By Dr. Michael M. Warren

A while back we talked about the importance of hand washing to reduce the spread of infections among people.

I explained the consequences of infections especially in hospitalized patients, who are particularly vulnerable to “catching something” that could increase their medical problems to a considerable degree.

The concept of hand washing is not new. Rather it has been known for a couple of centuries that cleanliness is critical to good health. That is why surgeons go to considerable lengths “scrubbing up” before they go into surgery.

But, for some reason, up until recently, most health care providers working in hospitals were not really complying with strict hand washing techniques. This is not a local issue. It is a national, if not international, issue.

But, as more and more bacterial infections are becoming more and more resistant to current antibiotics, patients are suffering from a problem which has an easy fix with a few simple steps.

In most hospital situations health care workers will find conveniently placed containers of hand disinfectant, in a gel formulation, that can be used to clean hands with ease. Of course, a sink with soap and water will do just as well, so that there can be no justification for not washing hands before and after contact with every patient.

Still, in many cases, getting compliance has been difficult. Along came the Joint Commission of Accreditation of Healthcare Organizations, which is charged with monitoring the quality of health care in hospitals among other sites. It performs periodic, on site, examinations of hospitals and has become increasingly interested in the hand washing issue.

Hospitals are now required to measure the numbers of health care providers that do and do not wash their hands before and after each patient encounter. So now there are “monitors” walking around hospitals whose job is to count the numbers and report them.

If not enough people comply with hand washing the Joint Commission could take punitive action that could even result in loss of accreditation. Loss of accreditation means that no Medicare or Medicaid payments will be made to the hospital. Since virtually every hospital in the country depends heavily on these funds, they could be forced to close.

So, what do you think happened? There has been a dramatic rise in the number of health care workers who comply with this regulation.

That is a good thing. It is labor intensive to do all of this monitoring. Yes, it would be better if people would just do what is right, all the time. But, we all know about people.

What does this mean to you? It means that you should be pleased that health care workers are following the rules. But, it is not yet 100 percent, even though it is close.

If you see someone not following the hand washing rules, speak up. You have every right to ask if the person about to care for you has washed their hands, since they may have done it outside your room before they entered. If they say no, you have every right to ask them to do it. If they refuse, you have every right to ask them to leave and, while they are at it, to send in a supervisor.

Don’t be intimidated. It is your right and more importantly it is your life.

Dr. Michael M. Warren is Ashbel Smith professor of surgery at University of Texas Medical Branch Division of Urology.