If you don't see nurse wash hands, it doesn't always mean she hasn't

Dear Abby: May I add a few thoughts regarding the letter from "Daughter of a Patient," who wrote to stress her concerns about health-care workers and hand-washing? I strongly confirm that health-care workers need to demonstrate frequent and proper hand-washing techniques. Gloves are required while performing invasive procedures such as starting an IV, drawing blood, changing a dressing, etc. But please do not assume that hand-washing did not occur if it was not done in the patient's visual field.

I have been an RN for more than 20 years. I wash my hands before and after patient contact -- always, without fail. Our institution does not allow us to use a patient's bathroom for our routine hygiene (unless our hands become soiled while in contact with that patient). Nurses, physicians and other health-care personnel in direct contact with patients generally use a central hand-washing area, such as in a nurse's station. In this case, patients and their families may never actually observe personnel washing their hands -- even though they have.However, if a patient or family member actually sees a health-care worker going from one area to the next, one patient to the next and having direct skin contact with that patient, I suggest they report it immediately to the unit manager. A health-care worker is more likely to acquire an infectious disease from the public than the other way around. That's now twice the reason to observe good hand-washing techniques. -- Informed and Hygienic RN in California

Dear Informed RN: The majority of mail I have received from medical personnel corroborates your statements. Read on:

Dear Abby: In response to the letter about hand-washing by medical personnel -- yes, it probably could be better in some cases. I have been an RN for 12 years.

Just because a patient doesn't see me wash my hands, it doesn't mean I haven't done it just before I entered the room. I generally wash my hands at the nurses' station for several reasons. I don't believe a patient's room or bathroom is the most hygienic place for me to wash my hands before I assess the patient.

At my hospital, the soap kept in the nurses' station is a stronger germ killer than what is kept in the patient rooms. Furthermore, I often follow hand-washing with an antibacterial spray or lotion of my own. With the dramatic rise in antibiotic-resistant bacteria these days, such precautions not only protect patients but also protect me. -- Susan Kelly, Scottsdale, Ariz.