As Nurses we offer handshakes to meet
patient’s expectations and to develop a rapport with them. In developing
countries such as India, shaking hands has become common, especially in
the large cities among nurses and other health care workers dealing
with patients.1, 2 Ritualistic touching plays a crucial role
in many cultures. Though handshakes give a profound impact in better
patient outcomes, it also has the potential for greater efficiency of
pathogen transmission, and handshakes are known to transmit bacteria.3,4In
India though significant advances have been made in infection control,
inadequate practices and surveillance systems persist and there is often
a high risk. Several food borne disease outbreaks have been reported
which are associated with poor personal hygiene. The US Centers for
Disease Control and Prevention says that one in 25 hospitalized patients
develop an HAI and 75,000 patients with HAIs die during their
hospitalization each year. Scientists at Aberystwyth University in Wales
have shown that a shake transfers more bacteria compared to other forms
of hand-on-hand action. Health care providers like nurse’s hands spread
potentially harmful germs to patients that leads to
healthcare-associated infections (HAI) i.e., infections acquired in
health care also called as “nosocomial” and “hospital” infections.7According
to WHO, out of every 100 hospitalized patients at any given time, 7 in
developed and 10 in developing countries will acquire at least one
health care-associated infection. The endemic burden of HAI is also
significantly higher in low as well as middle income than in high-income
countries, in particular in patients admitted to intensive care units and in neonates.5
So what next? Will fist bumps (also
called dap, pound, fist pound, brofist, donsafe, spudding, fo’ knucks,
box, Bust, pound dog, props, Bones, respect knuckles, bumping the rock,
or knuckle crunching) replace handshakes in the hospital or any public
places? Fist Bumps are basically an urban form of greeting one another
by the bumping of fists together, meant as a form of respect.
When you do a fist bump, a smaller
amount of surface area is in contact between the two hands. According to
a new study “Fist bumping” transmits less bacteria than either
handshaking or high-fiving while still addressing the cultural
expectation of hand-to-hand contact among patients nurses and
clinicians.6 A British study has found that high-fives pass less germs as the traditional greeting and the fist bump is even cleaner.7In
an another study the West Virginia researchers found that the
individuals who shook hands had four times as many pathogens on their
hands as the individuals who fist-bumped, according to results published
last year in the Journal of Hospital Infection.8
There have been calls in the Journal of the American Medical Association to ban handshakes from hospitals and make it a global best practice.9
American Medical Association, suggested that hospitals, clinics and
other healthcare facilities post signs with messages as “Handshake-free
zone: to protect your health and the health of those around you, please
refrain from shaking hands while on these premises.”10
If we go back to the Victorian age; when
on meeting someone you bow or curtsy from a respectful distance .
NURSES – NO MORE HANDSHAKES. Next time you want to say “hi,” show off
how casual you are with a friendly fist bump or just bow and say a
Namasthe!
The question remains if healthcare facilities implement the fist bump and make it a global best practice.
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