Our personal handwashing rules: use hot water and soap, do it after potentially touching something yucky and sing “Happy Birthday” to be sure you’re scrubbing long enough. Physicians, though, need to know a lot more. And a small study of third-year medical students in Germany finds that they aren’t entirely clear on when handwashing is indicated. The study , published in the American Journal of Infection Control, covered 85 third-year students at Hannover Medical School, most of whom said they’d had at least some clinical experience. Researchers asked the students whether handwashing was indicated in seven situations: Before contact with a patient Before preparing IV fluids Before touching a urine-drainage system During regular nursing After removing gloves After contact with a patient’s bed After contact with vomit Was handwashing indicated? In order: Yes, Yes, No, No, Yes, Yes, Yes. How’d you do? Among the students, 21% correctly identified all the true and false indications, while 67% correctly identified the

five conditions under which handwashing is appropriate. (That means a third missed at least one.) Most commonly missed were the need for handwashing before preparing IV fluids and after removing gloves. (Though the majority of students did get those right.) Depressingly, the students perceived that compliance with basic handwashing guidelines declines as physicians progress and move up the career ladder. They also perceived that their own compliance, as students, would be better than that of nurses — though other research has suggested nursing students are better at hand hygiene than med students. Some limitations to this study: it doesn’t necessarily reflect the experience of med students in the U.S. or elsewhere, and it’s not clear whether students’ knowledge will improve during the rest of their medical education. Handwashing bonus: Changing One Word to Get Health-Care Workers to Wash Their Hands Image: iStockphoto

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Do Med Students Know When to Wash Their Hands?