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down a department or a floor," Dr. Victor Yu, a professor of medicine at the University of Pittsburgh, told the Tribune. "Even a few hours is a significant loss of revenue." As a result of all these hospital practices, according to the Tribune study, approximately 75 percent of patient rooms are infected with methicillin-resistant staph. A s t o u g h a s s o m e o f t h e s e pathogens are, most health- care experts agree that MRSA and other superbugs are no match for hospital hygiene. The solution to hospital infections may have less to do with high-tech labs and fancy biochemistry than old-fashioned remedies like proper cleaning procedures and keeping the nurse-to- patient ratio down. The Tribune study found that out of 103,000 fatal infections in 2000, some 75,000 were "preventable." According to a study by the CDC and the Society for Healthcare Epidemiology of America, 20,000 lives could be saved by health workers just cleaning their hands more often. Hand washing "is the single most effective way to prevent transmission of disease," says the CDC, but fewer than 70 percent of health workers follow the proper guidelines. According to the CDC, proper hand washing translates into an average of 1.5 hours per shift—time consuming and also irritating for the skin. The introduction of alcohol rubs has improved the situa- tion—such gels save users about 15 seconds compared to traditional soap and water and are less irritating—but since they are flammable, their use may run into fire code problems. Fishman says he has found that nurses are better at washing their hands than doctors, and nursing students are better than nurses. But sometimes nurse-to-patient ratios simply overwhelm tech- nique. Depending on the hospital unit, nurses may have upwards of 12 patients and more than 100 bedside contacts in one shift. "Some- times it is a matter of time," says Hedy Dumpel, RN, JD, chief director of nursing practice and patient advocacy for CNA/NNOC. "Under conditions of speedup, people will take shortcuts." Because of CNA/NNOC, California has the best nurse-to-patient ratios in the country, ranging from 1:1 in trauma units to 1:5 in medical surgical units. But those figures are rare elsewhere in the United States. Many nurses also work over 60 hours a week, leaving them exhausted. Studies show that tired healthcare workers are less likely to follow proper hand care procedures. McVay says her experience is that many hospitals simply do not 14 R E G I S T E R E D N U R S E W W W . C A L N U R S E S . O R G A U G U S T 2 0 0 6 "People seldom sue over hospital-acquired infections, and it's difficult to prove