Hanover, Germany. Only 21 percent of surveyed medical students could identify five true and two false indications of when and when not to wash their hands in the clinical setting, according to a new study.

Public health organizations and hospitals around the world, historically a source of information on proper hygiene for the lay public, have become increasingly concerned about deficiencies among medical practitioners that do not know when to wash their hands.



In this study, three researchers from the Institute for Medical Microbiology and Hospital Epidemiology at the Hanover Medical School collected surveys from 85 medical students in their third year of study during a lecture class that all students must pass before bedside training and contact with patients commences. Their findings appear in the American Journal of Infection Control (AJIC).

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Video courtesy of the University of Geneva.
Time: 00:05:07.

Hand Hygiene (HH). This video was sponsored by the Infection Control Programme of the University of Geneva Hospitals and its VigiGerme initiative. A performance group, the Rythmakers demonstrate the efficient cleansing of hands with an alcohol-based hand rub solution.

In the US, two million people each year become ill as a result of a hospital-acquired infection. Proper hand hygiene is critical to the prevention of these infections — which contribute to the death of nearly 90,000 hospital patients per year and $4.5 billion in medical expenses.Students were given seven scenarios, of which five were correct hand hygiene (HH) indications:

• before contact to a patient
  
• before preparation of intravenous fluids
  
• after removal of gloves
  
• after contact to the patient's bed, and
  
• after contact to vomit.

Only 33 percent of the students correctly identified all five true indications, and only 21 percent correctly identified all true and false indications.

Additionally, the students expected that their own HH compliance would be "good" while that of nurses would be lower, despite other published data that show a significantly higher rate of HH compliance among nursing students than among medical students.

The surveyed students further believed that HH compliance rates would be inversely proportional to the level of training and career attainment of the physician, which confirms a previously discovered bias among medical students that is of particular concern, as these higher-level physicians are often the ones training the medical students at the bedside.

"There is no doubt that we need to improve the overall attitude toward the use of alcohol-based hand rub in hospitals," conclude the authors. "To achieve this goal, the adequate behavior of so-called 'role models' is of particular importance."

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