Germs and Infection
Germs are transmitted from person to person in many different ways. Sometimes illness are spread through direct contact with someone who is sick or through contact with contaminated body fluids (e.g., saliva, blood or semen). Respiratory viruses are often spread through contact with germs expelled in a sneeze or cough. Some bacteria and viruses can live on surfaces (like countertops or doorknobs) for two hours or more. A healthy person can become ill by touching the contaminated surface and then transferring the germs into his/her mouth, eyes or nose.
Hospitalized patients are susceptible to infections because they typically have weaker immune systems and are less likely to be able to fight the germs. Occasionally, hospital-acquired infections can be transmitted through contact with contaminated medical equipment. More commonly, however, the germs are carried into the room from visitors, other patients or hospital staff.
The Centers for Disease Control and Prevention estimates the annual cost of hospital-acquired infections to be $28.4 to $33.8 billion. Patients who get an infection while in the hospital may require further treatments and a longer hospital stay. In the worst cases, a hospital-acquired infection can cause death. Experts with the Safe Patient Project estimate about 99,000 Americans die each year from hospital-acquired infections.
Washing Away Germs
One of the most effective methods of infection prevention is thorough hand washing. The most effective hand washing routine involves scrubbing with soap and water for at least 15 seconds. Infectious disease experts recommend washing your hands before making meals, eating, after coughing or sneezing, after using the bathroom or after changing a diaper.
Hospital workers are supposed to wash their hands before and after examining patients. Yet, researchers have found 40 percent or fewer health care workers follow the recommendations.
Richard Lewis, M.D., Anesthesiologist with Princeton Baptist Medical Center in Birmingham, AL, says most health care workers understand the importance of hand washing in reducing the spread of infection in the hospital. However, there are many reasons why hand washing compliance rates are so low. Sometimes health care workers are rushing to get a job done and don’t think they have time to wash or forget that it should be done. Sometimes soap and water aren’t located in a convenient spot. Some may also believe that using gloves reduces or eliminates the need for hand washing.
Hospital staff at Princeton Baptist Medical Center are involved in a pilot study testing radio frequency identification (RFID) technology to monitor compliance with hand washing guidelines. Every health care worker wears a touchless tag embedded with a unique identification signal. When the worker enters a patient’s room, an entry sensor picks up the RFID. A soap dispensing system also contains an RFID sensor. When the health care worker activates the dispenser, the date and time of activation is recorded. Then a personal message about hand hygiene is displayed to the worker. The message contains a hand hygiene “score” that lets the worker know how he/she is doing in hand washing compliance compared to peers. A third part of the system allows the dispenser to display information about the patient’s status or needs, making efficient use of the hand washing time. The system can even be programmed to provide other information, like current news headlines.
Lewis says the RFID system will enable administrators to monitor hand washing compliance rates among hospital staff and improve a worker’s efficiency. So far the system is only set up in a small number of hospital rooms. However, Lewis says the information gained in the monitoring analysis may help hospital administrators make decisions that improve compliance and, ultimately, patient safety and care, through the entire hospital.
Centers for Disease Control and Prevention, http://www.cdc.gov/Features/FightGerms/ or
National Institute of Allergy and Infectious Diseases, http://www.niaid.nih.gov/topics/microbes
The Safe Patient Project, http://www.safepatientproject.org/2010/04/septicemia_statistics_and_the.html
The company providing the RFID technology is Proventix™. Information can be found at http://www.proventix.com
“Guideline for Hand Hygiene in Health-care Settings,” MMWR: Morbidity and Mortality Weekly Report, October 25, 2002, Vol. 51, No. RR-16.
Mody, Lona, M.D., et al., “Adoption of Alcohol-Based Handrub by United States Hospitals,” Infection Control and Hospital Epidemiology, December 2008, Vol. 29, No. 12, pp. 1177-1180.
Rosenthal, T., et al., “Observation and Measurement of Hand Hygiene and Patient Identification Improve Compliance with Patient Safety,” Academic Medicine, December 2009, Vol. 84, No. 12, pp. 1705-1712.
Thomas, Bruce, D.O., et al., “Conspicuous vs Customary Location of Hand Hygiene Agent Dispensers on Alcohol-Based Hand Hygiene Product Usage in an Intensive Care Unit,” Journal of the American Osteopathic Association, May 2009, Vol. 109, No. 5, pp. 263-267.