title: Handwashing patterns in two dermatology clinics.
abstract: BACKGROUND
  The hands of health care workers are a major source of nosocomial infection. Studies conducted mainly in intensive-care units and emergency departments have shown low compliance with hand hygiene recommendation.
  
  
  OBJECTIVE
  To study hand hygiene practices in outpatient dermatology clinics in Israel.
  
  
  METHODS
  The fingers of 13 dermatologist physicians were sampled for bacterial cultures and their hand hygiene practices were monitored by two observers. In addition, 51 dermatologists attending a professional conference completed a questionnaire on hand hygiene practice.
  
  
  RESULTS
  All the physicians' hands were found to be contaminated. Staphylococcus aureus was isolated in 9 cases (69.2%), a methicillin-resistant S. aureus in 1 (7.7%). Monitoring revealed 555 opportunities for handwashing; the average compliance was 31.4%. In the questionnaire, the main reasons given for poor hand hygiene were excessive work schedule (58%), lack of awareness (35.3%), reaction to disinfectants (17.7%) and lack of readily available facilities (15.7%).
  
  
  CONCLUSIONS
  The hands of dermatologists are frequently colonized with microbial pathogens, but compliance with hand hygiene practice recommendations is low, despite a fairly high awareness of the importance. An active educational infection control program should be introduced in dermatology clinics.
authors.affiliation: Pediatric Ambulatory Center, Department of Family Medicine, Petach Tiqwa, Israel. hermanc@post.tau.ac.il
authors.forename: H A
authors.initials: HA
authors.lastname: Cohen
authors.forename: E
authors.initials: E
authors.lastname: Kitai
authors.forename: I
authors.initials: I
authors.lastname: Levy
authors.forename: D
authors.initials: D
authors.lastname: Ben-Amitai
mesh_terms: D000554:Ambulatory Care Facilities; D001291:Attitude of Health Personnel; D003428:Cross Infection / Q000517:prevention & control; D003880:Dermatology / Q000592:standards / Q000639:trends; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D019983:Guideline Adherence; D006225:Hand; D006235:Hand Disinfection / Q000592:standards*; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007557:Israel; D008297:Male; D010820:Physicians; D018570:Risk Assessment; D012494:Sampling Studies; D012867:Skin / Q000382:microbiology*