Handshake-Free Zone: Keep Those Hands – and Germs – to Yourself in the Hospital

Though the formal experiment is now over, the signs in the NICUs are still in place and doctors and nurses still discourage handshakes.

Avoiding handshakes is an effective way to decrease the spread of germs, said Maureen Shawn Kennedy, editor-in-chief of the American Journal of Nursing. Health care providers do wash their hands frequently, she said, but often they don’t do it for long enough or use the right technique. And bacteria live on computers, phones, medical charts and uniforms throughout hospitals, she noted.

“There are just so many reasons to avoid handshakes, even when people are washing their hands,” Kennedy said. “Just because someone is walking around in a white coat … doesn’t mean they don’t have bacteria on their hands.”

Although there is no data to prove that reducing handshakes limits hospital infections, one study showed that bumping fists was more hygienic than shaking hands.

However, some infectious-disease specialists believe health care workers don’t need to stop shaking hands. They just need to scrub better.

In a 2015 editorial in the Texas Heart Institute Journal, Herbert Fred, a Houston physician, wrote that “the problem isn’t the handshake: it’s the hand-shaker.” Doctors need to ensure their hands are clean before touching patients, he said.

Didier Pittet, an international expert on hand hygiene, said in an email that handshake-free zones are not the solution for hospital-acquired infections. They simply “reflect the lack of capacity in infection prevention and control,” he said.

Sklansky agreed that hospitals need to improve compliance with hand hygiene, and he said handshake-free zones aren’t designed to replace hand-washing but to complement it. “I actually think handshake-free zones will bring attention to the hands as vectors for disease and help improve compliance with hand hygiene,” he said.

Neonatologist Joanna Parga, who was part of UCLA’s handshake-free survey, said she liked the idea when she first heard about it but wasn’t convinced it would work. Shaking hands is “so ingrained in our culture,” and it is how many doctors connect with patients, she said.