" ... Including about 100,000 annually at a cost of $30B in North America alone. ... Inadequate hand hygiene remains a frequent and modifiable contributing factor, as established from hospital outbreaks of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and other hospital-acquired infections. ... ... A classical study, for example, found that physicians had about half the rate of compliance when compared with nurses (30% vs 52%, p<0.001). ... Here, we explore a different account for why the problem might not be solved by changing the personalities or motivations of physicians. Specifically, we suggest that the circumstances surrounding physicians in hospitals are rife with behavioral factors conducive to failures of hand hygiene."
Why even good physicians do not wash their hands.
Jon Stewart interviewed Atul Gawande on this book "Being Mortal". Gawande reports that a group of cancer patients choosing palliative care at end of life lived 25% longer than those choosing more severe medical care. The study was of stage 4 lung cancer patients. The discussion of end-of-life tradeoffs started with the statement that 17% of people die at home and most die in other institutions. There was some mention of his previous book, "Checklist Manifesto" which sounds like a book we need to pick up. The importance of planning medical checklists can be and will be followed is important.
In the United States alone, hospital borne illnesses reach to more than 1.7 million and 99,000 of them die every year. In Europe, nosocomial infections result to 2/3 of their 25,000 annual deaths. Severe nosocomial illnesses vary from bloodstream infections, UTI and pneumonia. And since many of their causative bacteria are antibiotic resistant like the gram-negative types, they can be hard to manage. However, it is interesting to note that 1/3 of hospital borne diseases can be prevented.