Hospital Hygiene Quiz

Hospital Hygiene

• Hospital hygiene is vital for any national public health system.
• Hospitals are places where medical staff provide specialized care to patients.
• Inside hospitals, doctors and health workers perform professional and technical tasks, interacting with sick people.
• Hospital construction needs special criteria, hygienic measures, and rules for its function.
• Hospital hygiene focuses primarily on preventing hospital infections.
• Protecting patients requires commitment to hygiene from all staff members.
• Hygiene is teamwork.
• Good hygiene prevents patients from catching dangerous infections.
• It prevents germs and bacteria from spreading to visitors and the community.

Introduction

• Management of health-care waste is crucial for hygiene and infection control.
• Healthcare waste acts as a reservoir for pathogenic microorganisms.
• This can lead to contamination and infections.
• Biomedical waste carries a higher infection and injury potential than other types.
• Proper final disposal (e.g., incineration) is essential.
• Inadequate waste management transmits microorganisms through direct contact, air, or vectors.
• This endangers hospital staff and patients.

General Hygienic Requirement of Hospital

• Hospital buildings need daily cleaning and regular maintenance (internal and external).
• Internal hospital areas are classified according to sanitary importance and infection risk:
  • Restricted areas (e.g., operating room, ICU, labor room)
  • Semi-restricted areas (e.g., intermediate rooms, pre-labor rooms)
  • Unrestricted areas (e.g., waiting rooms, outpatient departments).

Personal Hygiene Requirement

• Medical staff must wear uniforms.
• Staff must maintain personal hygiene.
• Staff should undergo regular medical checkups.

Basic Sanitation of Hospital

• Water supply, vector control, liquid waste, garbage, food, and waste management are crucial.

Specific Hygienic Requirements

• Hygienic requirements differ based on department characteristics and function.
• Special hygiene measures are needed for specific departments.
• Some rooms require routine cleaning; other areas need focus on hygiene.
• Key areas for attention include:
  • Waiting rooms
  • Causality rooms
  • Outpatient rooms
  • Admission rooms
  • Infectious disease areas
  • Premature and newborn rooms
  • Operating and delivery rooms.

Nosocomial Infections

• Nosocomial infections (also called healthcare-associated or hospital-acquired infections) are a subset of infectious diseases acquired in a healthcare facility.
  • To be considered nosocomial; infection cannot be at admission.
  • It must develop at least 48 hours after admission.
  • These infections can cause serious problems (e.g., sepsis, death).
• Two forms of nosocomial infection:
  • Endogenous Infection: The causative agent is present at the time of admission, but there are no signs of infection. The infection develops during the stay, resulting from the patient's altered resistance.
  • Cross-contamination followed by cross-infection: Patient comes into contact with new infective agents, contaminating them, and ultimately developing infection.
• Many nosocomial infections are preventable; national public health institutes (e.g., CDC) provide guidance.

Nosocomial Infections (additional)

• Nosocomial infections occur at a rate of 5 to 10 per 100 admissions in US hospitals.

• In American hospitals, HAIs account for approximately 1.7 million infections and 99,000 associated deaths yearly.

• Factors that increase nosocomial infection risk:

  • Increasing age
  • Length of hospitalization
  • Excessive or improper use of antibiotics
  • Number of invasive devices (e.g., catheters, ventilation)
  • Accompanying conditions (e.g., diabetes, lung disease, renal failure, malnutrition).

• Hospital-acquired infections may be studied from three perspectives; sources, routes of spread, and recipients.

  • Sources: patients, staff, and environment.
  • Routes of spread: direct contact, droplets, airborne particles, hospital procedures.
  • Recipients: all patients in a hospital are at risk of cross infection.

• Sites of nosocomial infections includes:

  • UTIs
  • Surgical site infection
  • Blood stream
  • Lower respiratory
  • Others

• The most common type of nosocomial infection is Staphylococcus aureus, bacteria.

• Other common pathogens include Escherichia coli, Enterococci, and Candida, often found on skin and mucous membranes.

• Antibiotic-resistant strains like MRSA (Methicillin-Resistant Staphylococcus Aureus) pose a significant risk.

Preventive Measures

• Isolation, especially for contagious diseases needing precautions.
• Proper hospital staff training and adherence to appropriate practices.
• Handwashing, dust control, and disinfection practices.
• Controlling infections (controlling droplet infections).
• Barrier/task nursing technique to minimize cross-infection.
• "Control of Infection Committee": reduce infection incidence, decide on measures to tackle reported cases.

Central Sterile Supply Department (CSSD)

• Critical for high-quality sterilization and disinfection.
• Establishing a central sterile supply department in a hospital (CSSD), aim to minimize acquired infections.
• CSSD design should consider close proximity to operation theaters.
• Centralized CSSD enhances efficiency and effectiveness of sterilization activities.

Function of CSSD

• Receipt of materials from operating/labor rooms.
• Sorting: re-sterilization or discarding of materials.
• Cleaning: removal of (e.g. blood, pus) using hot/cold water.
• Processing; repair, and packing, preparation for sterilization.
• Sterilizing: steaming in autoclaves, ultraviolet (UV), or ethylene oxide.
• Storage: Unused storage materials needing checking for sterility.
• Issuing: pre-planned distribution system of sterile materials.

Bio-medical Waste (BMW)

• Biomedical waste (BMW) is generated during diagnostics, treatment, and immunizations.

Strategy Adopted for Hospital Waste Management

• Waste reduction and management strategy
• Waste assessment strategy
• Waste recycling strategy
• Hospital waste disposal

Certain Procedures and Guidelines for Hospital Waste Management

• Collection of waste
• Waste segregation
• Waste transportation
• Waste storage
• Waste treatment