Three keys to keep in mind to avoid hospital infections

Although the COVID-19 health crisis focused the world’s attention on professionals, staff and the health system, after vaccination campaigns and the control of the pandemic, health institutions recovered their usual rhythm, with constant demand, but without neglecting the key aspects that make the care and recovery of those who undergo hospitalization or outpatient treatment in these spaces. Hospitalized patients are susceptible to hospital-acquired infections and although this phenomenon has not been quantified so far at the national level, it is estimated that they result in substantial morbidity and are the cause or contribute to 80,000 deaths annually in the United States. While it is true that mortality from some bacteria is relatively low (ranging between 12 and 25%), it does translate into an extension of the hospitalization time until discharge, “explained Damaris Pita, Head of Hospital Hygiene and Biosecurity in hospitals such as El Cruce (F. Varela), Posadas, Cuenca Alta Cañuelas, among others. The dissertation was given in the framework of the 1st Congress of Public Health held last week in Buenos Aires.In turn, Pita explains that the strict protocols in hospitals, sanatoriums and health care centers are a very important link in the chain of transmission of possible outbreaks: “the entire patient’s environment must be clean and disinfected. Cross-contamination must be avoided in order to reduce the risk of contagion of bacteria or viruses and prevent complications.” About the 3 keys to take into account to prevent hospital-acquired infections- Cleaning: The infection process can be produced by the interaction of six elements but it is in the fourth link of the chain, in the mode of transmission, where the most important and frequent contact with hospital microorganisms occurs, which in turn are subdivided into 2 groups:- Direct contact: is the contact between a susceptible host and an infected person. It is more frequent that it happens between the patient and the medical team than from patient to patient.- Indirect Contact: It is one that happens between a susceptible host and a contaminated intermediate object, such as medical supplies (needles, instruments, dressings, etc.) or cleaning elements that have been in the environment of the contaminated patient. In this situation, it is key to have an efficient and routine cleaning, after which it is disinfected (“you can only disinfect what is clean,” says Pita). This is done in all areas, surfaces and contact elements that are used on a regular basis, being essential and necessary to reduce the risk of transmission of microorganisms. Damaris also added in her speech that: “In a hospital the cleaning service is super complex, the staff has several months of training and works with specific equipment and specific products.” He added: “All this series of care contributes to the patient’s recovery and creates safer environments.” It is important to emphasize that in this type of spaces it is necessary not only an exhaustive and systematized work (with particular techniques), but also a specific training for those who are in charge of these tasks added to the specialized supervision. These reviews are carried out in different stages, for example in the case of PULCRUS, a company that is dedicated to the cleaning and maintenance of about 10 hospitals and sanatoriums in the country, specializing in critical areas, operating rooms and emergencies and using the control technique with Bioluminescence. It is key to control the concentration of cleaning products, such as chlorinated hydrogen peroxide, to certify that it is effective against microorganisms. Health work implies that all the actors involved (medical professionals, nursing, nutrition and cleaning) use the necessary elements to ensure the non-contamination of spaces, elements and direct contact between bacteria, viruses and susceptible hosts. Hand cleaning and disinfection, the use of both dust jackets and surgical clothing (including trousers, jacket, gown, surgical cap, goggles, chinstrap, shoe covers and gloves) for doctors, nurses and instrumentators, such as aprons and kitchen caps, are essential elements for patient safety. At the same time, after a thorough cleaning of healthcare environments, pathological waste must be treated in the appropriate manner. The Ministry of Health of the Nation regulates in the Law 24051 the management of hospital waste so that it is safe throughout the chain. The management of pathological, pathogenic and urban waste requires the commitment of the institution’s staff and compliance with the regulatory framework. The Waste Life Cycle consists of 9 stages with strict control in each of them that include collection in specialized bags, separation and classification of pathological, pathogenic and urban waste, and the treatment they receive to transform them into smaller volume waste and without risk of contaminating infections. According to Mr. Sergio Beget, Coordinator of Hospital Hygiene and Safety at Posadas Hospital, who also participated in the Congress, “an example of a public hospital that has its own internal treatment plant is Posadas, where each cycle processes 130 kilos and takes 1 hour. In this process, each bag is weighed and recorded, each bag is identified to achieve traceability (monitoring from start to finish of the chain) and cases of non-conformity are detected (failure or event that affects the final result). This is done in stainless steel carts with sterilization, shredder for volume reduction and transfer to final destination to specific cells for non-hazardous industrial waste.” In summary, pathological waste management involves the management of contaminated elements that may be infected with viruses and bacteria (and thus affect the space where they are deposited: land, water, etc.) in safe and reduced waste to minimize the environmental impact. In search of continuous improvement, prevention of complications and optimal patient care, health entities today have a great responsibility when it comes to preventing the spread of intrahospital viruses through thorough compliance with the health protocol.

Original source in Spanish