HAND-WASHING PROBLEM
by Stan Patrick, 11/19/99

Dc: A recent study done at the Duke University Medical Center found only 17 percent of physicians in an intensive care unit washed their hands appropriately. Experts say, if you don't count the people themselves, hands are the most dangerous thing in a hospital, because they transmit disease. While most hospital workers DO wash their hands regularly, a few who don't could be causing terrible problems. Stan Patrick reports.

Stan: To find out if it's true that some medical professionals don't adequately wash their hands, I spent a day in a hospital. But it didn't take me long to get an answer. At 7am, I accompanied Doctor Delmore Krietz on his early rounds.

(sfx: hospital ambience)

Delmore: Let's look in here. Mr. Melrose is just about ready to go home.

(sfx: door open, footsteps)

Hello, Mr. Melrose! How are we this morning?

Melrose: Ungh.

Delmore: (to stan) Mr. Melrose is here for a severe case of paper cuts.

Stan: Paper cuts? Really?

Delmore: He's a lawyer and he was thumbing through some briefs last week when they got away from him. You work with paper for years and you can forget how dangerous it is, right, Mr. Melrose?

Melrose: Uhngh.

Delmore: The papers flew everywhere and he was almost shredded. It took us 5 hours to piece him back together. (as if talking to an idiot) Mr. Melrose, I'm going to take a look at your paper cuts now, to see how they're healing. OK?

(sfx: ripping off of bandage)

Melrose: Owwwwwww!

Delmore: Yes, sorry!

(sfx: more ripping off of bandage)

Melrose: Eahahghghghghghg!

Delmore: Well you can see ... the injuries were scabbing over quite nicely but something seems to be interfering with that process.

Stan: Maybe if you didn't yank the bandages off so violently.

Delmore: I'm sorry, are you a doctor?

Stan: Well no, but ...

Delmore: You really shouldn't second guess a doctor if you don't have the training. You probably wouldn't know the Latin name for this stuff oozing out from between the sutures right here and here ...

Stan: Doctor! Your hands!

Delmore: What?

Stan: You've got ... peanut butter on your fingers.

Delmore: Yes, I just had a sandwich. When you're working all night you need your nutrition. Again, my medical training tells me that. I wouldn't expect you to understand.

Stan: Putting fingers caked with peanut butter ON the patients open wounds? Isn't that ... unsanitary?

Delmore: Oh, for crying out loud. You don't like the peanut butter? Fine.

(sfx: licking/sucking sound)

Stan: What are you doing?

Delmore: (pb mouth) Cleaning off my fingers. Isn't that what you want?

Stan: But your patient ...!

Delmore: Oh, he doesn't mind. Do you, Mr. Melrose?

Melrose: Unghghgh.

Delmore: He's full of antibiotics anyway. Nothing can live in there.

Stan: (anncr) Mr. Melrose survived his paper cuts, but was sick for ten weeks after he left the hospital, and has developed a terrible peanut allergy that makes it impossible for him to enter a grade school without an isolation suit. I described the Melrose case to Phoebe Jeeves, chief administrator for the Association of Sterile Handed Health Care Professionals, who said she couldn't comment on the particulars of any one case.

Phoebe: However ... the situation you describe ... were it to happen ... could possibly constitute a violation of safe practices.

Stan: (int'vw) Licking fingers and putting them on the actual wounds?

Phoebe: (sigh) Yes. Yuk.

Stan: But the doctor said the patient was loaded with antibiotics and probably wouldn't be infected.

Phoebe: Well again, I can't comment on a specific case.
But in general ... I would say ... balderdash.

Stan: (anncr) There are no national regulations for hand-washing practices at hospitals, but the Association of Sterile Handed Health Professionals recommends a vigorous soaping of 10 to 15 seconds, followed by a thorough rinse with water. And this should be done both before and after every instance of patient contact.

Phoebe: If your doctor doesn't remind you of a raccoon the way he's always rubbing his hands together, and if those hands aren't dried and cracked and even bleeding ... you should ask, "are you washing your hands enough?"

Kildare: (phone) Look, I'm not gonna try to snow you on this one.

Stan: Welby Kildare is CEO of Sprawling Medical, the large HMO.

Kildare: We have a devil of a time getting people to wash their hands vigorously enough. And just between you, and me, and the hypodermic disposal bin on the wall over there, that's why we at Sprawling Medical have been accused of throwing people out into the street before they're ready to leave the hospital. We know they shouldn't go home, but we're trying to save their lives here.

Stan: (int'vw) Let me understand this. Everybody knows they should wash their hands, a lot. But it's still hard to get people to do it?

Kildare: It's hard to get SOME people to do it. The ones who dig in ... resisted when their mother told them to do it. They've spent a lifetime resisting it. I don't think there's anything we can say that will change their minds. We have to DO something. Something different. Something radical. And for a man in my position ... that's hard to admit.

Stan: (anncr) But what? Inventor and Psychologist Emerald Edison has developed onr poddinlr solution, which is already in use in some major hospitals.

Emerald: Psychology. That's the answer.

Stan: Hand psychology?

Emerald: If you ask me to do a better job of washing my hands with soap and water, I'm going to conclude that you're a busybody and a know nothing. That's automatic. If you suggest that I carry around a packet of pre-moistened anti-bacterial wipes and use those INSTEAD of soap and water, I'm going to think you're a know nothing busybody backwards low tech Puritan scold.
But ... if you ask me to sterilize my hands in the M.L.M.S., I'll do it because that machine cost this hospital a quarter of a million dollar and by God, we're going to use it!

Stan: Can you walk me through that? It's the ... what?

Emerald: M.L.M.S. M for Magnetic, because other expensive hospital machines use magnets. L for Laser, because it's the latest thing. Another M for Mitt, because that's a colloquial term for "hand" and it makes this seem like maybe it's "the people's way" to deal with the problem, and S for Scanner, because we spend more money testing for problems than we do in actually fixing the problems themselves.

Stan: The Magnetic Laser Mitt Scanner?

Emerald: I've got one right here. A small metal box with a motion detector inside. Stick your hands in ... go ahead.

(sfx: small motor, squirting)

... and the machine automatically squirts anti-bacterial soap all over them.

(sfx: click)

And then a 200 watt light bulb comes on for ten seconds.

Stan: This must be the "Scanning" part?

Emerald: After ten seconds it spits out a transparency ...

(sfx: spitting out x-ray like results)

Which you then put up on the x-ray display ... click on the light behind ...

(sfx: click)

... and see? It shows you all the places your hands are too dirty!

Stan: These are really my hands?

Emerald: No, not really. It prints the same picture every time, but people's hands are almost always too dirty, so it never hurts to wash again.

Stan: The light bulb does nothing?

Emerald: Oh, it does something. It makes you wait ten seconds while the anti bacterial soap works. Then you wipe your hands off on a sterile paper towel from a dispenser on the side ...

(sfx: paper pulled out, rustling of towel)

It's really sticky stuff, so you have to work at it.
There! Now you've done a serious job of washing your hands!

Stan: And people will do this more eagerly than using soap and water?

Emerald: Oh, yes. Because there's a machine involved. It's got a mysterious name "MLMS," And special goop. People respond to important - sounding machines, and special goop.

Stan: And you really charge a quarter million dollars for these? With so few moving parts and such low technology?

(sfx: squirting motor running)

Emerald: It's not easy to change behavior.

Stan: Still, the mark up must be ...

Emerald: It's not about what it cost to make the machine. It's about what the machine will DO. This is a bargain.

Stan: In my grade school ... we just sang "Yankee Doodle" really loud while we washed our hands. Couldn't you ...

Emerald: If you can convince 800 doctors to sing "Yankee Doodle" at the sink 25 times a day ... I'll pay YOU a quarter million dollars.

Stan: The jury on MLMS is still out. But if it helps save just one life ... if it can spare just one innocent child the agony of coming home from the hospital with a cold or the flu, if it can get rid of peanut butter stains, if it can make one pair of hands cleaner ... one life better ...isn't it worth the expense? I'm Stan Patrick.

Dale Connelly Reporting Home