In the latest edition of the American Animal Hospital Association’s Trends magazine, there’s an article about veterinary clinic design. The section dealing with exam rooms says:

Discussion is ongoing about whether sinks are needed in the exam room now that hand sanitizers are available.

• I’m not sure who’s discussing this. Hand sanitizers are great and should be used as much as possible, but that doesn’t mean handwashing is obsolete. Some pathogens we deal with are resistant to alcohol, such as parvovirus, Clostridium spores and ringworm. We need to wash hands when these bugs might be present. Hand sanitizers also don’t help if you have chunks of pus, blood or feces on your hands. If there’s no sink in the exam room, handwashing usually won’t be done when it’s supposed to be. If someone has to leave the room and walk to a sink, it just doesn’t happen often, even if it’s a short distance. A person also runs the risk of contaminating other surfaces along the way, between the exam room door and the sink.

Experts agree, however, that if you have a sink, your clients will expect you to use it to wash your hands.

• I’m not sure who these experts are, or what they’re experts in. Certainly not common sense or infection control. What they’re implying here is that pet owners will think veterinarians aren’t doing a good job if they see a sink and the vet doesn’t use it, but that if no sink is present, no one will think twice about a vet failing to practice good hand hygiene. If an owner is going to clue in to the presence of the sink and failure to wash hands (something we should be encouraging), their common sense and observation skills won’t evaporate if there’s no sink.

This is similar to an interview with an architect on dvm360.com where the guy says "if I have a sink I better wash my hands or the client thinks my hands aren’t clean. In many cases it’s better off not to have a sink…" (note: the banging you hear is me hitting my head against a wall). The same architect cited in this article, so hopefully he’s actually the only one pushing this approach.

Pet owners aren’t dumb.

Infection control isn’t rocket science.

Handwashing is important and under-used.

We need sinks in exam rooms.

Common sense needs to be more common.

It’s difficult to put sinks in existing exam rooms – some clinics just can’t do this easily. That’s tolerable if they are diligent in their infection control practices, use hand sanitizers as appropriate and make sure they get to a sink (without contaminating things along the way) when they need to wash their hands.  Not putting sinks in a newly designed clinic is just dumb.