Re: Handwashing

August 3, 2002

I am a nurse(RN) and also HepC with cirrhosis...all that aside, I am appalled at the number of doctors nurses and other personell that do not wash thier hands.No wonder there are so many nonsocomial(hospital acquired) infections.A glove is not a substitute for good hand washing!!! Laurie

claudine intexas wrote:

>>>--- Jeanine London <hepc@...> wrote:I agree with both of you. It is IMPOSSIBLE to acheive a healthybioterrain in today's world. We have depleted the nutrition and thehydrides, the Life, right out of our food and water supply.<<<Maybe I just don't know what you are talking about when you say"hydrides". Hydrides are in just about everything. They areEVERYWHERE. All a hydride is is hydrogen combined with some otherelement.I don't think it was EVER possible to achieve a healthy 'bioterrain'.Conditions have never been perfect, ever. Examination of the remainsof humans from hundreds of years ago, a thousand years ago, MANYTHOUSANDS of years ago, long before pesticides, artificalfertilizers, etc., show evidence of disease and parasites. The humanbody, the immune system, is VERY complex, and so are diseases! Evenif you could eat the perfect organic diet and live in an area with nopollution, some virus could still come along and take hold - even inthe healthiest body. And Pasteur and Bechamp didn't even knowviruses existed. Viruses, and bacteria too for that matter, evolveand mutate to find ways to evade our immune system. This is nothingnew, it's been going on for as long as humans and diseases have hadto co-exist on this world. If doctors from the 1800's (when lifeexpectancy was about 40 - 50 years of age, compared to 76.9 years in2000) are going to be used as a reference as to the "biologicalterrain", I would have to wonder if the 'terrain' they were speakingof was the uncleanliness of both the environment in which theypracticed, and the lack of knowledge about the simple technique ofhand washing. In the late 1840's Dr. Ignaz Semmelwiess postulatedthat doctors and medical students were the cause of 'childbed fever'and began insisting his students washed their hands after attendingan autopsy and before going into the delivery room. Physicians ofthat time were extremely insulted that anyone could believe THEY werethe cause of the spread of disease. He was ridiculed and ostracizedfor his 'theory'. "In the 1870's in France, one hospital was called the House ofCrime because of the alarming number of new mothers dying of childbedfever within its confines. In 1879, at a seminar at the Academy ofMedicine in Paris, a noted speaker stood at the podium and cast doubton the spread of disease through the hands. An outraged member of theaudience felt compelled to protest. He shouted at the speaker: "Thething that kills women with [childbirth fever]...is you doctors thatcarry deadly microbes from sick women to healthy ones." That man wasLouis Pasteur. Pasteur, of course, contributed to the germ theory ofdisease (and the developer of pasteurization)." (Quote from Hygenius- The History of Hand-Washing)It was not generally accepted until well into the 20th century thatcleanliness of the 'terrain' was an important factor in the spread ofdisease. Pasteur and Bechamp may have been progressive and theleaders in the medical field in their day, but we've come a LONG wayin our knowledge of health, medicine, diseases ---- just abouteverything really. Unfortunately, simple handwashing, or rather, alack of, is still a major problem in hospitals, nursing homes, andother medical offices, and is still one of the major causes ofinfections in hospitals and nursing homes. (I won't even start on thelack of gloving when drawing blood, starting IV's, doing blood sugartests, etc.)Sorry if I sort of got off track on handwashing. It's my current 'petpeeve'. When I was trained handwashing and cleanliness, andhandwashing, and sterilization of all instruments, and morehandwashing, was drumed into my head over and over again, and everyday I go to the nursing home and watch all the aids and nurses thinka pair of gloves is a substitute for washing their hands. Today isthe FIRST TIME since my grandmother went into this nursing home inApril that I actually saw someone wash their hands without beingtold. (He must be brand new.)Claudine__________________________________________________

August 3, 2002

--- LAURIE ALEX & lt;Lmalex@... & gt; wrote:

& gt;

& gt; I am a nurse(RN) and also HepC with cirrhosis...all that aside,

I

& gt; am appalled at the number of doctors nurses and other personell

& gt; that do not wash thier hands.No wonder there are so many

& gt; nonsocomial(hospital acquired) infections.A glove is not a

& gt; substitute for good hand washing!!! Laurie

I know - and it's driving me crazy! It's so basic, so simple! All the

aids and nurses at the nursing home hide when they see me. I know

they are busy, but it's NO excuse!

So many people think of hospitals as clean, sterile, and safe places.

If only they knew how wrong they are! (Don't let me even BEGIN to get

started on infections in the newborn nursery or NICU!!! When I would

go to see any newborn I had to transfer to NICU I would scrub -

nails, hands, arms - and gown, then watch other personnel, including

doctors, go from one sick baby to another with no hand washing, no

cleaning a stethoscope.... And then they wonder why the outbreak of

E.Coli infection in half the babies there.... see, I did get

started!) I saw a disgustingly horrible report recently on doctors

and hand washing in various hospitals. I can't remember it exactly,

but the AVERAGE number of doctors who washed their hands properly

before and after touching a patient was something like only 24% - and

the HIGHEST rate found at any hospital was 48%! A hospital is a

really good place to catch an infection, and they do tend to be

treatment-resistant infections. My advice - stay out of hospitals

unless absolutely necessary! They are great places to get sick!

Claudine

__________________________________________________

February 22, 2010

Hmmmmm.... as someone who grew up East of Suez, Sheelah,

I wonder how many HVs know to take their shoes off on entering certain

households?

But a cautionary note: in several cultures it is rude/obscene to show the

soles of your feet towards your hosts!

Perhaps the best rule of thumb is to see what the Mother has on her feet, if

anything, and ask if you should do the same....

In terms of handwashing, what did you do on visiting a traditional Roma

caravan in your Cambridge days, Sheelah - I was told in those cramped

circumstances cleansing rituals could be a sign of welcome and mutual respect

between women?

Warm regards through the snow,

Woody.

________________________________

From: on behalf of Sheelah Seeley

Sent: Sun 21/02/2010 20:37

Subject: Return to Statute - sign sign sign!

Thank you Maggie - I wasn't aware of this. I have sent your email on to

recent attendees at some of our courses.

On another note - I have an American research colleague, interested in early

detection of postpartum depression and first line primary care

interventions/treatments for ppd. She asks if the HV primary visit is

mandatory in UK, and if so where is this published? I would grateful if

anyone has this information.

On yet another note - I have just been working in a PCT where the HVs MUST

wash their hands on entering each house and again before leaving.. Have I

missed something here? Is this happening anywhere else?

Personally, I think it is crazy - for lots of reasons, but think of a new

mother on the verge of OCD, say, and the HVs first action is to obsessively

wash her hands...............

Sheelah

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February 22, 2010

Hi Woody

The Cambridge days are centuries ago now! And the idea of cleansing rituals completely passed me by.........what a terrible health visitor I was.

The serious question was - is this directive to home visitors ( hand washing on entering and leaving each house) something that is happening widely?

Sheelah

February 22, 2010

Hi SheelahI think the points you are making are important. We should be very aware of avoiding cross-infection, especially if going from e.g. a household where there is a virus infection of some sort to a new baby. I think most health visitors would ask to wash their hands before examining a very young baby, as well, and mothers would expect that. But don't we have very effective hand cleansing gels these days? Surely the answer would be for every visitor to be issued with these to have in the car, so they can use them between visits. I agree, it would cause all sorts of anxieties for the mothers, who have enough to put up with from the health visiting service these days, without yet more institutionalised bad practice.I remember just once in my entire time in practice badly needing a toilet, and asking a mother I thought I knew quite well if I could use hers; she was seriously discomfited by it, and sure it was a ploy on my part to check how clean she kept it (her house was always far cleaner than mine!). I kept my legs crossed after that! best wishesOn 22 Feb 2010, at 10:40, Sheelah Seeley wrote:Hi WoodyThe Cambridge days are centuries ago now! And the idea of cleansing rituals completely passed me by.........what a terrible health visitor I was. The serious question was - is this directive to home visitors ( hand washing on entering and leaving each house) something that is happening widely? Sheelah Cowleysarahcowley183@...http://myprofile.cos.com/S124021COn

February 22, 2010

Valid points indeed, I always use an alcohol hand rub before and after handling a new baby, as I feel mothers expect you to cleanse in some way, also coming from an intensive care background (NICU) I am afraid hand hygiene is always at the forefront of my mind, especially with so many droplet borne infections, in some instances it is actually cleaner to use a hand gel than a family towel that has been repeatedly used. As far as drinking tea, I uphold the idea that if families offer a hot drink then it should be accepted, as it does give the notion of an unhurried visit and time giving on the Health Visitors part (and on some days could be the only fluid you get!!) I was taught this as good practice when doing my training, and a chat over a cup of tea can reveal a

great deal and build on the relationship between HV and client, I've had some amazingly fancy coffees out of high tech machines and simple builder strength brews, but they all allow time for extra interaction and building of relationships!

Time for a cuppa I think! (Maybe it could become part of Statute along with the Primary visit!!)

Regards

Mel

From: Cowley <sarahcowley183@...> Sent: Mon, 22 February, 2010 11:57:59Subject: Re: RE: Handwashing

Hi Sheelah I think the points you are making are important. We should be very aware of avoiding cross-infection, especially if going from e.g. a household where there is a virus infection of some sort to a new baby. I think most health visitors would ask to wash their hands before examining a very young baby, as well, and mothers would expect that. But don't we have very effective hand cleansing gels these days? Surely the answer would be for every visitor to be issued with these to have in the car, so they can use them between visits. I agree, it would cause all sorts of anxieties for the mothers, who have enough to put up with from the health visiting service these days, without yet more institutionalised bad practice.

I remember just once in my entire time in practice badly needing a toilet, and asking a mother I thought I knew quite well if I could use hers; she was seriously discomfited by it, and sure it was a ploy on my part to check how clean she kept it (her house was always far cleaner than mine!). I kept my legs crossed after that!

best wishes

On 22 Feb 2010, at 10:40, Sheelah Seeley wrote:

Hi Woody

The Cambridge days are centuries ago now! And the idea of cleansing rituals completely passed me by.........what a terrible health visitor I was.

The serious question was - is this directive to home visitors ( hand washing on entering and leaving each house) something that is happening widely?

Sheelah

Cowley

sarahcowley183@ btinternet. com

http://myprofile. cos.com/S124021C On

February 22, 2010

Well said Mel. There are some things that we simply can't afford to loose.

Re: RE: Handwashing

Hi Sheelah

I think the points you are making are important. We should be very aware of

avoiding cross-infection, especially if going from e.g. a household where

there is a virus infection of some sort to a new baby. I think most health

visitors would ask to wash their hands before examining a very young baby,

as well, and mothers would expect that. But don't we have very effective

hand cleansing gels these days? Surely the answer would be for every

visitor to be issued with these to have in the car, so they can use them

between visits. I agree, it would cause all sorts of anxieties for the

mothers, who have enough to put up with from the health visiting service

these days, without yet more institutionalised bad practice.

I remember just once in my entire time in practice badly needing a toilet,

and asking a mother I thought I knew quite well if I could use hers; she was

seriously discomfited by it, and sure it was a ploy on my part to check how

clean she kept it (her house was always far cleaner than mine!). I kept my

legs crossed after that!

best wishes

On 22 Feb 2010, at 10:40, Sheelah Seeley wrote:

Hi Woody

The Cambridge days are centuries ago now! And the idea of cleansing

rituals completely passed me by.........what a terrible health visitor I

was.

The serious question was - is this directive to home visitors ( hand

washing on entering and leaving each house) something that is happening

widely?

Sheelah

Cowley

sarahcowley183@ btinternet. com <mailto:sarahcowley183@...>

http://myprofile. cos.com/S124021C On <http://myprofile.cos.com/S124021COn>

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07:34:00

February 22, 2010

We follow an evidence-based protocol around best practice for

infection control. That is if hands are unsoiled hand-wash can be used

five times, and this should be then followed by a full wash with soap and

water. As someone mentioned hand towels in family homes are not always as

clean as they might be, but the combination of hand wash with alcohol wash and detergent

wipes for scales and equipment “models” good hygiene without

obsessive washing!

As far as cups of tea go I think on new birth visits I and my

colleagues are very pleased to share a drink with families. In many homes,

especially Eastern European and Asian families they are very keen to show hospitality

by offering refreshment, and it is a good opportunity to get to know them and

their health needs better. Needless to say...I also make use of toilet facilities

on my visits, how else would I last working in the community?

Best, Pam

From:

[mailto: ] On Behalf Of Whittaker

Sent: 22 February 2010 23:33

Subject: RE: RE: Handwashing

Well said Mel. There are some things that we

simply can't afford to loose.