Handwashing Effects on Hospital-Induced Illness

Each year, two million Americans leave hospitals with something they didn't arrive with: infections-everything from staph and strep to urinary tract infections. According to the Centers for Disease Control in Atlanta, 20,000 to 30,000 people even die from these infections (15:27). Nosocomial infections have historically contributed to outbreaks of sickness and disease in hospitals. The landmark concepts of hygiene and antisepsis arose independently in the mid1800s. Although others recognized and described the contagious nature of childbed fever, Ignaz Semmelweis, demonstrated conclusively that contaminated hands of medical attendants were spreading the disease and that this spread could be minimized with antiseptic hand cleansing.

At about the same time, Joseph Lister applied principles of antisepsis to wound care in an effort to change surgery from a last resort procedure which usually caused septic death to a comparatively safe practice. In yet another part of Europe, Florence Nightingale instigated radical changes in the management of hospitals for soldiers and dramatically reduced mortality from contagious disease among the soldiers in the Crimean War (14:92).

Handwashing was certainly not a new practice in health care; physicians had been recommending general hygiene and cleanliness for decades. The unique contributions of Semmelweis were his recognition that the viral agent was being directly transmitt

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reductions in infection and death began appearing throughout the world (4). Even though Florence Nightingale did not adopt the idea of personal contagion or recognize the importance of cleanliness in the way that Semmelweis and Lister did, her contributions to health care complemented theirs. While they were concerned with individual spread of disease and prevention of direct contamination of wounds and tissues, Nightingale was concerned with a clean and healthy environment. It was absolutely clear from the results of her reforms that infectious diseases were being spread in the dirty and crowded environments of hospitals and military camps. And even though she did not believe in antisepsis, she insisted upon absolute cleanliness of the environment, the staff, and the patients (3). Hers was the modern link between medical practice in the 19th century and that of the 20th century. Current Situation In health care settings today, these elements have been incorporated into standards of practice, and since the turn of the century the problem of "hospitalism" or nosocomial infections has been dramatically reduced. Nevertheless, nosocomial infections continue to be one of the major preventable complications of hospitalizat
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Approximate Word count = 2647
Approximate Pages = 11 (250 words per page)