At last weekend’s MITSS patient safety workshop, some of us remarked out loud that it would be great to have a simple video teaching newly admitted hospital patients the importance of hand washing, and even showing them how to speak up to a staff person who doesn’t wash before touching.
Well, seek and ye shall find: this just arrived via Twitter, forwarded to us by Susan Carr, editor of Patient Safety and Healthcare Quality magazine. From the good people at CDC:
I especially love that they posted (at http://www.cdc.gov/CDCTV/HandHygiene) all sorts of ways to use this resource: the embeddable code for the video, downloadable versions of the video file, a PDF transcript, and an overdubbed Spanish version (with Spanish transcript).
Hey hospitals – let us know when you’ve made this (or an equivalent) available to your patients!
This may be conflicting information, but I felt compelled to link.
LINK: Germ Theory Of Disease Is One Of The False Foundations Of Modern Medicine
Are you serious that you don’t believe in germs?
Then how do you explain that the rate of hand washing correlates with rate of hospital acquired infections, and how do you explain Lister’s experience at reducing wound infections and Semmelweiss’s experience, described above?
The paper you linked to suggests that a healthy body naturally resists germs. Are you suggesting that hand washing in a hospital room remotely causes the patient’s body (over in the bed) to become healthier?
It’s my opinion that germs do not cause sickness. Germs are everywhere and life on this earth could not have existed without them.
I would also be one to promote the title ‘Healthy eating saves lives’ – building a strong immune system takes worrying about germs out of the equation!
Just my humble opinion, ofcourse.
I applaud the CDC’s commitment and persistence to promote hand washing. A few years back I wrote about “The Semmelweis Reflex” defined as the dismissing or rejecting out of hand any information, automatically, without thought, inspection, or experiment.” The ‘reflex’, though not part of his legacy, honours Dr. Semmelweis, an astute Austrian-Hungarian physician called the “savior of mothers”. Semmelweis discovered in *1847* that the number of new cases (incidence) of childbed fever could be drastically cut by use of *hand washing* standards in obstetrical wards. It took the medical establishment years to adopt his findings into practice. This failure to recognize and apply hand washing led to tragic and unnecessary deaths of thousands of young mothers. Semmelweis’ case is an example of a situation where scientific progress was slowed down by the inertia of established professionals.
163 years later, we keep trying.
Definition from http://en.wikipedia.org/wiki/Ignaz_Semmelweis
Overall I liked the video, but I found the vignette of the patient’s relative asking the physician to wash her hands to be overly submissive.
“Dr., I’m embarrassed to even ask you this…:
Why would this be embarrassing? Is it because the patient is questioning the power of the physician? I wish that they had used a more empowered sounding patient to demonstrate how to ask professionals to wash their hands.
Rats, I SWEAR I posted this reply many hours ago. Ugh.
Penelope, I agree, but I think the challenge is how to reach people and show them the way when they’re (for whatever reason) very disinclined to speak up.
At the MITSS workshop I talked with empowered *hospital staffers* who, when the themselves became patients, *still* wouldn’t speak up in the way demonstrated in this video.
I’m sure shrinks will do a ton of work to identify why this happens, but in the meantime I imagine the CDC people knew that too and, as a good practice for training, modeled how to do it: tacitly, it says “If you can’t imagine how to handle such a conversation, here’s an example.”
Hi Dave, I thought about this more last night after I wrote my reply, and perhaps I am being too critical.
I do think that many people would have difficulty challenging their physicians – even for something as basic as hand sanitizing. It is interesting that even professionals have difficulty with this as well.
I’m not sure I could come up with a better way to demonstrate for patients myself, so I will give props to the video for trying.
This reminds me of how professional culture was found to be a problem with respect to airline safety. When employees deferred to pilots, unwilling to challenge their perceived authority, problems were left unchecked.
I suppose it is the culture of not challenging (or feeling embarrassed to challenge) the physician that bothers me. I wish there were a way to demonstrate a spirit of partnership and equality in the interaction.
Penelope,
> I wish there were a way to demonstrate
> a spirit of partnership and equality
Bingo: participatory medicine. Have a look at these:
Recent: Compliance: it’s not just for patients anymore
From May: Patient-centered care: coordination and putting the compliance shoe on the clinician’s foot (Far longer and wandering)
Current, on Running A Hospital: Do Patients Want to Punish? (See my comment tonight, about exactly your point.)
Part of that video seems very unrealistic. When the patient asks the doc to wash her hands, the doc says “I just washed them” the patient says “Please wash them in front of me” and the doc says “Sure, no problem”.
Seriously, do you think the average doc would behave that way? Docs do not like being told what to do. More likely they would scream at the patient and storm out of the room.
But that’s the point, Tom – perhaps today a lot of docs & nurses would respond like that, but this is part of culture change: modeling the new behavior, to set expectations for the customer (patient, in this industry) and for the service provider.
“This is what you should expect. Provider, here’s what we expect of you.”
I’m not saying this is easy or instant, but it’s starting, and as the post says, even highly empowered and trained people seem to need help in speaking up about this, so I think this is worthy and sensible.