human behavior

New word: iatros

Posted in Habits & Manners, Health & Medicine, New Word by humanb on December 19, 2006

medlogoiatros (Greek)
: physician

As in: pediatrician, psychiatrist, and iatrogenic infection – the last an infection acquired while under a physician’s care or in hospital.

Iatrogenic infections may also be called:

nosocomial (Greek)
: nosos (disease) + komeion (to take care of/hospital)

Nosocomial, or hospital-acquired, infections (more appropriately called health care–associated infections) are today by far the most common complications affecting hospitalized patients…. Currently, between 5 and 10 percent of patients admitted to acute care hospitals acquire one or more infections, and the risks have steadily increased during recent decades…. Four types of infection account for more than 80 percent of all nosocomial infections: urinary tract infection (usually catheter-associated), surgical-site infection, bloodstream infection (usually associated with the use of an intravascular device), and pneumonia (usually ventilator-associated).

Burke, J (2003). Infection control: a problem for patient safety, New England Journal of Medicine, Volume 348(7): 651-656.

While the statistics are alarming, the public health care system is continuing to work resolutely to improve upon these numbers. But improvement requires a commitment from all health care workers:

Behavioral change remains a formidable obstacle. For example, cross-infection of patients by health care workers with contaminated hands is a major source of infections. Despite educational efforts, health care workers, including physicians, continue to fail to adhere to standards for hand hygiene, which is universally considered the single most important method for infection control.

There are certainly health care workers resistant to the idea that they are infecting patients because they do not wash their hands frequently enough. However, I suspect there are more health care workers who wash their hands frequently, and try to do so before seeing each patient, but cannot reasonably see themselves washing their hands any more than they already do without skin damage or development of an obsessive-compulsive disorder.

As much as the public health system may work to maintain the highest standards of hygiene, the hospital is simply not a sterile environment. The house of the sick and the people within it, will always be home to sickness-causing bugs.

Of course, this is no reason for some health care workers to behave like the rest of us. Since I started medicine, I have taken to washing my hands at least 3 times as often as I used to, and I cannot help but notice the alarming number of women who do not wash their hands in public restrooms. Some flee in a hurry to avoid the looks of dutiful hand-washers. But the most common and perplexing group are those who approach the sink, turn on the water and perform the symbolic rinse of the fingers for the benefit of onlookers, perform a quick dry, and then dash away with hands as dirty as before. Why bother? Or why not go all the way? It is simply fascinating how loathe we humans are to washing our hands.

But women in public restrooms at shopping centers and movie theaters are not handling patients, weak and susceptible to disease. Health care workers are handling multiple patients and successively over the course of a day. We can’t expect there to be no iatrogenic infections in hospitals, any more than we can expect health care workers to be germ-free. But we can expect that before seeing us, they do more than perform the symbolic rinse of the fingers.

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