“Over the years, a very simple question about hand hygiene, which people think is so basic and obvious, led to more questions and answers,” Larson says. Three decades later, her findings have shaped practices in hospitals and the general public. She was one of the first advocates for alcohol-based hand sanitizers and co-authored the Centers for Disease Control and Prevention’s 2002 guidelines for health care workers, which recommend the use of hand sanitizers instead of soap, in part because alcohol kills germs faster and doesn’t require sinks or towels.
For a surgeon doing a pre-operative hand scrub, using a hand sanitizer is equivalent to at least a five-minute scrub with soap. “When I started doing research on alcohols, the infection control community was against it because they worried that people would stop washing their hands,” Larson recalls. Now it’s a standard practice. This summer, Larson became the first recipient of the Distinguished Scientist Award by the Association for Professionals in Infection Control and Epidemiology for her contributions to hand-washing and other epidemiologic research.
Larson’s work has shifted beyond the germs that cause infection to the behaviors that promote hand-washing, specifically, how to get hospital workers to practice better hand hygiene. Infection prevention is crucial—the CDC estimates hospital-acquired infections cause nearly 100,000 patient deaths a year and cost the health care industry $30 billion. Larson’s research team is conducting studies in a Massachusetts hospital and in three pediatric longterm care facilities in New York using electronic monitoring. Employees receive feedback on how the group is doing. “We don’t record names because we believe that an infection-control practice has to be a team commitment,” Larson says. Preliminary results show the monitoring system improves compliance; the team will present some of the findings at IDWeek, an infectious disease conference in October.
Larson’s illustrious career was not planned; she is the first woman in her family to graduate from high school and became a nurse because nursing and teaching were the typical professions for women when she was young. She attended the University of Washington, where she received a bachelor’s degree in nursing, a master’s in nursing and microbiology, and a Ph.D. in epidemiology.
“I love nursing, and I can’t imagine a better career,” says Larson, who came to Columbia in 1998. “I got interested in science as soon as I started school and published my first peer-reviewed paper before I graduated.” Her curiosity has led her to other areas of academic expertise. She chairs one of the Columbia University Medical Center’s institutional review boards and runs a program to train researchers on methods to study infection control. “The fellows are nurses, physicians, computational biologists, microbiologists, epidemiologists,” she says. “What I love about infection prevention research is that by definition it is interdisciplinary.”