Doctors, wash your hands

THE CALIFORNIA health department's recent finding about what caused an outbreak of infection at White Memorial Medical Center is almost as disturbing as the outbreak itself. Last December, seven children, including five infants so fragile they needed neonatal intensive care, contracted pseudomonas aeruginosa. Two of the infants died. The Boyle Heights hospital had failed to sterilize equipment used to help the children breathe, though the manufacturer specified that sterilization was necessary.

The saddest thing about this story, however, is how often it happens.

Every day in hospitals across the United States, wondrous medical procedures rescue patients from the brink of death. But there's a catch: In these same hospitals, hygiene is so inadequate that one out of every 20 patients contracts an infection. Why? Because of dirty hands, inadequately cleaned equipment, unclean rooms and lax procedures.

Astoundingly, over half the time, physicians and other caregivers break the most fundamental rule of hygiene by failing to clean their hands before treating patients, according to the Centers for Disease Control and Prevention. Caregivers often think putting on gloves -- without cleaning their hands first -- is sufficient, but this simply contaminates the gloves.

Cleaning hands, while essential, is only the first step. Stand in an emergency room and watch caregivers clean their hands, put on gloves and then reach up and pull open the privacy curtain to see the next patient. That curtain is seldom changed and is often covered in bacteria. The result? Caregivers' hands are soiled before reaching the patient.

Research shows that nearly three-quarters of patients' rooms are contaminated with dangerous bacteria, including the dreaded methicillin-resistant staphylococcus aureus. These bacteria are on cabinets, counter tops, bedrails, bedside tables, IV poles and on the floor under the bed. Once patients or caregivers touch these surfaces, their hands carry disease-causing bacteria to other patients.

Stethoscopes, blood-pressure cuffs, pulse oximeters and other equipment spread bacteria. Doctors and nurses rarely clean stethoscopes before listening to patients' chests, though the American Medical Assn. recommends it. When the inflatable blood-pressure cuff is wrapped around a patient's bare arm, is it cleaned first? Virtually never, though a recent study in the journal Infection Control and Hospital Epidemiology indicated that 77% of blood- pressure cuffs were contaminated.