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Assembly Bill 280 Leaves Handwashing Out of Hospital Health Checklist

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The Reno Gazette Journal‘s Frank Mullen Jr. reports:

A state Senate committee Thursday passed a hospital checklist bill, but declined to put a section about hand washing, requested by advocates for hospital patients, back into the measure.

Assembly Bill 280 would require safety checklists and patient safety policies at hospitals and other health care facilities.

Assembly lawmakers removed language that mandated health workers "wash their hands before and after every interaction with a patient and after coming into contact with a surface or object that may be contaminated."

The bill now refers to using proper "hand hygiene," a term that the bill’s sponsor, health care industry lobbyists and a committee member said encompasses all types of hand hygiene, including soap and water.

"The sinks often are not close enough to the patient, but (alcohol-based) gels are," said state Sen. Joseph Hardy, R-Clark County, a doctor who is on the state Senate Health and Human Services Committee.

He said putting in a reference to hand washing would "send a message that hand washing is enough, but hand washing is not enough."

The Nevada Chapter of AARP and other advocates submitted an amendment that mentioned hand washing among the options available for hand hygiene.

They said that hospital staffers often ignore existing hand hygiene provisions and that the alcohol-based gels mentioned by Hardy don’t kill an intestinal infection called Clostridium difficile, that is known to spread in health care settings.

"I personally prefer the (hand-washing) amendment," said state Sen. Sheila Leslie, D-Reno. "It would be in the bill as an option, not a mandate."

The measure passed without the amendment.

Steve Winters of Reno, who became an advocate for patient safety when his mother died last year of C. diff, said he was disappointed.

"Doctors don’t want to be told to wash their hands," he said after the vote. "So, it’s business as usual, and people will keep dying of preventable infections."

On Wednesday, three other hospital reform bills were heard in the Assembly Health and Human Services Committee with no action taken.

Senate Bills 209, 264 and 339 would require hospitals to publicly report their annual number of hospital-acquired infections and medical errors, require doctors to inform patients when they have an infection, and allow greater access to other patient safety information.

During the Wednesday hearing, health care industry lobbyists testified that they favor transparency, but objected to reporting raw numbers of facility-acquired infections for every hospital.

They would rather report infections in rates per 1,000 "patient days," a method they said allows fairer comparisons among large and small hospitals.

Patient advocates argue actual numbers of cases, not rates expressed in decimals, are more easily understood by consumers.