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onds doesn't cut it.) Granted, when
we're in the OR, we have intense
hand-washing rituals. But in other set-
tings, we become laissez-faire.
Patients may be at their most vulner-
able on the operating table, but they're
also very vulnerable before they reach
the OR. Consider the patient in pre-op,
lying there with an IV in his arm, while
multiple caregivers — the anesthesia
provider, the surgeon, a nurse — file in
and out, each greeting him by extend-
ing a bare hand. And while this is going
on, chances are the patient occasional-
ly touches his face, mouth, nose and eyes. Now, with each touch, he
increases the risk that the bacteria he just picked up will result in a
post-op infection.
Seen in that light, shaking hands seems like a crazy and unnecessary
ritual. The challenge is to reduce it without coming across as rude. By
posting numerous signs in our facility and generating conversations
among both patients and providers, we've accomplished that.
Will we decrease infections? We haven't demonstrated that yet,
although we think we will. But knowing what we know, there's no rea-
son for people to wait around for that study to be completed.
Discouraging handshaking in your facility is a logical step you can
take to help address the enormous challenges related to nosocomial
infections.
Mark S. Sklansky, MD
UCLA Mattel Children's Hospital
• SHAKING THINGS UP One of the many signs posted
around UCLA Mattel Children's Hospital.
Los Angeles, Calif.
msklansky@mednet.ucla.edu
