Safety: An easily avoidable serious health issue, or not?

In 1846 Ignaz Semmelweis started a new job at the maternity ward at the Algemeines Krankenhaus in Vienna Austria. There were two departments and Semmelweis discovered quickly a dramatic difference between his and the other ward. At his ward the average mortality was one out of ten young mothers who died due to maternity fever. During some months this figure was even up to 30%! At the other ward the mortality is much lower, average 4%.

He decides for a methodical approach. He tries out several possible resolutions and monitors the results closely. In 1847 he starts experimenting with hand washing. He suspects that students that carry out autopsy at the mortuary and then help out at his maternity ward, do bring toxic particles on their hands. The students only do work at his department and not at the other one. Semmelweis obliges all employees to wash their hands in a chloric solution prior to entering the ward. The results were staggering. Within weeks the mortality drops from -at that moment- 18%, to less than 2%. Within months the figure drops to below 0,2%!

Despite proving that the figures were right and, that he was seeking publicity for his findings, washing hands is not adopted by most doctors. Even worse: the idea that doctors and nurses themselves did spread diseases throughout the hospital, was being ridiculed by a great number of colleagues.

It took more than 15 years before the French chemist and biologist Louis Pasteur discovered that many diseases are caused by micro-organisms that are not visible to the naked eye. Step by step doctors accept it to be good idea to wash hands before and after contact with patients, and guidelines were set.

Meanwhile we are 170 years ahead. Each doctor and each nurse know when he or she should wash their hands, but do they do so? Or, somewhat more precise: are employees in an average hospital capable to stick to the rules for hygiene to their hands set by the medical stand themselves? You guessed it already: NO!

Research from 2012 showed an average compliance to the standard for hand washing is 20% (see also note). Every year there are more victims caused by poor hand hygiene compared to traffic accidents in the Netherlands. Now isn’t that something crazy since this is -apparently- easy to prevent?

This story comes from the book ‘De Ladder’ from Ben Tiggelaar and he reveals how hard it is to change habits but he also offers good solutions for changing (bad) habits.

Note: a more recent study in Sweden also found <20%: https://domotica.nl/2017/08/17/handen-wassen/