Hand-washing frequency and factors that influence it in a family practice clinic.

Ignaz Semmelweis first linked hand washing before examining women in labor with favorable outcomes in 1847.1 Although initially ignored, hand washing has become a mainstay in reducing the spread of infections in all patient encounters. Multiple studies have confirmed that health care workers are the major cause of spreading nosocomial infections from patient to patient in the hospital setting.2 These infections cost an estimated $5 billion to $10 billion annually.3 Despite general acceptance of the importance of hand washing and the staggering economic impact of nosocomial infections, compliance in all health care settings studied is suboptimal. Hand-washing rates between patient encounters in intensive care units range from 17 to 75 percent, on pediatric wards the rate is 57 percent, and in the emergency department 32 percent. The purpose of . our study was to evaluate compliance with hand washing in a family practice residency clinic and its relation to clinical setting, level of training, and direct observation by a medical student.