vaccine as soon as possible, and a pneumonia shot as well, unless contraindicated.
The Wellness Letter offers some closing advice. You don't have to wrap yourself in a plastic envelope. However, those who are especially susceptible to infection should be extra careful. "But a healthy immune system (including the skin) is good at protecting against most microbes. Usually all that's needed is commonsense precautions like hand washing and not sharing intimate objects such as toothbrushes."
Herb Denenberg, a former Pennsylvania insurance commissioner and professor at the Wharton School, is a longtime Philadelphia journalist and consumer advocate. His column appears daily in The Evening Bulletin.