Handwashing technique in a pediatric intensive care unit
L. G. Donowitz
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 overgown. 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 remains an important but neglected method of interrupting the
transmission of hospital pathogens.
