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HEALTHCARE

Hygiene

in healthcare Dr Denis Boulias’ shares his tips to improve hygiene and reduce spread of infection and illness in a healthcare setting. Infections within a hospital environment can be a significant risk and are often referred to as nosocomial infections. The causative agent of the infection may be present on the patient at the time of arrival (endogenous infection). However, the infection may also be acquired during their stay at hospital – which is referred to as cross contamination. Often microorganisms can penetrate the skin or mucous membranes and reach areas such as the bones, muscles, and body cavities, for example the bladder – an area that under normal circumstances is sterile. Where a reaction to such contamination develops with symptoms then there is an infection. Healthy people have a normal general resistance to infection. However older people, babies, pregnant women and the immunocompromised (e.g. cancer patients) have a higher susceptibility to developing infection. Microorganisms may be transmitted from their source point to a new host by indirect or direct contact or through the air or various vectors. Sneezing and coughing is an example or airborne transmission. Touch between a healthcare worker and a patient is an example of direct transmission. The most common vector of transmission, however, is indirect contact where a contaminated person touches (contaminates) an object and the further contact between that object and another person may then lead to an infection.

Cleaning Possibly the most fundamental measure for maintaining hygiene is cleaning, and this is particularly important in a hospital environment. The microbial effect of cleaning is a mechanical process – microorganisms are suspended in the cleaning fluid and hence removed from the surface. Most cleaning will remove more than 90 per cent of microorganisms, however, should the cleaning be rushed or careless then cleaning may disperse microorganisms over a greater surface area, increasing the probability they may contaminate other objects. As such, a well-planned colour coded cleaning process is essential, particularly in healthcare environments.

Precautions Hand hygiene: Poor hand hygiene can comprise the level of

cleaning we are aiming to achieve. For example, in handling rubbish a cleaner may come into contact with items such as 22 INCLEAN May/June 2019

tissues noting the flu virus can infect a person for up to eight hours after being deposited on a surface. It is vital cleaners are trained to never put their hands where they cannot see them when handling rubbish and wash hands as required. There are a number of reasons cleaners may not follow a strict regime of washing their hands which include: • Workload: when busy a cleaner may be less likely to hand wash. • Time: there may not be enough time to wash the hands fully and properly. • Appearance: the hands may not appear dirty, but germs are too small to be seen. • Presence: a sink may be hard to get to, such as in a messy cleaning room. It is crucial cleaners are trained that hand washing is a priority for their own health benefits and that of the client. Personal protective equipment: It is always important to risk assess all work tasks and comply with any relevant site specific safety requirements already in place. It is important to wear gloves if ever required to clean blood, body fluids, excretions, secretions and contaminated items. In any cleaning process that may result in a splash of blood, body fluids, excretions or excretions then a risk assessment of the situation is essential. This may result in the use of a mask, eye protection and/or face shield or even a gown. The handling of linen may also be a hazard and where soiled must be treated as infectious. Again, all safety precautions and requirements associated with a healthcare facility must be complied with especially if any cleaning is required within an isolated room of a contaminated patient. Most importantly consistent and proper handwashing is essential. Handwashing: Soap acts as a detergent with one side of its molecule liking water (hydrophilic) and the other side of its molecule liking oil (hydrophobic). Cell membranes are also made up of a dual sided hydrophilic and hydrophobic molecule. As such, soap solvates the hydrophobic parts of a cell membrane and hence kills the bacteria by dissolving the membrane. Furthermore, the hydrophilic part of the molecule then causes it to be easily washed away. Soap isn’t as effective against viruses because viral membranes are more protein based than lipid based and hence the viral membrane isn’t as easily dissolved. That said, however, a soapy environment can still adversely affect protein structure and

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INCLEAN May-June 2019  

Published for more than 25 years, INCLEAN magazine is the only dedicated cleaning and hygiene industry magazine in the Australian and New Ze...

INCLEAN May-June 2019  

Published for more than 25 years, INCLEAN magazine is the only dedicated cleaning and hygiene industry magazine in the Australian and New Ze...