Hygiene and your hospital
Filed under: Work Life, Places To Go, Health & Safety: Babies
The online edition of the London Times reported this week on television's queens of clean, Aggie McKenzie and Kim Woodburn, visited Ealing Hospital, in West London, a unit that had the third worst rate of infection in the UK in 2003. Given that one patient in ten catches an infection in hospital, and that hospital-acquired infections kill about 5,000 people in England every year, the tone of this one-hour special is a little more serious than their usual romps. Though the program over covers only one hospital, what it found was both reassuring and shocking. Microbiologists could not find a trace of the MRSA that blighted Ealing's reputation. Preventive measures introduced since 2003, such as a wash-your- hands campaign and executive team walkabouts, have clearly worked. However, that didn't mean the hospital was clean. Aggie and Kim found toilet brushes encrusted with feces , containers of bloody dressings left exposed on corridors for hours , and a doctors' lounge that brought a new meaning to mess- room ("It's like a student flat"). One microbiologist found high levels of the bacteria Staphyloccus aureus all over the place, particularly on the bed tables that patients ate from, their lockers and telephones. This bacteria is one of the most common sources of infections in hospitals, and when it enters under the skin it can cause anything from a pimple to potentially fatal blood poisoning or pneumonia. These are the bugs that, when they become resistant to antibiotics, become MRSA. What was genuinely shocking in the program the apparent reluctance of some of the doctors and nurses to address the issue of cleanliness.
Microbiologists believe that by simply using an antimicrobial alcohol hand gel when people enter and leave a ward could cut infection rates by 50% at a stroke. Yet secret cameras placed in the hospital over one weekend revealed that 65 per cent of visitors, 55% of nurses and 93 per cent of doctors did not use the gel. In fact, the main message from the program is the one that health education experts have been pressing for years, but which clearly still hasn't sunk in. It's the really simple things, such as washing your hands, that can help to reduce hospital infection rates.
Do you think similar findings would be found in the U.S.? I don't: a recent study looked at who was most apt to wash their hands in the hospital. You guessed it: physicians were at the bottom of the list. This could be because many use rubber gloves, but it is still not too reassuring if the leader of medical teams don't set an example. What do you think?
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ReaderComments (Page 5 of 9)
8-29-2006 @ 10:54PM
renee said...I had a friend whose doctor canceled the surgey because he got a splinter in his hand and didnt want the risk of infection .. I think some are good docs but some dont care about anything but money.. as for hospitals they lack the care they used to have...and race has nothing to do about infection germs dont discriminate who they are on... white people black people and mexicans all spread germs the same way..
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8-29-2006 @ 11:01PM
Margie said...BD: Yes we all have normal flora that lives on our skin, including staph. The problem occurs when the normal flora or staph enters the body through a cut or incision. On the skin it's harmless. In the body it can be deadly. Our skin is our first line of defense against many germs. Once the integrity of the skin is broken we are at risk. Keep all wounds covered with a clean dry dressing and don't let anyone mess with it until they wash their hands including yourself. Plus make sure those gloves they have on are at least clean (just put on from the box) if not sterile. If someone comes into your hospital room with gloves on, they're not clean and certainly not sterile.
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8-29-2006 @ 11:39PM
Lynn said...My 96 year old grandmother went into the hospital to have a wound on her leg looked at by a specialist and came out of the hospital with a staph infection. Fortunately, intravenous antibiotics cured it, but she was really put at risk by this hospital.
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9-07-2006 @ 7:55PM
Linda Hoaglin said...When did the hospitals become so lax on precautions for MRSA? I worked housekeeping for two years in the early 90's in a local hospital. First, a notice that a room was an isolation room was posted on the door with instructions. No one was allowed in an MRSA room without complete covering. A paper hat, paper gown, gloves, mask, and coverings for the shoes were required of anyone entering. The water we used for our cleaning cloths was disinfectant and was used in every room. Our mop water was also disinfectant. We used clean disinfectant mop water for MRSA rooms and a clean mop head, clean cloths and disinfectant for wiping all surfaces in the room, including the bed railings. A red trash can was kept in the room for all trash and infectious waste items (bandages, etc.)This trash can was lined with a red bag. This was taken to a room and put in another red container which was collected once a day and put in a sealed and taped plastic container which was stored in an outside shed until it was picked up to be taken to another facility to be burned. All hospital clothing was also red bagged and taken to the laundry to be washed separately from anything else. There were strict guidelines in the laundry that were followed. After cleaning the room the mop head and rags were also red bagged and sent to the laundry. Then anything in the way of dust mops or mops that had been taken into the room was completely sprayed down with a special spray used for that purpose. Our paper gowns, head covering, etc. also were red bagged as infectious waste. Even visitors were required to wear the paper outfits and masks. When the patient discharged a cleaning team went in and completely washed down everything in the room and curtains were sprayed with a special spray for MRSA. We had very few cases of MRSA in a 280 bed hospital. Yet, my mother was in a hospital in Illinos 2 1/2 years ago. This was a large hospital, the only one, in a town of about 50,000 people. They had just opened their new cardiac wing and Mom was the first woman to have a triple by-pass. She came down with MRSA in the wounds where they harvested the veins from her leg for her heart procedure and almost died. We were never told what Mom had, just that she had two infections going on (MRSA & C-Diff). We were given no guidelines as how to protect ourselves, or our children. There was a green isolation tag on her door with little information. The housekeeper barely cleaned her room, no one ever gowned up except the Radiologists when they came into her room. The only way we found out Mom had MRSA was when I point blank asked the case manager if Mom had MRSA. A doctor came in without washing his hands, without gloving up and pressed around on Mom's wound. When I asked him why he didn't wear gloves he said he had been in charge of infectious disease for 25 years and he was very careful not to touch anything in a patient's room, and then he placed his hand on the bedrail and leaned on it while talking. He did not wash his hands when he left the room although he may have used gel in the hall. I never saw any trash red bagged, and that included the bandages from the wounds. She was taken outside the room for procedures and her gown was never changed. Mom never regained her strength and steadily declined. Her wounds never completely healed, the MRSA colonized in her body and she went through the whole ordeal a second time. What was supposed to be a wonderful new life resulted in a very painful death. All because someone didn't get a piece of surgical equipment sterlized or a room wasn't properly cleaned after another MRSA patient or someone didn't wear gloves or wash there hands, or a nurse subbed from another floor and didn't take any precautions to protect her patients. One small step wasn't done by someone that could have saved my mother from suffering so terribly.
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8-29-2006 @ 10:56PM
Patty said...Reply to:
excuse me, but i am a nurse and i and all the nurses i work with wash our hands until they almost bleed. we do it for the patients but even more so for ourselves and our families. if you ask me, the problem is with the noneducated, don't really care-- housekeepers. i have watched them for 20 years in the hospital- they will use the same mop to mop all the rooms-nasty- just spreading germs everywhere. i just hate it when they put their gloves on (to protect themselves of coarse) and clean an infectious room, then come out of the room with the same dirty gloves on and insist on using the nurses phone at the desk- i have screamed at them many times and they keep doing this-disgusting!! many are hispanic or black with very little education and do not take pride in their work and don't realize the dangers they lie in their hands when they don't clean properly. all the hand washing won't help a darn thing if the housekeepers are spreading the crap all over the place-everything is then contagious and you can't wear gloves 100% of the time.
Posted at 8:31PM on Aug 29th 2006 by alien help don't know or care 0 stars
Well, now, aren't we a little testy! You are educated? (to protect themselves of coarse) Learn to spell, and maybe you will have some credibility. That my dear is course. Not coarse as in salt or sugar. You apparently appear to be racist too and your attitude bothers me. There are plenty of whites with little education as you appear to be. I am also white, but do not care to hear from losers like you as to what race is to blame for spreading germs. It has no relevance what so ever. Everyone should take more precautions for the well being of germ spreading. If the hired help is not getting it, maybe the place where you work should have more in-services on the subject. A little understanding from a nurse such as yourself might not be to yell at the help, but explain the problem and solution to the one doing the wrong thing (for at least the first time). You could also recommend to your employer an in-service on the subject for all. Also, I am sure the facility in which you work does not provide new mops for each room; what choice does the help have in that matter?! Swiffer could make a killing couldn't they?
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8-31-2006 @ 12:05PM
Diane Butler, M.D. said...As a pediatrician, I work in an office that has a sink, soap, water and paper towels in every patient room. For those who desire it, there is also the antibacterial gel, although I personally prefer the soap and water routine. Although I understand that some physicians seem to have a hard time remembering to wash their hands, there are others of us who work hard to try and prevent such infections and change such behaviors. I wonder if there is a gender difference between those who wash their hands and those who don't, or whether their is a "Goddess" as well as a "God" complex at work. As medical professionals, we need to keep working on our colleagues to change behaviors which have been clearly demonstrated to be harmful whether it is the overuse of antibiotics or the underuse of the soap and water.
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8-29-2006 @ 11:00PM
jim said...Lets see how much you people complain next time the ALS unit carts you into the trauma wing and saves your ass from certain death! sometimes an infection is the Least of your problems and you should really stop being so critical. why dont you check what goes on in the local elementary school or McFat burger ? these same people are throughout our society! Heck , swab your own keyboards!
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8-29-2006 @ 11:16PM
Mary said...Hospitals are germy - duh........
So why do people do stupid things like bring a little baby in to visit their sister's sick toddler? Or bring their snotty-nosed toddler in to visit sick grandma? Or auntie who just had surgery comes in to visit.
And when nurses like myself politely ask family members to protect themselves and each other, the families are offended.
MRSA (methicillin resistant staph aureus) is no longer a hospital acquired infection. It is out in the community. Probably between 75 and 90%of the population carries it, because people do not clean their own bathrooms. It is treatable - there are a number of antibiotics that work quite well. But people who have had the infection need to have themselves tested twice, six months after first being diagnosed. And most people just don't bother. Until a family member is hospitalized, and then they are sure that the infection came from the hospital.
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8-29-2006 @ 11:20PM
sls said...I was in the hospital in 2001 for a cardiac cath procedure. During the course of that procedure, the insertion site in my groin became infected with Mersa. The doctors were unaware that I had acquired this infection and could not understand why I was in such bad shape. When I was close to death, my family had me lifeflighted to a major metropolitan teaching hospital where I was told that I had acquired Mersa during the cardiac cath at the first hospital and that I needed an operation on my groin to excise all infeced tissue. After that,I was placed on vancomycin for 6 weeks. The IV had to be dripped into a central line in my chest and it took 45 minutes twice a day to accomplish this. This is an extremely caustic antibiotic which can only be given IV through a major vessel, not an arm. Having had this and discussed it at length with my second set of doctors, it became apparent that this is a problem which can and should be corrected. It is the dirty secret of hospitals; they all have it. What is needed are kick ass hospital administrators committed to stopping it. The solution is a total focus on infection control in every part of the hospital. Infection rates among hospitals should be published and posted in a conspicuos place so patients could make an informed choice before being admitted.
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8-29-2006 @ 11:19PM
shannon said...I had a baby in jan 2005 which reqired a c-section My doc and nurses all were told by me or my husband to wash their hands infront of me before touching me even with gloves.. This is what we need to do. REQUIRE them to do this.. Its the only way to know they are clean...
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8-29-2006 @ 11:21PM
Barbara said...Here are some of my observations: Hospital rooms with carpet on the floor instead of cleanable tile , Uncleaned bathrooms...bloody bandages left for days in the waste can, a filthy rag used to clean the pharmacy floor later used for wiping down the area where IV's are mixed, tubing placed down my mother's throat that was allowed to drag on the floor. These incidents took place at a variety of hospitals, from local county facilities ( where I once worked), to huge univeristy-affiliated centers. It's a wonder anyone survives a stay at the hospital.
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8-30-2006 @ 2:41PM
Jill said...Every one keeps talking about mrsa, has anyone ever heard of necrotizing faciitis? The flesh eating disease,,most of these infections come from hospitals, where the staff doesnt wash their hands. The terrible part of this disease is that its always mis diagnosed so many who have it die within 2 days of infection. Email me if you want more info on it, I am happy to share. Garyjill2325@aol.com
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8-29-2006 @ 11:57PM
Amber said...Well it's really not a surprise to me that the M.R.S.A infection is a real threat when people don't pratice proper hand washing.In the year 2003 my 14 year old sister has a cold went to the e.r room for treatment and had caught M.R.S.A and died within 3 days and here in the U.S the medical people try to hide the fact that it's a problem and noone wants to to responce ability for there actions so I am here with no family and no peace!!People need to wake up and spead the message not M.R.S.A!!God help the next person who gets it!!!!!!
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8-29-2006 @ 11:36PM
Angie said...This is in response to #14. You are in the same category as the "uneducated housekeepers". Whoever heard of a nurse that is unable to spell. What a retard!!
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8-29-2006 @ 11:39PM
Devasted Mom said...My 19 year old son got legionnaire's disease in a "clean room" at a nationally recognized hospital. He was getting a stem cell transplant for leukemia and ended up dying from being exposed to a bacteria that should have never entered his room. It's not just hand-washing, it's overall maintenance that needs to be addressed. And to make it worse, the doctor's hid the truth from us for two weeks. We found out what my son really had by accident the day before he died. They didn't report the legionella to the health department until more than two weeks after my son's death. Well after the source was cleaned up.
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8-29-2006 @ 11:42PM
Barbara said...I was in the hospital in November for a Colon resection. I ended up with an infection in my chest and my chest filled up with fluid. I had to go back to the hospital for another week and it took 3 months to clear up the infection. I had surgery in June and was in there a month because I got a strep infection in my intestines. I went home and had to go back for another week. I have been on IV antibiotics every since I got out of the hospital. They are still trying to get the infection cleared up. The doctors didn't wash their hands. Housekeeping never cleaned my bedside table and only cleaned the bathroom about every 3rd day. I'm afraid to go back there.
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8-29-2006 @ 11:43PM
Diana said...Ladies do you know that your hand bag has as many germs on it as a toilet seat....Something to think about isn't it!
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8-30-2006 @ 9:06PM
Peg said...I was in a rehab for 24 days - cost $37,000.00 plus doctors fees for daily visits. What a stink-hole! Overflowing wastepaper cans containing soiled diapers, cath products, and bed pads on a daily basis in the room and bathroom. We were only allowed a shower every other day - in a room across the hall where everyone else was wheeled for their shower. My room was never thoroughly mopped the entire time I was there. The same dust bunny was in the bathroom when I got there and when I left. Doctors did not wash or use sanitizer. Aids taught "newbies" the way they did procedures, and then told them the way they were supposed to be done. It was so discusting that I took some pictures with my cell phone just in case I need them later. I have to have more surgery and I have told all my doctors that I don't want to go back to that rehab and why. They even lied on my paperwork to make it look like I was getting better, but I wasn't! I'll now need more surgery. I'm glad I got out of there alive. DUH!
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8-30-2006 @ 10:43PM
MIKE STASHO said...A FEW YEARS AGO A NEIGHBOR NEXT DOOR WAS READY TO COME HOME AFTER A CHECKUP.HE WAS FINE. THEN HE SOMEHOW PICKED UP INFECTION AND DIED. TOO MUCH NEGLIGENCE IN AMERICAN HOSPITALS!
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8-30-2006 @ 12:02AM
Charlene Anfinson said...My husband went from the ER to Intensive Care. There he contacted Staph. He passed away. This is a problem that must be delt with. Too many people are exposed to this dreaded illness.True my husband was ill, but Staph contributed to his death. This is an outrage that so many are exposed to this carelessness. Someone needs to monitor the staff more closely.It is a shame they have to be treated like grade school children, but if that is what it takes, so be it.
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