Help the development of the site, sharing the article with friends!
Hospital infections are a serious problem and can be easily minimized. Prof. Didier Pittet - a Swiss scientist - proved that proper hand hygiene guarantees a reduction of infections by at least 50 percent. His many years of experience is the basis of the "Clean care is Safer Care" program adopted by the WHO, which in Poland was called "Hand Hygiene is Safe Care".
How often do hospital infections occur ? Last year, about 8 million patients passed throughPolish hospitals . For nearly 7 percent of them, the stay there "resulted" in an additional, unforeseen disease - they were infected with dangerous bacteria or viruses.
The Chief Sanitary Inspectorate reports that 70 percent of diseases acquired in a hospital environment concern the digestive and respiratory systems, which are generally managed quickly. But there are also infections with drug-resistant pathogens, e.g. methicillin-resistant staphylococcus aureus, MRSA for short. Cases of such infections often end tragically.
World statistics alarm: 16 million people lose their lives each year as a result of nosocomial infections - more than due to malaria, tuberculosis and HIV combined. Even in a country as developed as the USA, it is 200,000. cases.
In our hospitals, the easiest way to get infected with Clostridium difficile and rotavirus. The first is the anaerobic bacterium that causes colitis. It manifests as watery diarrhea and increased body temperature. The infection occurs through the ingestion. Rotaviruses spread and work similarly. They are especially dangerous for children and the elderly because diarrhea in them quickly leads to life-threatening dehydration.
Regardless of the type of pathogenic microorganisms, it is known that strains developing in the hospital environment mutate more often and are more resistant to treatment. It is also important that people with reduced immunity become infected with them, who are not fully he althy, because they are hospitalized, and it is more difficult for them to fight the infection. The problem is serious and can be easily minimized. Prof. Didier Pittet - a Swiss scientist - proved that proper hand hygiene guarantees reductioninfections by at least 50 percent. His many years of experience is the basis of the "Clean care is Safer Care" program adopted by WHO, which in Poland was called "Hand Hygiene is Safe Care". We checked how the idea and strategy of a modern fight against nosocomial infections is explained by its creator - prof. Didier Pittet.
According to an expert prof. Didier Pittet, expert in tropical medicine, epidemiology and public he althProfessor Pittet is co-chair of the 1st International Conference on Infection Prevention and Control (ICPIC), author of the "Geneva Model of Hand Hygiene", which reduced nosocomial infections by 50 percent. On behalf of WHO (World He alth Organization), he manages the program of fighting hospital infections "Hand Hygiene is Safe Care", the assumptions of which are implemented in 170 countries around the world. Poland joined it in May 2013. At the end of April, prof. Pittet visited Poland.
- Is it true that 30 seconds can save lives?
Prof. Didier Pittet: In fact: it takes only 30 seconds to disinfect your hands with an alcohol-based preparation and destroy harmful germs. We have developed a number of actions to change awareness and attitudes as part of the
program to combat nosocomial infections.
- What is the program?
D.P .: "Hand Hygiene is Safe Care" is a multi-faceted strategy consisting primarily in the use of alcohol-based hand sanitizer in hospitals instead of washing hands with soap and water - which is very effective in the fight against most pathogens. It also involves introducing training and education of he alth care workers, monitoring and feedback on their practices, placing a range of reminders in the workplace.
- When should you disinfect your hands?
D.P .: We have created a 5-step rule that helps you quickly assimilate this aspect. It shows the most important moments when harmful microorganisms are transferred. Hands should be disinfected before contact with the patient, before the aseptic procedure, after exposure to body fluids, after contact with the patient and after contact with the patient's environment.
- These are simple rules, why is it so difficult to implement them?
D.P .: Simple solutions are usually the best. The studies on the effectiveness of using alcoholic preparations, which we conducted initially in Geneva, clearly show that they help reduce the number of infections by up to 50 percent. But the problem does not lie in the impossibility of implementing a different hand hygiene style than the one used to date. The problem is resistance tochanges that also affect the medical service. It's not enough to tell people what to do. It is important to create a consistent approach to hand hygiene. You need highly motivated people, such advocates.
ImportantSad 30 Percent
In May 2015, two years have passed since the introduction of the WHO "Hand Hygiene to Safe Care" program in Poland. 93 hospitals (out of approx. 800 existing ones) joined it, but only 30 percent had implemented all program provisions and thus improved hand hygiene compliance. The self-assessment protocols carried out in these facilities show that they care best for the hand hygiene of nurses, and doctors do it with the same care as in attendants.
- But doctors and nurses complain that they don't have time to wash their hands more often …
D.P .: This matter should be made very clear. In the past, when we washed our hands with soap and water, there was indeed a shortage of time. Today, when we rely on modern disinfection, it takes several seconds to prepare your hands for work.
- What to do to improve the situation?
D.P .: I am in favor of starting the monitoring of applied practices. This will enable he althcare professionals to be presented with information from their own facility. This information should also be available to patients. They are at the heart of the strategy. They should be our partners, help he alth care workers to improve their behavior, e.g. by reminding them to disinfect.
- Which hand sanitizer products are best to use?
D.P .: Hand hygiene products should contain at least 80-85 percent ethanol or 70-75 percent isopropanol. The most important thing, however, is that it meets all standards.
ImportantSoap, water, alcohol
In most hospitals in Poland, and also in the world, soap and water are the basic means of hand hygiene of medical personnel. The problem is that the hands should be disinfected at each skin-skin contact with the patient, and the traditional method primarily removes physical impurities, does not destroy pathogens. It takes much more time and requires access to a wash basin. The alcohol preparation does not have these disadvantages. When rubbed into the hands in accordance with the procedure, it kills even the most dangerous microorganisms, takes up little space, fits into the pockets of the apron, and the dispenser with it can be installed at any hospital bed. The time to disinfect is also important - it only takes 30 seconds! In addition, research has shown that alcohol does not induce resistance in microorganisms, i.e. they cannot change their structure in defense againstits operation.
- Alcohol won't cope with Clostridium difficile though …
D.P .: There is no hand hygiene product that can eliminate Clostridium difficile spores. In this case, alcohol is not the best preparation, but there is no product with this effect that can be used on the hands. Chlorine is effective, but only at concentrations that can be applied to surfaces, not hands. Therefore, the control of Clostridium difficile is all about following the right practices: putting on and taking off gloves at the right time, cleaning and washing hands, rubbing a disinfectant. Here in Geneva, we managed to completely control Clostridium difficile. This is not only because of hand disinfection, but above all because of the strict adherence to infection control strategies in every patient. It is also a fact that publications that indicate a decrease in the rate of Clostridium difficile infection emphasize that this is due to more frequent hand washing with soap and water, as well as alcohol.
- Hospital infections often require antibiotics. And this, in turn, contributes to progressive multidrug resistance - a serious problem in today's medicine.
D.P .: It's true. The strategy to combat antimicrobial resistance consists of two factors. The first is the inappropriate use of antibiotics in humans and animals. The second is cross-contamination, the transmission of the pathogen from person to person. Administration of antimicrobials must be reduced and efforts must be stepped up to contain bacterial cross-contamination that occurs between patients, surroundings and he althcare professionals. Where these two elements are used, antibiotic resistance can undoubtedly be reduced and controlled.
You must do it- Take these tips to heart when going to the hospital. Thanks to them, you can avoid contamination with dangerous pathogens.
- Next to the bath towel, put 2 or 3 small hand towels into the bag. Do not use one of them for more than 2 days. After that, it must be washed and boiled.
- Choose shoes for walking in the hospital, which you will not regret throwing away, because it is better not to take them home.
- Take a bactericidal hand wash without water with you (you can buy it at any pharmacy or drugstore). It will come in handy when access to the washbasin is difficult, e.g. after surgery.
- A cologne or spirit can also provide a good disinfection.
- Wash your hands often - preferably also with a preparation containing alcohol - not only after usetoilets or before eating. Do this carefully, keeping in mind the spaces between your fingers and above your wrists.
- Do not walk barefoot on the hospital floor, do not touch medical equipment.
- After returning from the hospital, wash all the clothes you wear there, and boil cotton underwear and towels.
- Observe that he althcare professionals are washing (disinfecting) their hands before each contact with a patient. If this is not the case, bring them attention. You have the right to do so, because your he alth is at stake!
"Zdrowie" monthly