Summit, I also respect you and don't think that your post wasn't harsh in the least. It's obviously a point that you're passionate about.
However, after reading your interpetation of my statement, I should reprashe to be a bit more clear as to my point; The OP seemed worried about getting cooties from his/her pen. This was followed by much talk about things getting icky... and my statement was made to reiterate that there are many possible vectors of disease transmission that should be as forefront as the everr popular "EMS pen".
And how do you know that the pen that waitress just handed you wan't contaminated by a sick person? When was the last time that pen saw a cavicide wipe? How do you know that the waitress hereslf isn't colonized by a drug resistant bug? How do you know the Pin Pad at the ATM wasn't just operated by a person with Impetigo and those weeping sores? Do you wash your hands before and after each use of the ATM? Does anyone?
Does the waitress have a imperative to protect me from the patogens that may be on the pen or the menu? Does the restaurant owner?
Yes, I agree. I think EMS hand hygiene, and infection control as a whole, is atrocious. But, that's where it needs to start. Not by scaring EMS providers into throwing away pens because every patient that signs will give them MRSA. If EMS really wanted to be relevenat in the world of infection control, we would we wearing a uniform that was discarded after each patient contact, use fully disposable equipment and have a full on decon procedure for the vehicle and fixed assests after each patient encounter. I don't see ANYONE doing that. Or anything close.
Barring all that, I think a base education other than, "if its wet and sticky and not yours, don't touch it" and a solid hand hygiene program is a good start.
"...handwashing is the single most important public health practice to prevent the spread of disease from person-to-person in instances in which respiratory droplets are not the vehicle of transmission."
Y Nigam and J Cutter. A preliminary investigation into bacterial contamination of Welsh emergency ambulances. Emerg. Med. J., Sep 2003; 20: 479 - 482.