Email Each year, in the United States, thousands of patients seek medical care at both inpatient and outpatient facilities, but emerge from routine, urgent or surgical care with an additional -- and sometime untreatable -- life-threatening illness.
Messenger Infections, like taxes, are inevitable to paraphrase Benjamin Franklin. Most are acquired in the community and the dangerous ones are, in the main, very difficult to prevent. But many infections are preventable and, regrettably, most of these occur as a consequence of hospitalisation.
It has been estimated that aroundhospital-acquired infections occur in Australia each year and these infections result in almost two million additional days in hospital. About ten years ago, health systems belatedly acknowledged that the means of reducing the transmission of infection in hospitals was right before our eyes: Even before bacteria had been identified as the cause of contagion, Dr Ignaz Semmelweis, a Hungarian-born physician working in the Vienna Hospital in the s, proved that his dirty-handed medical staff were responsible for the high death rate of women after childbirth.
Nevertheless, within decades the germ theory of infectious diseases had been universally accepted. The ability of invisible micro-organisms to cause serious illness and death became a plank of Western medicine. By the turn of the 20th century surgeons learnt how to minimise but not eliminate the risk of surgical infection through sterilisation of instruments, the creation of clean operating theatres and the wearing of sterile gowns and gloves.
The introduction of antibiotics in the mid 20th century further reduced the risk of post-operative infection and the wards that had been full of patients suffering from dreadful infections soon emptied out. But over the next two generations the medical community lost much of its previous respect for germs.
Doctors with unwashed hands are like bees which move through the hospital, cross-infecting their patients. Washing hands with soap and water before and after every single patient contact takes too long.
So staff apply hand rub and move between tasks while it is drying. Bottles of hand rub can be placed throughout the hospital, acting as constant reminders to perform hand hygiene. But this remarkable achievement in hand hygiene was spoilt by one disturbing statistic — doctors only increased their compliance rate to One reason may relate to modelling of behaviour — health professionals are tribal and follow the lead of their professional peers.
At our medical school, we provide intensive education about hand hygiene for our medical students but when they enter the hospital they are influenced by the example of their often unwashed supervisors.
Alcohol-based hand rubs are more convenient than using soap and water. Medical cultures, it would appear, are much harder to change than microbiological cultures. We are now entering a time when the end of antibiotics may be in sight for many bacterial infections. This will have terrible implications for people who are at increased risk of infection, such as those with kidney, heart and bone marrow transplants.People now use nosocomial infections interchangeably with the terms health-care associated infections (HAIs) and hospital-acquired infections.
For a HAI, the infection must not be present before. Now wash your hands. Washing your hands, aside from vaccination, is probably the most effective contribution you can make to public health. Regularly washing your hands, especially after going to the toilet or if you have the cold or the flu, will help prevent the spread of infection.
The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings.
In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of. The effect of hand hygiene compliance on hospital-acquired infections in an ICU setting in a Kuwaiti teaching hospital.
Hand hygiene compliance and infections caused by multidrug-resistant bacteria. D. PittetCompliance with hand disinfection and its impact on hospital-acquired infections.
Journal of Hospital Infection, 48 (Suppl. .
Conclusions A hand hygiene protocol for patients in the intensive care unit was associated with reductions in hospital-acquired infections and improvements in nurses’ hand-washing compliance. Prevention of such infections requires continuous quality improvement efforts to monitor lasting effectiveness as well as investigation of .
In one study, hospital-acquired infections were reduced 25% by handwashing with soap plus antiseptic compared to a control group who washed with soap alone. 7 The absolute indications for handwashing with plain soaps and detergents versus handwashing with antimicrobial-containing products are not known because of the lack of well- controlled.