Tessa Quinn
Hospitals are often perceived as havens of sterility and cleanliness, but they can be breeding grounds for germs and pathogens. While healthcare professionals follow strict protocols to prevent the spread of infections, the prevalence of hospital-acquired infections remains a concern. From unclean medical equipment to bed linens and even the clothing of doctors, hospitals present numerous opportunities for the transmission of harmful microbes. This raises the question: are hospitals doing enough to protect patients from these dangers?
| Characteristics | Values |
|---|---|
| Germs in hospitals | Staphylococcus aureus, Corynebacterium striatum, Enterococcus faecalis, Staphylococcus, Streptococcus, C. difficile, antibiotic-resistant bacteria, bloodborne pathogens, drug-resistant bacteria |
| Sources of germs | Doctors' white coats, ultrasound equipment, mobile phones, bed linens, bedrails, cloth dividers, tray tables, pens, hospital room floors, carpets, blood, used needles, unwashed hands, rooms, catheters and other tubes |
| Preventative measures | Handwashing with soap and water, antimicrobial soaps, respiratory hygiene, barrier protection, disposable gloves, standard precautions, transmission-based precautions, isolation, personal protective equipment (PPE), room disinfection |
| Consequences of inadequate hygiene | Infections, illness, death |
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What You'll Learn
Hospital-acquired infections
HAIs can occur in hospitals, surgical centres, dialysis clinics, and long-term care facilities. They are typically absent or incubating at the time of hospital admission and usually manifest within 48 hours of hospitalisation. HAIs are monitored by agencies such as the National Healthcare Safety Network (NHSN) of the Center for Disease Control and Prevention (CDC) to prevent their spread and improve patient safety.
HAIs are associated with various factors within healthcare settings, including medical devices, surgical procedures, transmission between patients and healthcare workers, antibiotic overuse, and unsanitary conditions. Examples of HAIs include:
- Catheter-associated urinary tract infections
- Central line-associated bloodstream infections
- Surgical site infections
- Hospital-acquired pneumonia
- Ventilator-associated pneumonia
- Clostridium difficile infections
To prevent HAIs, standard precautions and infection control procedures are essential. These include basic hygiene practices such as handwashing, respiratory hygiene, and equipment disinfection. Additionally, specific transmission-based precautions are implemented for patients with known or suspected infectious diseases, such as isolation, maintaining distance, wearing personal protective equipment, and avoiding unnecessary surface contact.
Furthermore, antibiotic prophylaxis and skin decontamination play vital roles in preventing surgical site infections. Antibiotics are employed early and adjusted based on clinical scenarios to cover common pathogens. Universal standard measures, such as handwashing with soap and water or using alcohol-based disinfectants before and after patient visits, are critical in reducing transmission rates of multidrug-resistant pathogens.
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Doctors' and nurses' hands
Hospitals can be hotbeds for germs, and doctors' and nurses' hands are no exception. Healthcare workers are trained to follow precautions and protocols to prevent the spread of infections, but studies show that basic hygiene practices, such as handwashing, are often neglected. According to one report, only 50% of doctors and nurses make time to wash their hands, which has resulted in preventable infections and even deaths.
The hands of healthcare workers can easily become a vehicle for the transmission of germs and pathogens. In one study, Staphylococcus aureus, a germ that causes infections like boils and toxic shock syndrome, was found on 23% of doctors' white coats, with a small set of those including the antibiotic-resistant strain MRSA. Ultrasound equipment, mobile phones, and other frequently touched surfaces in hospitals can also harbour bacteria, which can be passed on to patients through hand contact.
Hand hygiene is a critical component of infection control in hospitals. Proper handwashing with soap and water for at least 20 seconds can remove more than 90% of germs from the skin's surface. Alcohol-based hand sanitizers are also effective and are often preferred in healthcare settings as they kill both good and bad germs quickly. However, it's important to note that hand sanitizers may not be as effective as soap and water for certain infections, such as C. diff.
Patients and their loved ones should feel empowered to remind healthcare workers about hand hygiene. The World Health Organization (WHO) has identified "My 5 Moments for Hand Hygiene," which outlines key moments when health care workers should wash their hands. These include before touching a patient, before performing a clean/aseptic procedure, after body fluid exposure/risk, before touching a patient's surroundings, and after touching a patient.
In addition to handwashing, there are other standard precautions that doctors and nurses should follow to prevent the spread of germs. This includes the use of personal protective equipment (PPE), such as masks, gloves, and gowns, when dealing with patients who have infections that can spread to others. Gloves should be changed between patients, and proper handling and disposal of needles and sharp instruments are crucial to prevent bloodborne pathogen transmission.
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Medical equipment
Hospitals are often breeding grounds for germs, and patients can be exposed to these germs in many ways, including through medical equipment. Medical equipment is supposed to be disinfected between patients, but this does not always happen. Ultrasound equipment, for example, is often not disinfected between patients, and bacteria have been found on the probe, cord, control knobs, computer keyboard, gel, and its bottle. Similarly, medical staff may not always clean their stethoscopes regularly, and these have been found to be common hotbeds for harmful microbes.
Bed rails in hospitals are also a significant potential reservoir of bacteria. A study found that the microbes on bed rails resembled those found on patients more than those on any other sampled material, suggesting that bed rails pick up a person's bacteria and continue to harbour them unless the bed is properly sterilized between patients. Other items frequently touched by patients and staff, such as blood pressure cuffs, call buttons, and tray tables, have also been found to be contaminated with disease-causing germs.
To prevent the spread of germs, healthcare workers are trained to adhere to rules outlined by the Centers for Disease Control and Prevention (CDC), known as standard precautions. These include basic hygiene practices such as handwashing and disinfecting equipment, as well as safety guidelines for handling blood and needles. Hospitals may also recommend certain vaccinations for hospital staff, such as hepatitis B and the annual flu shot, and instruct patients and staff about covering coughs and reporting respiratory symptoms.
While hospitals may be filled with germs, it is important to note that a study suggested that many hospital-acquired infections are actually brought in by the patients themselves. However, this does not mean that hospitals should neglect their sanitation duties, as tens of thousands of lives could have been saved if doctors and nurses simply washed their hands.
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Hospital beds
Hospital-acquired infections, also known as nosocomial infections, are a serious issue. In the US, about 6% of hospital admissions, or over 2 million people, will pick up some type of infection. While these infections might not be harmful to healthy people, they can be deadly for sick patients with weakened immune systems.
Other high-touch surfaces in hospital rooms, such as tray tables, pens, and cloth dividers, are also often contaminated with bacteria, including multidrug-resistant organisms (MDROs). Mobile phones, which are used a lot by hospital workers, have also been found to be covered in bacteria, including drug-resistant types.
To prevent the spread of infections, healthcare workers are trained to adhere to standard precautions outlined by the Centers for Disease Control and Prevention (CDC). These include basic hygiene practices, such as hand washing and disinfecting equipment, and safety guidelines when dealing with blood or handling needles. Respiratory hygiene is also important to reduce infections spread by coughing and sneezing.
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Sanitary violations
Hospitals are filled with germs and bacteria, and sanitary violations are common. A study by Tribune reporter Michael J. Berens found that 75% of hospitals have been cited for sanitary violations. Many hospitals do not clean rooms between patient admissions, and germs from previous patients can remain.
One of the most common sanitary violations is the failure to disinfect equipment between patients. Ultrasound equipment, for example, is often contaminated with bacteria on the probe, cord, control knobs, computer keyboard, gel, and bottle. Similarly, hospital beds and bedrails are rarely cleaned properly, allowing bacteria to thrive and spread to new patients.
Another violation is the improper handling of sharps, such as needles and other instruments, which can transmit bloodborne pathogens like HIV and hepatitis B. Healthcare workers are trained to follow standard precautions, such as wearing disposable gloves when handling blood and body fluids and changing gloves between patients. However, these precautions are not always followed, and the consequences can be deadly.
In addition, hospital room floors are often covered in bacteria, and items that fall on the floor can transfer these germs to patients' hands. Carpets in hospitals have been shown to harbor pathogens, although there is limited evidence of harm.
Furthermore, healthcare workers' mobile phones are frequently contaminated with bacteria, including drug-resistant strains, as they are used extensively, especially in intensive care units.
Lastly, inadequate handwashing by healthcare workers is a significant issue. Studies have shown that only 50% of doctors and nurses wash their hands regularly, and this simple act could save tens of thousands of lives. During the early COVID-19 pandemic, about 6% of hospitalizations were hospital employees, and proper hygiene protocols could have reduced this number.
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Frequently asked questions
Yes, you can get sick from germs in hospitals. About 6% of hospitalized patients, or 2 million people, will pick up some type of infection. Infections can include C. difficile infections, urinary tract infections, bloodstream infections, or surgical site infections.
Hospital room floors, bed linens, bedrails, mobile phones, ultrasound equipment, and registration desk pens can all be sources of germs.
You can protect yourself from germs in hospitals by practicing good hand hygiene and using sanitizing wipes on commonly touched surfaces.
Yes, hospitals are taking measures to reduce germs by following standard precautions outlined by the CDC, such as basic hygiene practices and safety guidelines when dealing with blood or needles.
Yes, it is possible to bring germs into a hospital. A study found that patients' microbial profiles changed during their hospital stay, suggesting that the most dangerous bacteria may be those that patients bring in themselves.
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