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Handshake ban: How one doc is fighting infection

Hospital Safety Insider, June 1, 2017

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It’s a universally recognized custom that evolved over millennia, but one pediatrician wants to ban it.

“We are trying to do everything to minimize hospital-acquired infection except for the most obvious and easiest thing to do, in my opinion, which is to stop shaking hands,” Mark Sklansky, MD, professor of pediatrics at the David Geffen School of Medicine at UCLA, told NPR in an interview published this week.

Sklansky outlined the cultural history of the handshake in a 2014 editorial published by the Journal of the American Medical Association, in which he proposed the idea of prohibiting the greeting in healthcare settings. The following year, he launched an experiment to test the idea.

Over the course of six months, Sklansky’s team posted signs in the neonatal intensive care units (NICU) at two UCLA hospitals: “To help reduce the spread of germs, our NICU is now a handshake-free zone,” the signs stated. “Please find other ways to greet each other.”

The experiment didn’t measure whether the ban effectively improved infection control. Sklansky aims to conduct a follow-up study to address that question. But the immediate results revealed that a ban effectively modified behavior. Handshake frequency declined, and most patient families and healthcare professionals supported the initiative, according to the results published earlier this year by the Association for Professionals in Infection Control and Epidemiology.

Backing for the ban, however, hasn’t been universal. Herbert L. Fred, MD, MACP, associate editor of the Texas Heart Institute Journal, wrote a 2015 editorial on the topic.

“I see the ban as a cop-out, a move that misses the point. The problem isn’t the handshake: it's the hand-shaker,” Fred wrote. “All the physician has to do is make sure that his or her hands are clean before making contact with a patient. Banning the handshake skirts the issue by exonerating the neglectful hand-shaker.”

For his part, Sklansky said his initiative isn’t designed to replace hand washing.

“I actually think handshake-free zones will bring attention to the hands as vectors for disease and help improve compliance with hand hygiene,” he told NPR.

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