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No More Secret Handshakes: A Healthcare Dilemma

In an effort to continually reduce disease transmission in hospital settings, one doctor is asking if we should stop handshakes altogether.

A Solution

Fist Bump

Dr. Mark Sklansky, MD, professor of pediatrics at UCLA Medical Center in Los Angeles, believes the right thing for many patients is for doctors to proceed more carefully when it comes to the standard greeting of spreading germs through the hand-to-hand gesture. With Sklanksy, the Journal of the American Medical Association (JAMA) recently called for a ban of handshakes in the healthcare setting for the sake of decreasing hospital acquired infections.

Detractors feel that the informal greeting sets a more congenial tone between doctor and patient, and removing that is a public health hazard of its own right, as it could potentially lead to decreased communication and/or treatment adherence. Sklanksy admits there are social benefits to handshaking in the healthcare setting, but warns that it may not outweigh the risk to vulnerable patients.

With the proliferation of antibiotic resistant bacteria on the rise, it’s not surprising that public health defenders are thinking outside of the box in terms of reducing HAIs. The CDC reports that just over 75,000 people die from HAIs annually, and just under a million acquire some sort of healthcare acquired condition. The CDC and other government health committees are hard at work with new legislation and recommendations to reduce the effects of HAIs in the United States, and most hospitals are happy to comply. Innovations and updated protocols for the reduction of HAIs include fluid resistant scrubs, automated hand-washing stations, computer and tablet disinfection stations, and strict guidelines for healthcare worker hygiene.

Who else is bumping?

Sklansky isn’t the only one to vilify the time honored greeting. Another research group from the Institute of Biological, Environmental, and Rural Sciences at Aberystwyth University in the United Kingdom, has determined that fist bumping transmits fewer germs than handshakes or high fives, when it comes to greetings between patients and doctors. The researchers determined this by having someone with a germ-infested glove fist bump, shake, or high-five someone with a sterile glove, then analyzed the previously sterile glove for contamination. Apparently, the palm is the culprit in this germ-spreading case; fist bumping transferred significantly less bacteria than the other forms of hand greetings. Senior investigator David Whitworth, PhD, supports fist-bumping as the new alternative doctor-patient greeting.

The fist-bump; perhaps the latest innovation in the fight against HAIs? What do you think? 

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Dana Carter, PhD

About the Author

Dana Carter, PhD is an academically trained, experimental neuroscientist. Currently, Dana is a science writer who focuses on different aspects of psychology, physiology, and overall health and wellness. Prior to her current role, she spent a combined seven years researching the genetic components of mental illnesses, and the effects of drugs and alcohol on fetal brain development. She received her PhD in Neuroscience from the Texas A&M Institute for Neuroscience and her B.Sc. in Psychology from Texas A&M University. She enjoys traveling, writing, and promoting learning about healthy, active minds and lifestyles.
 

References: 
Evans, G. A modest proposal: Ban handshakes in healthcare (2014). HIC Prevent. http://hicprevent.blogs.ahcmedia.com/2014/06/11/a-modest-proposal-ban-handshakes-in-healthcare/

Sklansky M, Nadkami N, Ramirez-Avila L Banning the handshake from the health care setting (2014). J Amer Med Assoc.  http://jama.jamanetwork.com/article.aspx?articleid=1873637

Miela S and Whitworth DE. The fist bump: A more hygienic alternative to the handshake. American Journal of Infection Control, Volume 42, Issue 8 (August 2014).

Tags: Managing Disinfection, Infection Prevention, Healthcare Acquired Infection, Healthcare, HAI

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