Can Empathy Lead to Hygiene? How to Get Doctors to Wash Their Hands

We've told you before about the problem of doctors not washing their hands enough. Every day, forgetful physicians and nurses around America handle very ill or wounded people with unclean hands and spread infection, which kills 100,000 hospital patients annually and sickens nearly two million others. In fact, according to the CDC, only about 40 percent of health care workers consistently adhere to recommended hand hygiene practices. We challenged our community to design a better hand-washing reminder, but our solutions couldn't be tested. Now researchers have discovered a truly effective way to get more health professionals to properly scrub up.

According to new research from the University of Carolina at Chapel Hill, a good way to get more doctors and nurses to regularly wash their hands is to remind them that they are not in danger of infection, their patients are. Traditionally signs and warnings about hand washing have been messages along the lines of "wash up to protect yourself." But it turns out that that's not very helpful.

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"There’s this perception among some health care providers that 'I’m around sick people all the time and I don’t get sick very often, so my immune system is extra strong,'" said David Hoffman, author of the Chapel Hill study. "[I]f you go back to the Hippocratic oath that all doctors adhere to, it’s 'First do no harm.' So if you have a sign that says 'Hey, look, here’s a really vulnerable person you’re about to walk in and see,' then maybe a sign focused on that person will cue this larger core value in the physician to protect the patient."

Using three different signs next to hand washing stations in a major North Carolina hospital—one doctor-oriented ("Hand Hygiene Prevents You from Catching Diseases"), one patient-oriented ("Hand Hygiene Prevents Patients from Catching Diseases"), and one neutral ("Gel In, Wash Out")—Hoffman discovered that the patient-oriented sign resulted in a 33 percent increase in soap and disinfectant usage. What's more, people reminded about the safety of their patients were 10 percent likelier overall to comply with proper hand-washing routines.

As a former hand-washing skeptic myself, I can say what got me to start washing all the time was the reminder that not doing so is a public health hazard. Not washing your hands isn't just a danger to you, it's a danger to everyone, and to not do so is selfish. It's a shame that no matter what experts try there are still many doctors who won't wash their hands regularly, thus putting a lot of people in danger for reasons as lame as "my hands are too full." But it's encouraging to see that a more effective way of getting people to follow the health protocols is to remind them of the greater good. It seems empathy is not dead.

Photo via (cc) Flickr user kokopinto