Why I don't wash my hands between each patient contact

EDITOR—The editorial on hand washing calls for all hospital staff to start regularly washing their hands between each patient contact.1 If, as the authors claim, there is such compelling evidence for the need to wash hands between each patient contact then why do I and the vast majority of my colleagues not do it?

Firstly, I have never seen any convincing evidence that hand washing between each patient contact reduces infection rates. The Handwashing Liaison Group assumes that we all know that hand washing is beneficial and therefore fails to put forward any evidence for it. It seems self evident that hand washing should be beneficial before and after a person has performed any procedures, examined wounds, or dealt with specifically high risk patients, but I have never seen any evidence for it in other situations. I shake hands with patients when I see them in hospital. Should I not do this, or should I wash my hands before and after each contact? Should patients be discouraged from social contacts with each other? Where is the evidence?

Secondly, I have maybe 60 “touch” contacts with patients each day, and many more with relatives. Washing hands between each contact (at 1-2 minutes per wash) would take on average 1-2 hours. Where will this time come from, and who will fund it?

If hand washing is to be performed between every patient contact then it would have major resource implications. For this it needs to be shown to be effective and worth the 15% extra staffing that would be needed to cover the extra time.

Healthcare workers washed their hands on only a third of occasions

EDITOR—We agree with the Handwashing Liaison Group that an explicit standard for hand washing needs to be set and that hand washing should be regarded as part of the normal duty of care.1 The group …