DIRTY hospitals are making patients sick. The superbugs are waiting in badly-cleaned wards and private rooms.
C difficile causes reaming diarrhoea. MRSA (Methicillin-resistant Staphylococcus aureus) eats away at open wounds and develops into pus-filled boils. VRA (vancomycin-resistant Enterococcus) bugs don’t just make you sick, they can also pass on their antibiotic-resistant genes to other bacteria.
All these breed on unwashed bedrails, gowns, buttons and machinery in hospitals.
But Professor of Clinical Medicine in Boston University School of Medicine Philip Carling’s sneaky study of just how clean hospitals were has already started to revolutionise hospital hygiene.
In the 12 hospitals of the Kaiser group in southern California, staff are using his methods and sharing their cleaning results - and have doubled their hygiene standards.
Professor Carling’s study of cleaning in 82 hospitals was demonically simple. He mixed up a fluorescent marker with detergent and a flour-and-water glue. “It makes a solution that’s hard to see after it dries, but it can be picked up with a fluorescent light,” he says.
This solution is easy to wash off - even plain water will wipe it away, never mind detergent or disinfectant.
His team marked the ‘high touch objects’, the 14 things patients and staff touch most. “We let a few patients cycle through the room to be sure the cleaning was adequately evaluated.”
To their shock, they found that a lot of things that should have been cleaned, weren’t, in most hospitals.
About half of what should be scrubbed was actually being cleaned. (What should be cleaned in hospitals: about 14 ‘high-touch’ surfaces, like bedrails, call buttons, tray tables, phones, handles, and also the controls and medical gadgets that nurses handle all the time.)
So they went and talked to the people in the hospitals. “We worked on the problem through education as well as through repeated feedback”.
The researchers kept testing, using the invisible marker - and the thoroughness of cleaning improved from 50pc to 80pc, 90pc and even close to 100pc of the touch surfaces.
Cleaning is vital in hospital, where very sick people can be at risk from deadly superbugs. “For each improvement of 10pc in thoroughness of cleaning, there’s probably going to be a 10pc decrease in acquisition of those pathogens by patients that occupy that room,” says Philip.
But cleaners are often terrified to wash the controls on ventilators, or the touchscreens and keyboards of monitors, for fear of changing a setting and endangering a patient.
“Nurses touch these all the time, then touch the patients,” says Prof Carling. So medical staff need to do some cleaning too, as well as keeping their own hands and clothes spotless.
Kaiser have succeeded because they’re sharing their results and benchmarking - with their names listed on their results.
Cleaning the right things, and cleaning them well, can save the health service money, as well as saving people’s lives, Prof Carling says. An average C diff infection costs from €5,000 to €7,000 to the health service. Soap and water and dedicated, benchmarked cleaning could save thousands of euros - if the hospitals want to tackle it.