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Ethical Considerations in the Use of Subliminal Stimulation to Improve Handwashing Compliance Scientific Utility Versus Autonomy of the Individual

Published online by Cambridge University Press:  21 June 2016

Michael B. Edmond  and
Richard P. Wenzel
Michael B. Edmond*
Affiliation:
Department of Internal Medicine and the Division of General Medicine, Clinical Epidemiology, the University of Iowa College of Medicine, Iowa City, Iowa
Richard P. Wenzel
Affiliation:
Department of Internal Medicine and the Division of General Medicine, Clinical Epidemiology, the University of Iowa College of Medicine, Iowa City, Iowa
*
Division of General Medicine, Clinical Epidemiology, and Health Services Research, C41 GH, University of Iowa Hospitals and Clinics, Iowa City, IA 52242
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Extract

Nosocomial infections remain a significant problem for the healthcare system in the United States. At least 5% of patients will acquire an infection during their hospital stay, extending hospitalization by four days per infection, directly accounting for an estimated 60,000 deaths per year and an additional $10 billion of the amount spent on healthcare.

Previous studies have demonstrated that pathogenic bacteria can be recovered from the hands of healthcare workers and transmitted to patients. Moreover, a recent study has shown that hand carriage of organisms and subsequent contact may be the most important mechanism of nosocomial infection transmission in the intensive care unit setting.

Type
Readers' Forum
Information
Infection Control & Hospital Epidemiology , Volume 14 , Issue 2 , February 1993 , pp. 107 - 109
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993

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References

1. Haley, RW, Culver, DH, White, JW, Morgan, WM, Emori, TG. The nationwide infection rate: a new need for vital statistics. Am J Epidemiol. 1985;121:159–167.CrossRefGoogle ScholarPubMed
2. Wenzel, RP. The mortality of hospital-acquired bloodstream infections: need for a new vital statistic? Int J Epidemiol. 1988;17:225–227.CrossRefGoogle ScholarPubMed
3. Leu, H, Kaiser, DL, Mori, M, Woolson, RF, Wenzel, RP. Hospital-acquired pneumonia: attributable mortality and morbidity. Am J Epidemiol. 1989;129:1258–1267.CrossRefGoogle ScholarPubMed
4. Sprunt, K, Redman, W, Leidy, G. Antibacterial effectiveness of routine hand washing. Pediatrics. 1973;52:264–271.CrossRefGoogle ScholarPubMed
5. Ojajärvi, J. Effectiveness of hand washing and disinfection methods in removing transient bacteria after patient nursing. J Hyg. 1980:193–203.Google Scholar
6. Guenthner, SH, Hendley, JO, Wenzel, RP. Gram-negative bacilli as nontransient flora on the hands of hospital personnel. J Clin Microbial. 1987;25:488–490.CrossRefGoogle ScholarPubMed
7. Casewell, M, Phillips, I. Hands as route of transmission for Klebsiella species. BMJ. 1977;2:1315–1317.CrossRefGoogle ScholarPubMed
8. Burke, JP, Ingall, D, Klein, JO, Gezon, HM, Finland, M. Proteus mirabilis infections in a hospital nursery traced to a human carrier. N Engl J Med. 1971;284:115–121.CrossRefGoogle Scholar
9. Bauer, TM, Ofner, E, Just, HM, Daschner, FD. An epidemiological study assessing the relative importance of airborne and direct contact transmission of microorganisms in a medical intensive care unit. J Hosp Infect. 1990;15:301–309.CrossRefGoogle Scholar
10. Semmelweis, I. The Etiology, Concept, and Prophylaxis of Childbed Fevel. Madison, Wis: University of Wisconsin Press; 1983.Google Scholar
11. Holmes, OW. Medical Essays 1842-1882. Boston, Mass.: Houghton, Mifflin and Co.; 1892.Google Scholar
12. Garner, JS, Favero, MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control. 1986;7:231–235.Google Scholar
13. Graham, M. Frequency and duration of handwashing in an intensive care unit. Am J Infect Control. 1990;18:77–80.CrossRefGoogle Scholar
14. Albert, RK, Condie, F. Hand-washing patterns in medical intensivecare units. N Engl J Med. 1981;304:1465–1466.CrossRefGoogle Scholar
15. Doebbeling, BN, Stanley, GL, Sheetz, CT, et al. Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units. N Engl J Med. 1992;327:88–93.CrossRefGoogle ScholarPubMed
16. Mayer, JA, Dubbert, PM, Miller, M, Burkett, PA, Chapman, SW. Increasing handwashing in an intensive care unit. Infect Control. 1986;7:259–262.CrossRefGoogle Scholar
17. Kaplan, LM, McGuckin, M. Increasing handwashing compliance with more accessible sinks. Infect Control. 1986;7:408–410.CrossRefGoogle ScholarPubMed
18. Preston, GA, Larson, EL, Stamm, WE. The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit. Am J Med. 1981;70:641–645.CrossRefGoogle Scholar
19. Dubbert, PM, Dolce, J, Richter, W, Miller, M, Chapman, SW. Increasing ICU staff handwashing: effects of education and group feedback. Infect Control Hosp Epidemiol. 1990;11:191–193.CrossRefGoogle ScholarPubMed
20. Larson, E, McGeer, A, Quraishi, A, et al. Effect of an automated sink on handwashing practices and attitudes in high-risk units. Infect Control Hosp Epidemiol. 1991;12:422–428.CrossRefGoogle ScholarPubMed
21. Gustafson, R, Källmén, H. Subliminal stimulation and cognitive and motor performance. Percept Mot Skills. 1990;71:87–96.CrossRefGoogle ScholarPubMed
22. Chakalis, E, Lowe, G. Positive effects of subliminal stimulation on memory. Percept Mot Skills. 1992;74:956–958.CrossRefGoogle ScholarPubMed
23. Urban, MJ. Auditory subliminal stimulation: a re-examination. Percept Mot Skills. 1992;74:515–541.CrossRefGoogle ScholarPubMed
24. Trials of War Criminals Before the Nuremberg Military Tribunals Under Control Council Law No. 10. Washington, DC: US Government Printing Office; 1949:181–182.Google Scholar
25. US Department of Health and Human Services. Protection of human subjects. Federal Register. 1983;48:9269–9270.Google Scholar