The Infection Control Week
I don’t if other hospitals have this, but it’s the one thing that
Worldwide, or ok, at least in the US, which most people accept has the best standards of health in the world, there are more deaths through mistakes made in hospitals than in aircraft accidents. And remember, there most people travel by air, not train or bus. In Infection Control, one talks of avoidable trouble to patients, which may mean something as minor as an extra day in hospital or as serious as loss of a limb or even life. More people die of hospital acquired infections than of road accidents (We don’t have statistics for India, but there’s no reason to suspect that it might be any different here, what with the kind of ‘care’ some of our ‘nursing homes’ give). Now you can argue that most of those patients were immuno-compromised anyway and if they hadn’t died in hospital, they’d have died at home. But then, think of this: most insurance companies abroad do NOT pay for antibiotics or infections or prolonged hospital stay after routine surgeries. There logic is, if you’ve been careful enough, there should be no problem with bacteria, viruses, fungi. Wonder if and when this will ever come to
And that’s the logic this Mumbai based hospital has been following as a policy since 1988. It’s possible that other, newer hospitals are doing the same, but none that I know involves people other than doctors and nurses. The hospital acquired infection rate here is a low 2%, which takes a lot of hard work to achieve. Here, the philosophy is to create awareness in everyone who comes in contact with the hospital, all stake-holders, including suppliers, visitors, observers, guards, liftmen, bank clerks, etc.
Here, every wardboy and ayah wears a badge: “Ask me if I’ve washed my hands.” As part of initial and on-going training, they are taught how to wash their hands. There’s a correct technique that ensures that the nails, the space between the fingers, the wrist, all get cleaned, without anything touching or spilling onto the sleeves. Washing hands has to be done before and after touching every patient, after all tasks in patient areas. Soap and water are a must, but so are anti-infection fluids which are easily accessible in the correct quantities. Housekeeping is considered a VERY important function. There are stringent methods to dust, mop, wipe, give urine pots, wash and store those urine pots, use-wash-and-store bedpans, and these are monitored thoroughly, through the day and night. Food handlers, even the garbage handlers, know how serious a sharps-wound (ie any cut or prick) might be. Interestingly, all employees here are vaccinated against Hepatitis B as a matter of policy. Technicians and nurses, whether they be permanent employees or on contract, have to follow a meticulous system to protect themselves and patients. Safety is considered to be paramount virtue, bordering on military discipline. (In fact, in the
Coming to doctors, that know-it-all community. Here, too, it isn’t assumed that surgeons know best. Nobody’s spared. Senior or junior, they are subjected to several quizzes to check whether they remember what they’ve studied, and more importantly, whether they follow what they’ve learnt. At their level, they should know where and when an ‘open TB’ case should be admitted, how to deal with an adult chicken pox or polio or chikungunya epidemic, a bleeding HIV case, and more. Infectious Diseases are becoming the latest mantra in super-specializtion.
Infection Control covers even the air that’s circulated in a hospital, specially in areas like the operation theatres and the intensive care units. That, of course, is well beyond the scope of this column, for there are micro filters, special rays, special methods of entry and exit of air with positive and negative pressure controlling its movement. Then there are chemical methods to kill or render harmless pathogens, which are disease causing micro-organisms.
To make the entire learning process fun, there are posters, skits and songs on the theme.
Whenever you are asked to remove your footwear before you enter a hospital, take time off to ask the doctor where and how his/her hospital is getting rid of its garbage. Covered feet don’t harm patients as much as badly disposed (or not disposed of at all!!) garbage. In fact, the latter might cause problems to robust, healthy people. Think about it.