How to Prevent Hospital Infections
What Are Hospital Acquired Infections?
Certain types of infections can be contracted from our hospitals, simply because we are around unwell patients. Those who may be carrying a virus or infection can pass it onto someone with a low immune system due to illness or recovery. They then become sick with the side effects and some are worse that others.
Sick patients can pass viruses onto other sick patients, or unwell visitors or staff may give a patient something nasty. The symptoms may be more severe in a vulnerable individual.
Having a low or weak immunity can appear in someone who is unwell, has medical problems, recovering from an operation, very old or very young.
The types of infections may include:
- Urinary Tract Infections (UTI)
- Surgical Wound Infections
- Lung Infections (such as pneumonia)
- Bloodstream Infections
Some forms of bacteria are known as 'Super Bugs', because they are becoming more resistant to antibiotics and harder to treat. These super bugs are known as MRSA (methicillin resistant staphylococcus aureus) and Clostridium -Difficile (C-Diff).
They are two examples of very different bugs that can be treated and killed in different ways. Because of this, it is important to be aware of knowing how to prevent them in the first place.
MRSA has built up resilience to some antibiotics which makes it hard to treat. Staphylococcus aureus is a type of bacteria which is common. It is found around the nose, on the skin and in the throat, but can cause infections such as boils or impetigo (pus filled blisters) or cellulitis (inflammation of the skin). It can be passed from person to person, or from touching infected bed sheets, dressings and clothing.
C-Difficile are spores which cause acute diarrhea, when certain antibiotics are taken which in turn kill off the 'good' bacteria in the gut. C-Diff is present in all of us, but when there is an imbalance of bacteria, it can make us unwell.
The spores are incredibly infectious and can be passed onto others very easily. The bacteria lives on surfaces, bed linen and can be passed by direct contact with an infected person.
Hand Washing Technique (NHS)
- Wet hands with water
- Apply soap from the dispenser and cover all areas of the hands
- Rub hands palm to palm
- Right palm over left hand and interlace fingers. Switch hands
- Palm to palm with interlaced fingers
- Backs of fingers to opposing palms, fingers interlocked
- Rotational rubbing of left thumb clasped in right palm. Switch hands
- Rotational rubbing back and forth with clasped fingers, right hand in left palm then switch
- Rinse hands with water hot enough to handle
- Dry with a new paper towel for 15 seconds. Hands must be thoroughly dried
How to Prevent Superbugs Occurring
The prevention of the spread of MRSA will minimise the risk of catching it. By taking simple steps, the spread of the infection can be reduced.
Hand washing is vital and can keep harmful bacteria at bay. Use the correct hand washing method to clean as much dirt and bacteria as is possible.
Before entering hospital wards, alcohol hand gel can be applied to instantly kill unseen germs. The alcohol gel does not wash dirt, but can kill potentially harmful bacteria which could be carried into the hospital. By touching doors, light switches and taps, you could be spreading the germs to the next person who touches them.
Other items need to be cleaned and sterilised for infection control. Using antibacterial wipes, antibacterial cleaning spray and hot soapy water can effectively clean:
- Bed pans
- Equipment such as drip stands, hoists and wheelchairs
- Bedsides and bedside rails
Linen and clothing must not be kept on the floor. Laundry needs to be transported in closed laundry bags and washed on high temperatures.
PPE stands for personal protective equipment which includes disposable latex gloves, plastic aprons and face masks. Using PPE when dealing with a patient can minimise the spread of any infection.
PPE must be thrown away in the correct bins to be disposed of properly. Hand washing must take place after wearing PPE and new PPE must be worn for each patient or returning to the same patient. Contaminated PPE (with bodily fluids) must be changed when still with the patient. Under no circumstances should personal protective equipment be worn around the hospital.
Other Ways to Prevent MRSA
Not sharing items such as towels or toiletries can help prevention. Keep nails short and clean and bathe regularly.
Open wounds must be covered with clean dressings and these must be changed every 1 to 2 days.
Patients With MRSA
Remain in an isolated bay so that the MRSA is not transferred to other patients.
Cutlery and drinking cups etc must be sterilised.
Laundry must be separated and washed on high temperatures. An antibacterial detergent can also be used.
The room must be cleaned with an antibacterial cleaning agent each day. Anyone entering the room must wear PPE and dispose of it in the bin at the door.
C-Diff is highly contagious and can be easily spread. For visitors and staff entering the hospital, it is important to wash hands thoroughly before entering and leaving. Alcohol hand gel is not effective enough to kill c-diff spores.
All laundry which may be infected must be washed on high temperatures at around 65 degrees centigrade. Staff should change into clean clothes after their shift rather than wearing uniforms home. Uniforms need to be cleaned before each shift.
Toilets, commodes and bed pans must be cleaned using a bleach cleaning product to kill the germs.
Infected patients need to be in an isolation bay to avoid the spread of C-Diff. Hands must be properly washed after using the toilet and before meals. PPE is important for infection control and towels must not be shared.
Visitors and staff must not enter the hospital if they have had diarrhoea, and must stay home for 48 hours after the last bout.
What if I have C-Diff?
You will be given antibiotics which are either vancomycin or metronidazole. You will be advised to drink plenty of fluids, maintain good personal hygiene and keep away from other patients.
Once the infection has cleared (a stool sample will be tested) the room will be deep cleaned.
Urinary Tract Infections
Urinary Tract Infections (UTI's) are infections of the urinary tract area. This area consists of the bladder, kidneys, ureters (tubes from the kidney to the bladder) and urethra (the tube which carries urine to the opening where urine is passed).
If the bladder becomes infected, we have cystitis and if the urethra becomes infected, it is known as urethritis.
There are different causes for UTI's, such as poor hygiene after using the toilet (wiping from back to front), not emptying your bladder after sexual intercourse or not drinking enough water or cranberry juice. UTI's in these cases tend to be more common in women than men.
UTI's in hospital may be related to having an indwelling catheter fitted. An indwelling catheter is fitted for long term use, rather than an intermittent one which is inserted to empty the bladder when urination cannot take place unaided.
The thin catheter tube leads to the bladder making it high risk to infection from the bacteria present. The patient will have a bag where the urine collects and emptied through a tap.
Reasons for Having a Catheter in Hospital
A catheter may be inserted when we are in hospital because:
- We cannot pass urine (for medical or post surgical reasons)
- We become incontinent and leak urine
- Preparation for surgery, such as a hysterectomy
UTI's cannot be passed from person to person whilst in hospital but there are ways to prevent contracting them.
How to Prevent UTI's
Preventing a UTI can be done by drinking plenty of water throughout the day. Flushing your bladder with 6 to 8 glasses of water a day can clear out nasty bacteria. Studies also show that by drinking unsweetened cranberry juice, you can also reduce a UTI. The active compounds in the juice can kill off bugs such as e-coli which are responsible for the infection. The compounds are not destroyed through the digestive system when drunk, which make it very beneficial.
When the catheter is fitted for long term use it is important to use a good hand washing practice. Before and after touching the catheter site and emptying the bag, hands should be washed and gloves and aprons worn.
Cleaning the site should be done with soap and water and the tube needs to be cleaned each day to minimise risk. Ensuring you maintain good personal hygiene such as good cleaning after opening bowels will also reduce the spread of bacteria.
The catheter must drain downwards so that urine does not go back into the bladder. By strapping your leg bag to your leg (if you are a mobile patient) or hanging the night bag on a stand below the bed (when the patient is in bed) will help with good drainage.
The bag must be emptied before it gets full or every 6 to 8 hours. Urine must be disposed of safely down a toilet or in the sluice room, and bottles must be sterilised.
The day bag needs to be changed every 3 to 4 days and the night bag changed every night. Putting the date on the bag will help a turnover in staff to know when the change is due. The catheter itself can be changed every 4 to 6 weeks, depending on the patient.
What if I have a UTI?
If you already have a UTI, it can be treated with antibiotics. They can be taken orally or intravenously.
Also continue to drink plenty of water and cranberry juice and keep up hand washing and personal hygiene. Use alcohol hand gel after handing day to day items and wash hands thoroughly after using the toilet and before eating and drinking.
Preventing Other Hospital Acquired Infections
Hygiene and cleanliness is the main way to prevent HAI (hospital acquired infections).
- Wound infections can be prevented by good hand washing procedures and keeping the wound cleaned. Dressings should be applied using the Aseptic Non Touch Technique. This is a procedure which nursing staff must comply to, which uses only sterile equipment in a particular way. Dressings must be changed every day or two, using the appropriate dressing for the wound.
- Bloodstream infections are generally caused by infection entering the bloodstream. By using sterile surgical equipment and again good hand washing and PPE, this will minimise the risk. Needles must be used once and not for more than one patient where an infection may occur.
- Respiratory tract infections are infections of the lungs, throat and airways due to a virus. Avoiding people with cold or flu symptoms or throat or chest infections can reduce the risk of respiratory infection. It is important that antibiotics for infection are prescribed to clear it quickly and before it becomes more serious. For viruses, plenty of fluid and rest can help with recovery. Good hand washing and PPE will help against the spread.