What a guy. I have always wanted to be a John Wayne character and be a real hero. We all would like to be heroes. I’m going to be a hero today and I’m deputizing each and every one of you. We are going to run the “varmints out of town.”

What in thunder am I talkin’ about? Well, I’m gonna tell ya! I am fed up with the problem of infections folks get when they check into a hospital. Ten percent of hospitalized patients contract an infection they did not have before they entered for care.

Hospital-acquired infections contribute to the deaths of 80,000 people annually in the United States. In an era when healthcare costs are ridiculous, these infections may double a patient’s bill.

“Gosh, buckaroos, what can we do to save the ranch?”
(Enter the slow-talking, tall, confident cowboy).

“Tell the doctors, the nurses, and the aides to WASH THEIR HANDS.”

What did that stranger say?

Our hero simply said what doctors and hospital administrators have known for 150 years. Hand hygiene, as called by the infection control experts, is the most powerful means of preventing hospital-acquired infections. This is because the single greatest cause of these infections is through the transmission of bacteria from the hands of healthcare workers to patients. Several studies have helped to define the problem, point out significant matters which bear upon the solution, and give the public and the medical community some specific ways to reduce the crisis of hospital-acquired infections.

I hate to bring up some embarrassing facts about the medical community and hospitals, but since I am in the role of the cowboy hero, I shall do it with courage and a good heart.

Doctors are the worst. They wash their hands only 30 percent of the time. If I followed infection control rules as John Wayne would and washed my hands before and after each patient contact, when I completed my hospital rounds today I would have done so 40 times. Nurses are better than doctors in that they observe the practices necessary to prevent hospital-acquired infections about 50 percent of the time. When working in an intensive care unit or in any under-staffed medical environment, nurses and physicians are less likely to adhere to prevention guidelines. The pace and stress of providing care does not allow them time to consider or complete a typical regime of hand hygiene. Beyond staffing considerations, hospitals are at fault in other ways. Wash areas are typically out of sight for some reason. Frequently the soap and towel dispensers are empty. Hospitals don’t talk much about this problem. It’s bad press.

In a recent study, 76 percent of patients admitted to hospitals were never informed of any risks of hospital-acquired infections or how to protect themselves. If only for medical-legal reasons, hospitals should have an efficient orientation program about hospital-acquired infections for patients and family members.

Now the hero stuff. We are going to clean up this town today. First, when a doctor enters the patient area, the clerk will give him the chart and two of those handy moist, anti-bacterial towelettes (supplied by the hospital). He will use one each before entering and upon leaving the patient’s room. Second, family will put a sign on the door that reads, “Use Hand Hygiene Here Or Be Shot” (or words to that effect). Third, as my deputies you may report any nurse, doctor or aide failing to heed your message. If your floor is under-staffed, you may report that and go to a hospital with the highest number of staff per patient. You are saving lives. With this program you can run the varmints out, save the town and ride into history. Get my horse.