ATLANTA (AP) _ If the doctor doesn't wash his hands, the nurses, residents and medical students under his supervision probably won't wash up either, a study found.
Overall, hospital staff members in the study washed their hands about half of the time after contact with a patient. But the influence of a senior doctor was so great that if he did not wash his hands while making rounds, the staffers with him washed up only about 10 percent of the time.
The study was conducted by the Centers for Disease Control and Prevention and Chicago's Northwestern Memorial Hospital.
The findings underscore the need to educate hospital ``role models'' to wash their hands so that ``students or technicians see it's an important part of patient care,'' said Dr. William Trick, a CDC epidemiologist.
The study observed handwashing practices at the hospital's old and new facilities in 1998 and 1999. It found that better access to sinks _ more were installed in the new hospital _ did not always lead to better hygiene. Workers washed up more frequently at the old hospital (53 percent of the time) than at the new hospital (23 percent of the time).
``Making things more convenient is not the answer,'' said Elaine Larson, associate dean of research at Columbia University's school of nursing. ``It's not going to really change people's behavior. You have to change the culture, make it so it's expected that everybody does it.''
An estimated 2 million infections occur in U.S. hospitals each year, causing about 90,000 patient deaths. Experts believe most hospital infections are from contact with health workers.
``Hand hygiene is the single most effective way to prevent transmission of infections in hospitals,'' said Dr. Gary Noskin, director of infection control and prevention at the Chicago hospital.
But handwashing practices vary. Since the 1980s, health workers have been found to clean their hands 5 percent to 81 percent of the time.
Last fall, the CDC said health workers should use fast-drying alcohol gels to kill germs. The gels do not require sinks, can be quickly applied and do not wear out the skin.
Despite attempts over the last two decades to improve hand hygiene, altering hospital handwashing culture may take time, Larson said.
``What's amazing to me is it hasn't changed,'' she said.