Re: Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis
Hand hygiene in hospital: Is there a role for Islamic teachings?
To The Editor
We read with great interest the review and meta-analysis of Luangasanatip et.al on the efficacy of interventions to promote hand hygiene in hospital.1 They confirmed that the WHO campaign is effective at increasing compliance with hand hygiene in healthcare workers and identified several interventions that can be used to improve the hand hygiene practices of healthcare workers in hospitals, if implemented appropriately. 2
Semmelweis was the first to demonstrate, in 1861, the role of hand hygiene in the prevention of person-to-person transmission of infection. 3 Hand hygiene is considered, nowadays, the cornerstone of prevention of healthcare-associated infection. Yet, compliance remains poor in many hospital settings. Hand hygiene just fails at times to reach our subconscious cost-benefit analysis.
We would like to consider the effect of adopting Islamic teachings by Muslin healthcare providers in their daily practice. In several cultures and religions, including Islam, hand hygiene is not only an action aimed at body care. It is done also for ritual reasons or because it bears an essential obligation in specific everyday life situations.4
Primary prevention, specifically skin care, is an important principle in Islamic Law (Sharia’h) just as it is emphasized in contemporary medicine. Observing regular prayer five times daily is one of the five basic tenets of Islam.5 Personal cleanliness is paramount to worship in Islam. Muslims must complete methodical ablutions before praying. Thus, every observant Muslim is required to maintain scrupulous personal hygiene five times a day, apart from his or her usual routine of bathing.4 Ablutions must be made in freely running (not stagnant) water and involve washing of the hands, areas between the fingers, face, forearm, ears, nose, mouth, and feet, three times each. It is an indispensable part of daily prayers which is mandatory for every Muslim.3,4 These habits are observed by Muslims of all races, cultures, and ages. The prophet Muhammad always urged Muslims to wash hands frequently and after clearly delineated tasks: before and after meals; after visiting the lavatory; after touching a dog, a cadaver, or one’s shoes; and after handling anything soiled. Hence, from the dawn of Islam, strict observation of hand hygiene with freely running water has been advocated for all Muslims.4
Unfortunately, no systematic review of this topic is currently available, and further investigations are needed to delineate the extent to which religious beliefs might affect health-care practices.
Increased awareness of Muslim health-care workers’ beliefs could improve compliance with accepted hand-hygiene practices.
Hassan Chamsi-Pasha, FRCP, FACC. Cardiac department , King Fahd Armed Forces Hospital, Jeddah, Saudi-Arabia. ( drhcpasha@hotmail.com)
Mohammed Ali Albar, MD, FRCP. Medical ethics department, International Medical center, Jeddah, Saudi-Arabia.
References
1. Luangasanatip N, Hongsuwan M, Limmathurotsaku D, et al. Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. BMJ 2015;351:h 3728.
2. Muller MP. Improving hand hygiene in hospitals-more is better. BMJ. 2015 Jul 28;351
3. AlGhamdi KM, AlHomoudi FA, Khurram H. Skin care: Historical and contemporary views. Saudi Pharm J. 2014;22(3):171-8.
4. Ahmed QA, Memish ZA, Allegranzi B, Pittet D; WHO Global Patient Safety Challenge. Muslim health-care workers and alcohol-based handrubs. Lancet. 2006 25;367(9515):1025-7.
5. Al-Bar MA, Chamsi-Pasha H. Contemporary Bioethics: Islamic Perspective. Springer.2015.(Open access), http://link.springer.com/book/10.1007/978-3-319-18428-9
Rapid Response:
Re: Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis
Hand hygiene in hospital: Is there a role for Islamic teachings?
To The Editor
We read with great interest the review and meta-analysis of Luangasanatip et.al on the efficacy of interventions to promote hand hygiene in hospital.1 They confirmed that the WHO campaign is effective at increasing compliance with hand hygiene in healthcare workers and identified several interventions that can be used to improve the hand hygiene practices of healthcare workers in hospitals, if implemented appropriately. 2
Semmelweis was the first to demonstrate, in 1861, the role of hand hygiene in the prevention of person-to-person transmission of infection. 3 Hand hygiene is considered, nowadays, the cornerstone of prevention of healthcare-associated infection. Yet, compliance remains poor in many hospital settings. Hand hygiene just fails at times to reach our subconscious cost-benefit analysis.
We would like to consider the effect of adopting Islamic teachings by Muslin healthcare providers in their daily practice. In several cultures and religions, including Islam, hand hygiene is not only an action aimed at body care. It is done also for ritual reasons or because it bears an essential obligation in specific everyday life situations.4
Primary prevention, specifically skin care, is an important principle in Islamic Law (Sharia’h) just as it is emphasized in contemporary medicine. Observing regular prayer five times daily is one of the five basic tenets of Islam.5 Personal cleanliness is paramount to worship in Islam. Muslims must complete methodical ablutions before praying. Thus, every observant Muslim is required to maintain scrupulous personal hygiene five times a day, apart from his or her usual routine of bathing.4 Ablutions must be made in freely running (not stagnant) water and involve washing of the hands, areas between the fingers, face, forearm, ears, nose, mouth, and feet, three times each. It is an indispensable part of daily prayers which is mandatory for every Muslim.3,4 These habits are observed by Muslims of all races, cultures, and ages. The prophet Muhammad always urged Muslims to wash hands frequently and after clearly delineated tasks: before and after meals; after visiting the lavatory; after touching a dog, a cadaver, or one’s shoes; and after handling anything soiled. Hence, from the dawn of Islam, strict observation of hand hygiene with freely running water has been advocated for all Muslims.4
Unfortunately, no systematic review of this topic is currently available, and further investigations are needed to delineate the extent to which religious beliefs might affect health-care practices.
Increased awareness of Muslim health-care workers’ beliefs could improve compliance with accepted hand-hygiene practices.
Hassan Chamsi-Pasha, FRCP, FACC. Cardiac department , King Fahd Armed Forces Hospital, Jeddah, Saudi-Arabia. ( drhcpasha@hotmail.com)
Mohammed Ali Albar, MD, FRCP. Medical ethics department, International Medical center, Jeddah, Saudi-Arabia.
References
1. Luangasanatip N, Hongsuwan M, Limmathurotsaku D, et al. Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. BMJ 2015;351:h 3728.
2. Muller MP. Improving hand hygiene in hospitals-more is better. BMJ. 2015 Jul 28;351
3. AlGhamdi KM, AlHomoudi FA, Khurram H. Skin care: Historical and contemporary views. Saudi Pharm J. 2014;22(3):171-8.
4. Ahmed QA, Memish ZA, Allegranzi B, Pittet D; WHO Global Patient Safety Challenge. Muslim health-care workers and alcohol-based handrubs. Lancet. 2006 25;367(9515):1025-7.
5. Al-Bar MA, Chamsi-Pasha H. Contemporary Bioethics: Islamic Perspective. Springer.2015.(Open access), http://link.springer.com/book/10.1007/978-3-319-18428-9
Competing interests: No competing interests