Fight against hospital-acquired infection begs joint effort

By Mariecar Jara-Puyod December 18, 2015 Print Send to Friend DUBAI: Have you ever wondered why the sheets at the doctors’ consultation rooms are similar to paper towels, easily rolled down and immediately discarded after use? It has to do with the prevention of hospital-acquired infection—HAI. In this regard, a hospital in Dubai, which The Gulf Today talked to, employs a certified company to run its water supply through a thorough quality test. This is done monthly. “Our water is also tested every month for bacterial and colony count (measurement for bacterial growth),” said Dr Anil Grover.

He quickly pointed out that health facilities must always excellently keep the resource, particularly for dental procedures.

The Internal Medicine specialist for two decades is the International Modern Hospital (IMH)-Infection Control chairman. He defined HAI or nosocomial infection as “that which is contracted from the environment or staff of a healthcare facility such as a hospital, nursing home, rehabilitation centre or clinic.

It occurs 48 hours after the patient’s admission, three days after his discharge, and 30 days after his operation (also known as surgical site infection or SSI).” Grover said it is a mandate for all health facilities to avoid HAI. Aside from SSI, the most common worldwide are the Central Line Associated Blood Stream Infection (the tube that doctors use in a large vein to collect blood for medical tests), Catheter Associated Urinary Tract Infection, and Ventilator Associated Pneumonia (the lung infection suffered by breathing machine-dependent patients in health facilities). According to Grover, the UAE Ministry of Health orders all health facilities “to have an infection and control programme to identify and reduce the risks of acquiring and transmitting infections among patients, healthcare personnel and visitors.” These are tasked to continually upload and update on their respective “intra-communication website” an infection control manual that is all about “appropriate policies and procedures” according to international infection and prevention guidelines.

These are directed to immediately report to health authorities any admission or occurrence of infectious diseases. Grover said: “Nosocomial infections are the responsibility of all individuals and services providing healthcare. Everyone must work cooperatively to reduce the risk of infection for patients and staff.” The IMH has several “link nurses” round the clock, who are highly trained and periodically taking up refresher courses.

Their main job is to spot and record their colleagues who are neglectful of hygienic practices or HAI-preventive measures such as the simplest hand-washing, glove use and appropriate aseptic (disinfection/germ-free) practices. Grover said the data are reviewed monthly in order to plug any gaps and easily resolve problems. These are submitted to the health authorities and are among the documents forwarded to the Joint Commission for international accreditation. Regarding the SSI, Grover explained that management conducts a “tracer” once this is reported. The “tracer” aims at knowing the root of any SSI, even when all tools and equipment used inside operation theatres and everything inside the patient’s room are sterilised and disinfected every after use, as masks and caps of the entire medical team are for one-time use only. On the other hand, the laboratory gowns, just like those worn by the staff and doctors assigned in the recovery rooms, the intensive care units and other sensitive areas, along with all the other used linens, are segregated and sent to an authorised industrial laundry for the washing, sterilisation and disinfection.

Asked if HAI could be controlled if hospital linen and the staff/management uniforms are separately washed at highly controlled temperatures and conditions, Grover pointed out: “When hospital workers wear both their clean and soiled uniforms in transit, the potential hazard of cross-contamination is increased. The inability of domestic washing machines to carry out a validated hygienic wash process and the practice of missing classifications at home further exacerbates the cross-contamination potential.” He quoted the US-based Centres for Disease Control and Prevention saying that albeit“soiled linen may harbour large numbers of pathogenic microorganisms, the risk of actual disease transmission from soiled linen is negligible.” Touching on the viability of huge commercial laundry facilities as a tool against HAI, Grover said: “These often use water temperatures of at least 160˚F and 50 to 150 parts per million of chlorine bleach to remove significant quantities of microorganisms from grossly contaminated linen.” © The Gulf Today Related Stories DHA clinic spotlights cervical cancer DUBAI: Medical professionals from the Dubai Health Authority (DHA) raised awareness about prevention of cervical cancer during the DHA’s #smart_clinic.

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