Infection control in the hospital setting
Posted on 25 June 2019
Infection prevention is a key performance indicator at all Mediclinic hospitals.
Sally Wolf, Infection Control Manager: Mediclinic Constantiaberg, explains how a comprehensive in-hospital strategy brings all units and staff members together to achieve one goal: keeping patients safe.
Mediclinic is committed to reducing and preventing the spread of harmful bacteria in its facilities, nationwide. As part of that strategy, each Mediclinic hospital has appointed dedicated, trained Infection Control Managers, who is responsible for the implementation and maintenance of the IPC programme in the hospitals
“Our core role is to assist the units in preventing the transmission of pathogens,” says Sally Wolf, Infection Control Manager: Mediclinic Constantiaberg. “These microorganisms can be either bacterial, viral or fungal, and it is our responsibility to ensure that measures are implemented and monitor compliance to prevent the transmission of microorganisms from one patient to another.”
Step one is identification: as patients enter the hospital, a risk assessment is done, based on the history of previous exposure to healthcare facilities, antimicrobial usage, existing diseases and travel history to establish the possibility of the presence of pathogens. A patient who has been identified as a high risk of being colonised or infected with a multi-drug resistant pathogen, for example, will be isolated, additional transmission-based precautions implemented and treated separately from other patients, to help prevent those microorganisms from spreading.
Pathogens can be transmitted through the air, droplets or through direct contact with the skin, explains Wolf. “Measles, chickenpox and pulmonary tuberculosis, for instance, are all transmitted through the air. In this case, a patient with one of these airborne communicable pathogens will be moved to a private room. We create some space to ensure those germs don’t infect other patients, and we require staff members who treat those patients to wear respirators, as they are also at risk.”
Consistent and continuous hand hygiene measurement forms a major part of the IPC strategy. “Hand hygiene, we believe, is the basis of an effective infection control programme,” says Wolf. “It’s been proven that this is the most effective way to prevent the transmission of pathogens.”
Strict hand hygiene protocols are implemented throughout the hospital. Nurses and doctors are particularly important, as they come into direct contact with patients, but Wolf explains that an infection control programme cannot be effective unless each and every staff member has invested in the strategy. “Hand hygiene is for everybody. Our receptionists, our supportive services – kitchen staff, for example, and cleaners – even administrative staff who never come into contact with patients, all of them must clean their hands regularly throughout the day, every day.”
Every room is fitted with a hand basin, but to help staff keep their hands clean in a quicker and more effective way, hospitals are equipped with alcohol hand rub dispensers at the point of clinical care. These dispensers empower staff to clean their hands at each of the “Five Moments for Hand Hygiene,” as recommended by the World Health Organization:
- Before touching a patient
- Before clean (aseptic) procedures
- After body fluid exposure
- After touching a patient
- After touching patient surroundings
Hand hygiene can be performed either by washing hands with soap and water or by using an alcohol based hand rub. “The five moments of hand hygiene tell us when hand hygiene should be performed,” explains Wolf. “Hand hygiene has to be performed whenever the patient’s environment is entered. Moment two is a critical moment, because pathogens can potentially enter a clean/sterile space. In the majority of cases an alcohol based hand rub can be used. However, when there was confirmed or suspected exposure to body fluids, hands have to be washed with soap and water.
Nurses and doctors who come into contact with blood and other bodily fluids are required to wear gloves, in order to protect themselves from transmission.
Infection prevention and control (IPC) forms a key part of Mediclinic’s “patient first” approach. Patient safety is paramount, says Wolf, and the effectiveness of each hospital’s IPC strategy is carefully monitored and measured. Infection rates are classified according to the definitions of the Centers for Disease Control and Prevention in the US, and that information is shared openly with service providers and stakeholders. The information is further used to improve practices.
“Infection control is a major key performance indicator for each and every Mediclinic hospital,” says Wolf. “It is critical for our clients, funders and investors to know that we adhere to strict infection control measures, and that they understand our patients are entering a safe and clean clinical space.”