By: James Searfoss, PA, Chief Medical Officer

Since 1847, hand washing has been known to reduce the spread of disease. It is still an effective, but underutilized technique for disease control. There are two major reasons for this:

  • It takes time. To wash your hands by the Centers for Disease Control & Prevention’s (CDC) six step protocol requires about two minutes. In a busy clinic or medical office, that means for clinical staff that a large portion of the day would be spent washing hands. This would be unacceptable to both clinicians and workflow conscious administrators.
  • Old curmudgeons. These are mostly clinicians who started their career prior to the 1990s. They have been doing without the hand washing for years and see no reason to change now. Some put on disposable gloves prior to patient contact which is at least as effective as using hand sanitizer.

The compromise is a quick squirt of hand sanitizer into one hand and five seconds to rub onto both hands. Hand sanitizer is recommended “only when soap and water are unavailable.” It is widely used as a quick convenience. The dispenser is always placed inside the patient area to give the illusion that the patient is now protected against the disease of the clinician’s last patient. This compromise is partially effective in the prevention of disease and a great sales technique. According to the CDC 2002 guidelines, hand sanitizer should only be used when hands are not “visibly dirty.”

Jen’s comment: Why not wash hands for 20 seconds with an antiseptic soap each time you visit the restroom or eat – the UPDATED recommendations for hand hygiene by CDC since 2002. The original CDC guidelines were meant more for in-patient settings, and likely skilled nursing. Also, since the CDC now says that “alcohol-based hand sanitizers are the preferred way to clean your hands in healthcare facilities” then the solution today, is to do both. Yet, I KNOW that clinicians don’t wash their hands after bathroom breaks and eating. Its the American way.

Personally, I sing “row-row-row your boat” while I wash my hands. And I have a decent hand lotion at my desk to address how dry my skin gets after a day of hand-washing.




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