NURSES – NO MORE HANDSHAKES

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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Telehealth Nursing in India is a Global Best Practice

As Indian population is growing rapidly and it has become the second highest in the world, there is a huge need to have more healthcare facilities. Most of the hospitals require more number of nurses and doctors who can treat patients quickly and efficiently. To fulfill this need, technology has provided a boon called as Telemedicine and further now it is growing as Telehealth Nursing.

Telehealth Nursing is a very novel concept in India. It is one of the Global Best practices, which is in the initial stage in India. First, let us understand what is “Telehealth Nursing” . According to American Telemedicine Association (ATA), telehealth nursing is defined as the use of telehealth/telemedicine technology to deliver nursing care and conduct nursing practice. Nurses are directly engaged in the virtual delivery of healthcare through telehealth nursing.

Telehealth nurses require the same nursing skills and knowledge similar to nurses practicing in specialty areas. Along with this they should have the ability to understand and apply technology to the best of their capability to assess and communicate the patient’s physical and mental status. Nurses also need to understand that even technology has some limitations and certain aspects in nursing are dealt with physical presence rather than virtual presence.

Telehealth Nursing is an extension of Telemedicine. Now, let us understand little bit about Telemedicine. According to ATA (American Telemedicine Association), it is broadly defined as the delivery of any health care service through any telecommunication medium, for example, a patient consulting a physician, nurse or allied health professional via a video conference, rather than face to face or in person, or a patient with a chronic condition utilizing an in home device to monitor vital signs and transmit data to a nursing center for assessment and medical intervention.

Patients and health care personnel such as physicians, nurses, and technicians living in different geographical places can communicate easily with the help of telemedicine. The senior Director of communication at ATA states that “the one thing that ties all telemedicine together is that it involves a clinical health care service, it directly contributes to the health and well being of the patients, and the patient and provider are separated by some geographic distance.

We Indians are becoming more technology savvy and it is need of the hour to understand and utilize Telehealth Nursing and telemedicine to our best advantage, as we are hugely populated. People should get all nursing and medical facilities even if they are in different geographical areas.

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