As you well know, hospital-acquired infections caused by opportunistic pathogens are on the rise nationwide. They are most-often transmitted to patients via breaches in germ-control protocols, direct contact with hospital staff, and contaminated environmental surfaces. The unfortunate truth is that infectious microorganisms are so plentiful in the clinical setting it is virtually impossible to find, let alone disinfect, every pathogen hot spot.
At the end of the day, preventing and reducing the spread of bugs and “superbugs” in your healthcare facility starts with knowing the obvious and unassuming places they lurk so that you can properly guard your patients and staff against them.
Pathogens are Resilient.
While most infectious microorganisms need to be inside a live host to replicate, many can survive on environmental surfaces for a long time—which makes them a continuous source of transmission to patients, hospital workers, and visitors. In particular, methicillin-resistant Staphylococcus aureus (MRSA), Acinetobacter spp. and vancomycin-resistant enterococci (VRE) can persist on hospital surfaces for days or weeks, while Clostridium difficile spores can live on surfaces for 5 months!
A healthcare worker’s hands are the principal route of pathogen transmission to patients.
Staphylococcus aureus, for example, can survive for over 2 hours on the hands and is found in 10% to 78% of staff infections. Obviously, proper hand hygiene is crucial to preventing the spread of infection. Wearing protective gloves can also help. However, ordinary protective gloves (latex/vinyl) are not always impermeable to blood and bodily fluids. Stretching, tearing, and puncturing gloves while performing patient duties is always a contamination concern. What’s more, pathogens on the gloves’ outer surface can transfer to a caregiver’s hands during removal. The same goes for protective clothing (disposable gowns, caps, and masks).
Contact times for surface disinfectants must be considered.
A number of antimicrobial germicides are used in the hospital and contact times for sanitization agents are generally germ-specific. Leaving a surface disinfectant in place for 1 minute and allowing it to dry might be effective against some pathogens, however, others, such as M. tuberculosis, Hepatitis B. Virus (HBV), and HIV specify a contact time of 10 minutes and then that surface must be wiped off. Unfortunately, rushing through the cleaning process to meet quick bed turnover rates, using cleaning products incorrectly, infrequent cleaning, and/or reusing contaminated cleaning cloths or mops increase the risk of infection to incoming patients.
Where Pathogens Commonly Hang Out
The hospital room is a reservoir for “sick” germs. Common touchpoints include:
- Bedside rails
- Bedside tables
- Over-bed tables
- Chair arms
- TV remote control
- Meal trays, drinking cups, water pitchers, eating utensils
- Nurse-call buttons
- Room phones
- Light switches
- Bathroom floors and fixtures (sinks, faucets, toilets)
- IV lines
- Personal care items
- Bed linens
- Towels and washcloths
- Window blinds or privacy curtains
- Monitoring equipment and medical devices
Healthcare workers’ personal belongings are also germ reservoirs.
- Cell phones and other hand-held devices (stethoscopes) are a petri-dish for germs. Kept in pockets and cupped in hands, these spots provide the warm, moist, and dark climate germs love to breed in.
- Hair accessories
Commonly shared equipment can spread infection: reusable blood pressure cuffs, wheelchairs, gurneys, utility carts
Nursing station work surfaces (desktops, office chairs, computer keyboards, writing tools,) can play host to lingering pathogens. Lids or containers of covered beverages may become contaminated and spread to the hands of an unsuspecting worker. The staff room is another potentially germy place (think furnishings, fridge handles, microwave buttons, and foodstuff).
Surprisingly, paper (which is a porous surface) can also harbor and spread pathogens amid healthcare workers, who review and shuffle nursing charts and patient files back and forth to one another several times a day.
Patient visitors can be notorious for transmitting and contracting nosocomial infections. Visitors can bring sickness into the hospital or introduce germs to patients by coming in contact with contaminated surfaces prior to entering the hospital room; elevator buttons, toilet seats, door handles, vending machines, public phones, water fountain buttons carry the most germs. Visitors who ignore warnings to wear protective clothing when calling on a contagious patient, and neglect to wash their hands when leaving the hospital, increase the potential for cross-contamination to other patients, hospital staff, and the community at large.
If you are looking for more ways to contend with issues in the workplace, rely on BOS Medical Staffing as your source for practical and timely clinical care advice and expertise. Since 2008, BOS Medical Staffing has brought talented nurses, therapists and medical administrators together with top facilities. Contact BOS Medical today to talk about customized staffing solutions.