Here it is finally, the study we all have been waiting for. 'THE question' that has never been answered... until now!
Every day we all do our best to establish the best patient-physician relation possible. The first impression counts and besides introducing ourselves verbally we ware name tags to visually inform about our name and position. But did anyone actually ever ask himself if it makes a difference wether you ware your name tag on the left or right side of your chest?
Well, an orthopaedic surgeon in Switzerland obviously has and conducted a 'blinded' study to answer this specific question. He made one hundred volunteers, blinded to the experimental setup, present for an orthopedic consultation in a standardized manner. The name tag of the physician was randomly positioned on the left chest side and presented to 50 individuals (age 35 years (range 17 to 83)) or the right chest side and then presented to 50 other individuals (35 years (range 16 to 59)). The time of the participant noticing the name tag was documented. Subsequently, the participant was questioned concerning the relevance of a name tag and verbal self-introduction of the physician.
38% of the participants noticed the nametag on the right as opposed to 20% who noticed it if placed on the left upper chest... hey, this turned out to be statistically significant, giving us a p-value of 0.0473!
The author concludes: Positioning the name tag on the right chest side results in better and faster visibility.
- Also orthopaedic surgeons seem to be interested in a close patient-physician relationship
- Orthopedic surgeons actually do talk to their patients!
- Orthopedic surgeons in Switzerland don't seem to be overstrained with their workload
Schmid SL et al. March 2015, PLOS One, DOI: 10.1371/journal.pone.0119042
Just this week the World Health Organisation WHO has issued a warning that resistance of organisms to antibiotics will become one of the biggest challenges of the upcoming decade. Indeed, the correct prescription of antibiotics is crucial for successful treatment and the WHO states that completing the full length of the treatment is just as important.
But what is actually the correct length of treatment for all the different antibiotics and diseases? How many ward rounds on ICU's have I spent with microbiologists (the maybe most important specialists on our sides!) wondering on how they always had a straight answer on the correct length of treatment. 7 days, 10 days or sometimes 21 days... a little mystery to most intensivists, until now!
Hitchhiking though the the wide space of the internet I finally found secret to this question. Back in the year 2010 Paul E. Sax, a Professor of Medicine at Harvard Medical School him self, posted an excellent blog for the NEJM Journal Watch website. Inspired by a New York Time article by Harvard Professor Daniel Gilbert he finally gave insight into one of the great mysteries of medicine:
To figure out how long antibiotics need to be given, use the following rules:
That did not occur by chance
Wow, not much more I can add!
Paul E. Sax, NEJM Journal Watch HIV/AIDS Clinical Care, October 22nd 2010
NYT article by Daniel Gilbert from October 2010
Fist Bumps Prevent Spread of Bacteria... And Why This Study Won’t Change Social Behaviour (Well, at least not in Ireland)
Some studies are fascinating and disconcerting at the same time... but at least they’re good for a smile!
In this paper by Ghareeb et al. the authors addressed the question whether a handshake or a fist bump is more effective in preventing or reducing pathogen transmission in the setting of a hospital, where most of us work of course. Unsurprisingly they found that using the fist bump instead of handshakes made skin contact 2.7 times shorter and this reduced spread of bacteria. They concluded that the fist bump is an effective alternative to the handshake in the hospital setting and that bumping might lead to decreased transmission of bacteria and improved health and safety of patients and health care workers alike.
So shall we all start bumping around the hospital?
We performed an observational study in our medium sized ICU in Galway (without approval of any committee and of course without any statistical evidence to be presented, actually just out of interest and for fun). We might also mention beforehand that working atmosphere in our unit is very good and nurses and doctors work very closely together.
Interestingly, neither nursing staff nor doctors shake hands when they meet and greet each other in the ICU. The only occasions handshakes were observed are when relatives are met for a discussion or a representative of some company comes in for a visit.
In regards of the study mentioned above I have some serious concerns: I wonder how many health care professionals out there would welcome a family fist bumping that has come in to discuss an end-of-life issue for instance. Also when representing the unit towards someone outside of hospital a fist bump carries some substantial risk of giving a very unprofessional impression... at least in Europe! And in very few occasions also a warm hug will be irreplaceable by some awkward bump. Social behavior is also a way on communicating... and anyhow, who pays for such studies?
Ghareeb PA et al. J Hosp Infect. 2013 Dec;85(4):321-3
Picture displayed above is taken from the New York Times