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TREAT SANITISATION AS AN INVESTMENT
HOSPITAL INFRA
Treat sanitisation as an investment
Dr Sulaiman Sharieff,Consultant Microbiologist and Infection Control Officer,Specialist Hospital,Bangalore highlights the importance of santisation in hospitals
COVID-19 has repositioned sanitisation as one of the most important features in the maintenance of a hospital. As healthcare centers, hospitals attract a large number of people, many of whom could be vulnerable to infection. It is primarily this aspect that has prompted hospitals to relook at best practices in sanitization.
The foremost purpose of sanitisation is to reduce and contain the spread of microorganisms that are prevalent in a hospital environment. Studies suggest that Healthcare-associated infections (HAI) are one of the most frequent complications that can occur in a hospital. Five to fifteen percent of all hospitalized patients may develop at least one HAI during hospitalization and it is estimated that over fifty to seventy percent of all HAI are spread through contaminated hands. It is important that sanitization crews focus not only on all furniture and objects, assembly areas and patient rooms, but also medical offices and nursing stations. Individual doctors and nurses also need to follow a strict sanitisation regimen.
There are five main components of sanitisation in a hospital. These include what sanitization products are being used, the technique and equipment used to apply the product, surface type, contamination level and the sanitisation crew. The cleaning practices in a hospital must include all these elements in order to ensure optimal sanitization. An ideal product would be one that is effective against all actively multiplying vegetative bacteria, most viruses and other microorganisms, and yet be environmentally friendly, safe and easy to use.
Alcohol based sanitizers and handrubs can be considered as Saviours, when it comes to hand hygiene. Chlorhexidine is a useful addendum, especially in Critical care areas, tackling multidrug resistant bugs. Sanitizers mixed with glycerol, or usage of moisturizers to provide care to those with sensitive skin, and with skin conditions like dermatitis could also be considered.
When it comes to surface disinfection, most chemical products available today have some impact on the environment. Different surface types may require customized products that work against certain types of pathogens that might be present on a particular surface. The product chosen should not alter the surface itself. Phenolic compounds are used for cleaning of floors, toilet seats, bed pans. Hypochlorite solutions are the cost-effective for treatment of blood spills in a hospital. Critical zones like Operation theatres, ICUs can be cleaned with commercially available dihydroxy - dioxahexane solutions or other appropriate solutions. Many more disinfectant products are out in the market. It is recommended to objectively scrutinize the studies done on such compounds, and read literature on its environmental impact and not just merely accept word of mouth. These could be discussed with the Infection Control Team and Safety Officers, before the order is placed.
Care must be also taken to ensure the AC ducts are fully functional, its HEPA filters regularly checked at least once in six months, by a qualified technical supervisor, and appropriate calibration and service reports are maintained. Regular environmental sampling, water quality testing, usage of physical and biological indicators goes a long way in achieving the goal.
In times such as these, where the level of contamination is high, it is important that hospitals follow a strict schedule for sanitisation with increased frequency. Hospitals are reducing frequent touchpoints, finding new and safer solutions for patients to reduce contact points by making mobile phones the primary point of access for appointment bookings, consultations, inpatient registrations, diagnostics services, reports etc.
Last but not the least, is the human component. It is vital that sanitisation crews are provided with the highest quality of training and protective gear. Cleaning crews play a vital role in infection control in a hospital. Hence, intensive and ongoing training is paramount. Schedules must be documented, and all standard operating procedures have to be followed.
Every hospital must have a set of procedures that define responsibilities of the sanitisation crew including standards and frequency. The management should introduce proper systems to monitor and assess environmental contamination on a regular basis. Sanitization crews must remember that they could well be carriers of microbes from one area to another on their person. It would be a good practice for the sanitization crew to begin the sanitization process with more healthy patients and then move to vulnerable ones. This way they will reduce chances of more infections.
Often sanitisation crew are pressed to complete the process quickly, many times ignoring the efficiency of the process. It is important that the sanitization crew follow the recommended dwell times for disinfectants in order for it to have maximum efficacy.
Many hospitals today assess hygiene maintenance costs from a cost cutting standpoint. A shift in this approach must happen where appropriate sanitization products and equipment are chosen over cost. It will immensely benefit hospitals if they look at these costs as an investment and choose quality products and equipments.
