Weren't their neck ties part of the problem once?

Always choose a surgeon with a bow tie.

*smirk* Oh, sometimes I wonder if it's perfectly conscious.

While Registered Nurses have to be more conscientious than most with hand hygeine due to increased patient contact, I think you'll find that RN's have a far higher rate of hand hygeine compliance than medical staff (http://www.hha.org.au/LatestNationalData.aspx) - indeed RN's have been found to have the highest rate of compliance of all healthcare worker types audited. Also, in just about every hospital I have ever worked (one small private hospital allowed short sleeved shirts and skirts or trousers as uniform), scrubs are the standard uniform for RN's.

I agree that permanent trained cleaning staff and ALL staff wearing scrubs would aid in reducing infection control.

If your reasoning is true would that not mean that doctors have a lower compliance with hygiene standards than other health workers because they have a more limited grasp on evidence and reason than e.g. nurses and allied health? Refreshing thought.

Or has it more to do with the fact that we are not 'shamed and forced' into compliance as much as our nursing colleagues?

Last time we raised this matter with a hospital they certainly 'washed their hands of it' simply stating that it could not be proven that medical staff hadn't washed their hands...

Put that in your pocket and have a look at it - or just pretend you had a good hard look/think/wash

Thanks Kate, downloaded it :)

Peter, glad to see that you are well enough to share some of your dry wit with us. Hope everything is OK!

"Horizontal gene transfer (HGT) in bacteria is largely responsible for the development of antibiotic-resistance"
"HGT can take place in the environment, on frequently-touched surfaces, such as door handles, trolleys and tables, which are made from stainless steel"
"We show prolonged survival of multidrug resistant Escherichia coli and Klebsiella pneumoniae on stainless steel surfaces for several weeks"

There are a huge number of fundamental flaws in the design and implementation of our hospitals. They range from lack of facilities, all the way to poor choice of design and actual materials of construction.
Carpet tiles or carpet of any kind (as an example), whilst lowering the noise level simply cannot be cleaned properly in any environment, let alone that of a busy hospital, where blood, faecal material and other fluids regularly make their way to the floor. Some of the built environment materials that we have long thought of as likely to be quickly fatal to micro-organisms (stainless steel as an example) are not at all so, except perhaps in the autoclave.
The introduction of soap and clean water to the general populace, followed later by detergent had huge implications for the improvement of public health and was probably (read the medical history) of as much importance as the discovery of anti-biotic therapy. However, after the discovery of anti-biotic treatments, humans, being what we are then designed a whole lot of remedial procedures (hip replacements, kidney transplants etc) around those anti-biotics without thinking through the issues surrounding, "Why"? Why are we needing so many of this therapy type? or "Why are so-many people drinking themselves to oblivion several nights of the week or Why are so many taking reality escaping drugs? The theme through all of this, is that one specialised narrow view will not solve the problem and all the data points must be collated and counted, including the outliers.

It requires interdisciplinary consultation to produce a world class result that would improve our hospital and other public health outcomes. Sadly, while the level of discussions between disciplines has increased (and this is a good vehicle to kick them off) it isn't yet leading to major breakthroughs and there are still cases, like the other half of the Semmelweis story which wasn't told here. Semmelweis was tricked ito visiting an "Insane Asylum", placed in a straight jacket, beaten by guards when he tried to flee and died only a few days later. His fame is entirely posthumous! History is littered with the professional deaths or actual deaths of innovators and change agents and until we can overcome that propensity to persecute what we don't understand or don't wish to understand, then we will keep on repeating our mistakes. We have to urgently go back, to the early years of childhood and primary school and teach the need for handwashing disciplines and the need for prevention of injury and infection as well as basic sciences that explain "Why?".
Lastly, vaccines are an essential tool in the armory of public health, but it is my observation that while ever they require breaking of the skin with a needle, and while they continue to contain even tiny quantities of old nephro-toxic antibiotics, they are going to continue to produce a percentage of very bad outcomes, if you say the risk is worth it, tell that to the parent with a child that was healthy a week ago and is now a paraplegic as a result of the vaccination; this is why parents are risk averse to vaccination. Later life children means higher investment in the success of each one, anything that can have (an apparently) high risk of injury to that precious child is going to be postponed or avoided. If you haven't seen a vaccine induce damage with your own eyes then do, for the sake of understanding both sides of the story and learning why the delivery mechanisms need to be improved.
I would also add that I am yet to find in my research, a doctor, nurse or other medical professional (in the three western countries where I have commenced this enquiry) who can carry out a risk assesment that even comes close to the level of discipline that is mandated in many parts of the financial sector and none approach that of the most accurate and rigorous of all, the work of the best of Project Managers.

Quote: Some of the built environment materials that we have long thought of as likely to be quickly fatal to micro-organisms (stainless steel as an example) are not at all so, except perhaps in the autoclave

One really has to wonder about the abilities of those in the medical field who 'stood by' and allowed steel to be used when simple research shows the ability of steel to harbour and grow disease , even better than anything else , HOW , could this have been overlooked ?

"The researchers looked at the transfer of the Hepatitis A virus and Norovirus between a range of fruit and vegetables and different kitchen knives or flat steel coarse graters. Tests were done with uncontaminated utensils on contaminated produce and contaminated utensils on uncontaminated produce.
Results found that when using uncontaminated utensils, more than half of all knives and graters were contaminated after preparing the contaminated produce"

Buggers of things bugs. Doesn't seem to matter what we do eventually they will get through our best defences. It's what they're really really good at. Getting access to food and the conditions for furthering themselves. Better than us at it really.

And yes you're right - it's a cultural and economic issue this attitude to cleanliness in hospitals. But the low fruit - the quickest, cheapest and most effective intervention - is hand-washing Graeme. Especially in a gastro ward. Especially from doctors who - unlike nurses who generally look after a handful of patients - doctors move through the ward ... touching things...wandering from bed to bed ... little typhoid marys with stethoscopes.

This is pretty basic stuff Graeme. It is basic procedure at child care centres. People working in food preparation wash their hands a lot. So should doctors.

Surprises me that I have not read of any research by these young nanotechnology wallahs aiming to give us some bacteria- unfriendly surfaces. Would seem to be a far more useful purpose than inventing stain-free joggers.

Most of our arsenal against bacteria have been chemical one way or another. These clever little fellas work their way around them eventually - breed themselves through - become resistant, modify their protein coats. But with nanotechnology perhaps there might be a second line of attack - of doing something physical ... a repellant surface.

Like corduroy ... I've always found that pretty repulsive. But smaller.

I spent a considerable time beside a loved one in hospital. He was in for an op but got a 'bonus' e-coli superbug. Thankfully, he survived. Me and my family got a handwashing lesson before going into the icu isolation room. It was hand wash and dry, then gloves and gowns, then wash hands on leaving. We were complimented on our compliance as they feared the bug would get into the icu and they would have to close it down for weeks. That would have been a disaster in the regional hospital.

While I sat, on the ward before and after icu I had the opportunity to observe the interactions of staff and the antics of the cleaners. The floors were moped with a murky bucket of water in a quick swish that would have been lucky to cover 1/4 of the floor area, and the bathroom was not much better. Spots of blood were on the floor when we got there and were still there for 2 days until I said something. The mop bucket then went to the next ward, along with the cleaning cloths etc. I can just imagine what nasties could be spread with the 'cleaners'.

Now I don't blame the cleaners as they were overworked, but I do blame the managerialists that run hospitals.

After my beloved came out of icu and was in a private room (isolation) he and I had to tell too many nurses and even doctors to wash hands and use gloves and gowns.

He got the bug because someone didn't wash their hands and we didn't want anyone else to get it, but the cleaners were very careless.

Not long after I had reason to sit beside my beloved in a small rural hospital where the cleaners moped every part of the room and bathroom; their cleanliness was impeccable.

Surely it is not hard to figure out that washing hands and keeping the hospital clean is vital in hospitals.