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Handwashing Technique in a Pediatric Intensive Care Unit FREE

Leigh G. Donowitz, MD
[+] Author Affiliations

Accepted for publication Oct 13, 1986.

Reprint requests to Department of Pediatrics, Box 386, University of Virginia Medical Center, VA 22908 (Dr Donowitz).


Am J Dis Child. 1987;141(6):683-685. doi:10.1001/archpedi.1987.04460060099044.
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• A one-year prospective study of 454 patients in a pediatric intensive care unit was performed to determine whether the rate of breaks in handwashing technique was different between medical professionals and to determine whether these rates were altered by the use of the gown. A handwashing break in technique was defined as not washing your hands after direct contact with either patients or support equipment before contact with another patient or departure from the unit. Ninety-four two-hour sessions were monitored by a research nurse during four cross-over periods of gown and no-gown use. Physicians did not wash their hands in 834 (79%) of 1056 contacts, nurses in 1073 (63%) of 1714 cases, occupational therapists in 21 (62%) of 34 cases, respiratory therapists in 269 (78%) of 346 cases, and radiology technicians in 59 (78%) of 76 cases. Nurses used significantly better technique when compared with physicians, respiratory therapists, and radiology technicians. Gown usage overall did not affect these breaks in handwashing technique rates. Physicians did not wash their hands 75% of the time when gowns were not used and 82% of the time when gowns were used. Handwashing rates were unaffected by gown use in all other professionals. Handwashing an important but neglected method of interrupting the transmission of hospital pathogens.

(AJDC 1987;141:683-685)

REFERENCES

Albert RK, Condie F:  Handwashing patterns in medical intensive care units . N Engl J Med 1981;;304:1465-1469.
Mortimer EA, Lipsitz PJ, Wolinsky E, et al:  Transmission of staphylococci between new-borns: Importance of the hands of personnel . AJDC 1962;;104:289-295.
Steere AC, Mallison GF:  Handwashing practices for the prevention of nosocomial infections . Ann Intern Med 1975;;83:683-690.
Knittle MA, Eitzman DV, Baer H:  Role of hand contamination of personnel in the epidemiology of gram-negative nosocomial infections . J Pediatr 1975;;86:433-437.
Interview with Philip A. Pizzo:  Isolation techniques in hospitals . Pediatr Infect Dis
Salzman TC, Clark JJ, Klemm L: Hand of personnel as a mechanism of cross-infection in nosocomial infections with antibiotic-resistant Escherichia coli and Klebsiella-Aerobacter . Antimicrob Agents Chemother 1967;;7:97-100.
Rammelkamp CH Jr, Mortimer EA Jr, Wolinsky E:  Transmission of streptococcal and staphylococcal infections . Ann Intern Med 1964;; 60:753-758.
Frappier-Davignon L, Frappier A, St Pierre J:  Staphylococcal infection in hospital nurseries: Influence of three different nursing techniques . Can Med Assoc J 1959;;81:531-536.
Fleck AC Jr, Klein JO:  The epidemiology and investigation of hospital-acquired staphylococcal disease in newborn infants . Pediatrics 1959;;24:1102-1107.
Wolinsky E, Lipsitz PJ, Mortimer EA Jr, et al:  Acquisition of staphylococci by newborns: Direct versus indirect transmission . Lancet 1960;;2:620-622.
Eisenach KD, Reber RM, Eitzman DV, et al:  Nosocomial infections due to kanamycin-resistant (R)-factor carrying enteric organisms in an intensive care nursery . Pediatrics 1972;;50: 395-402.
Lowbury EJL, Lilly HA, Bull JP:  Disinfection of hands, removal of transient organisms . Br Med J 1964;;2:230-233.
Sprunt K, Redman W, Leidy G:  Antibacterial effectiveness of routine handwashing . Pediatrics 1973;;52:264-271.
Larson E:  Handwashing and skin physiologic and bacteriologic aspects . Infect Control 1985;;6:14-23.
Larson E, Leyden JJ, McGinley KJ, et al:  Physiologic and microbiologic changes in skin related to frequent handwashing . Infect Control 1986;;7:59-63.
Morrison AJ, Gratz J, Cabezudo I, et al:  The efficacy of several new handwashing agents for removing non-transient bacterial flora from hands . Infect Control 1986;;7:268-272.

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References

Albert RK, Condie F:  Handwashing patterns in medical intensive care units . N Engl J Med 1981;;304:1465-1469.
Mortimer EA, Lipsitz PJ, Wolinsky E, et al:  Transmission of staphylococci between new-borns: Importance of the hands of personnel . AJDC 1962;;104:289-295.
Steere AC, Mallison GF:  Handwashing practices for the prevention of nosocomial infections . Ann Intern Med 1975;;83:683-690.
Knittle MA, Eitzman DV, Baer H:  Role of hand contamination of personnel in the epidemiology of gram-negative nosocomial infections . J Pediatr 1975;;86:433-437.
Interview with Philip A. Pizzo:  Isolation techniques in hospitals . Pediatr Infect Dis
Salzman TC, Clark JJ, Klemm L: Hand of personnel as a mechanism of cross-infection in nosocomial infections with antibiotic-resistant Escherichia coli and Klebsiella-Aerobacter . Antimicrob Agents Chemother 1967;;7:97-100.
Rammelkamp CH Jr, Mortimer EA Jr, Wolinsky E:  Transmission of streptococcal and staphylococcal infections . Ann Intern Med 1964;; 60:753-758.
Frappier-Davignon L, Frappier A, St Pierre J:  Staphylococcal infection in hospital nurseries: Influence of three different nursing techniques . Can Med Assoc J 1959;;81:531-536.
Fleck AC Jr, Klein JO:  The epidemiology and investigation of hospital-acquired staphylococcal disease in newborn infants . Pediatrics 1959;;24:1102-1107.
Wolinsky E, Lipsitz PJ, Mortimer EA Jr, et al:  Acquisition of staphylococci by newborns: Direct versus indirect transmission . Lancet 1960;;2:620-622.
Eisenach KD, Reber RM, Eitzman DV, et al:  Nosocomial infections due to kanamycin-resistant (R)-factor carrying enteric organisms in an intensive care nursery . Pediatrics 1972;;50: 395-402.
Lowbury EJL, Lilly HA, Bull JP:  Disinfection of hands, removal of transient organisms . Br Med J 1964;;2:230-233.
Sprunt K, Redman W, Leidy G:  Antibacterial effectiveness of routine handwashing . Pediatrics 1973;;52:264-271.
Larson E:  Handwashing and skin physiologic and bacteriologic aspects . Infect Control 1985;;6:14-23.
Larson E, Leyden JJ, McGinley KJ, et al:  Physiologic and microbiologic changes in skin related to frequent handwashing . Infect Control 1986;;7:59-63.
Morrison AJ, Gratz J, Cabezudo I, et al:  The efficacy of several new handwashing agents for removing non-transient bacterial flora from hands . Infect Control 1986;;7:268-272.

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