The impact of poor air quality can be a major problem leading to sickness or even death - but not enough is being done to combat the problem.
The problem is partly that many people simply don’t think about air quality or its importance as an essential contributor to health and wellbeing in healthcare environments. Also, as the only legal requirement regarding ventilation hygiene is that systems are regularly inspected and the findings recorded but there is no legal obligation to clean, when budgets are under pressure as they are now it is too easy to put off what may be essential cleaning work.
In hospitals highly infectious diseases like MRSA and Clostridium difficile are not only carried through ventilation systems, but can thrive and feed on flakes of dead dry human skin which is a component of hospital dust and can build up in ventilation ducts.
Recent data from the Office for National Statistics showed that while the number of people dying due to MRSA and Clostridium difficile fell in 2008, superbug infections were still responsible for 30,000 deaths in five years. However, one expert believes that the number of patients in British hospitals dying from superbug infections has reached more than 10,000 every year.
Mark Enright, professor of molecular epidemiology at Imperial College London, said that the real number of those succumbing to MRSA and Clostridium difficile in the UK is higher than the government’s records show. “I think it is at least 10,000 a year,” he said. “A lot of people are never tested for these infections and their deaths are put down to something else.”
Dr Ghasson Shabha is facilities management MSc course leader at the School of Property, Construction and Planning at Birmingham City University. He is also MRSA project co-coordinator and is currently assessing commercial viabilities for new technologies for tackling infection control in health environments.
Dr Shabha agrees there is a real and urgent need to make regular duct cleaning an essential part of sustained hospital cleaning and maintenance programmes. He said: “MRSA has increasingly become one of the major sources of healthcare associated infection in hospitals in Britain and a main contributory factor to 100,000 cases per annum. It thrives in relatively non – humid environments and feeds on flakes of dead, dry human skin. It withstands desiccation at temperatures of 18-37 C and is thus a frequent component of hospital dust, making it more likely to spread via ventilation and air-conditioning systems. Ducts in hospitals, depending on type and function of rooms, should be cleaned on a three to six monthly basis; filters, depending on whether multi-layered or single layered, should be replaced on regular basis, ideally six monthly, as part of planned preventive maintenance programme.”
The cost of not having a thorough and regular duct cleaning and maintenance programme is very high indeed – in human terms alone, probably more than 10,000 lives lost every year - and the cost to the NHS of treating healthcare associated infections which is estimated to be around £1BN per annum.
Author: Ian Wall, sales director, Ductbusters
www.ductbusters.co.uk
Monday, 5 July 2010
Monday, 16 March 2009
Involvement in research into S.aureus bloodstream infection
Dr Martin Llewelyn is a consultant infectious diseases specialist in Brighton and is looking to undertake some research studying treatment of S. aureus blood-stream infection. He is interested in involving members of MRSA Action UK or anyone else who has been affected by S.aureus blood-stream infection in the developing the project. In particular he would like help in identifying the most important questions for the study, how to approach patients to take part in the work and how to communicate the findings to the public. If anyone is interested in becoming involved, could they contact him by email. m.j.llewelyn@bsms.ac.uk
Sunday, 8 June 2008
Focus on the healthcare environment and airborne bacteria
Full implementation of measures in the Hygiene Code show that a multi-factorial approach is needed to eliminate the risk of avoidable healthcare infections:
- Hand hygiene
- Strict aseptic procedures
- Screening
- Isolation
- Information for all healthcare providers, including social care, and patients and carers
There also needs to be a stronger focus on the environment. The deep-clean was not a wasted exercise from the viewpoint of raising the profile and marking a change in behaviour in many of our healthcare settings. Although criticised as a gimmick we have seen a sea-change in many hospital trusts who are now committed to keeping the environment clean – although sadly this is not in all hospitals and care facilities.
The Health Act 2006: Code of Practice for the Prevention and Control of Healthcare Associated Infections requires healthcare providers to take this into account as part of their duty to provide the patient with “so far as is reasonably practicable, patients, staff and other persons are protected against risks of acquiring healthcare associated infections, through the provision of appropriate care, in suitable facilities, consistent with good clinical practice...”
Of concern are the number of experts who now confirm that many of the major threats from infections in both the hospital and care home environment is risk from airborne bacteria.
We believe that by being airborne this gives as much, if not more chance, of contaminating the environment where there are patients and healthcare works carrying the bacteria on their hands.
We know that those who have had MRSA or Clostridium difficile are potential carriers and we know that, particularly in the case of Clostridium difficile, once in the environment it is very difficult to remove it.
This is why every effort should be made to eliminate these bacteria from the air, after all if its airborne then it lands on surfaces, and may be responsible for many deaths from pneumonia – often the micro-organism that causes the pneumonia, for example MRSA, is not recorded on death certificates. We believe more research should be conducted to establish why it is that MRSA is often found in the throat, the sputum and in the nose.
With threats from MRSA, MSSA, Clostridium difficile and others, the duty to provide and maintain a clean and appropriate environment for healthcare becomes even more important. Yet not all healthcare facilities are making use of the technology that exists to alleviate this problem. More attention needs to be placed on the risks from airborne bacteria, Clostridium difficile spores have been found on the tops of curtain rails, therefore air handling equipment should be used routinely in cohort wards and isolation units, and may prove to be beneficial if used in the care environment, as prevention is better than cure.
The Dutch take the risk of airborne bacteria very seriously. Isolation facilities have negative pressure rooms, and those giving clinical care routinely wear masks. Guidelines in care homes are far more stringent than they are here in the UK. Masks are worn for changing bedding if a patient is colonised with MRSA or other contagions.
Used in conjunction with regular deep-cleaning there are portable devices that use biocides that can remove harmful pathogens from the air, and other technologies such as UVGI.
Policies for the environment relating to the fabric of hospital buildings, including air handling systems, is one of the many requirements of the Hygiene Code, and we believe a significant requirement to combat the problem.
More investment is needed to implement innovative solutions that exist to help healthcare providers meet their duty to protect against risks of acquiring healthcare infections.
This important element of keeping the environment clean and safe should not be overlooked when spending Infection Prevention and Control budgets. Prevention is always better than cure.
- Hand hygiene
- Strict aseptic procedures
- Screening
- Isolation
- Information for all healthcare providers, including social care, and patients and carers
There also needs to be a stronger focus on the environment. The deep-clean was not a wasted exercise from the viewpoint of raising the profile and marking a change in behaviour in many of our healthcare settings. Although criticised as a gimmick we have seen a sea-change in many hospital trusts who are now committed to keeping the environment clean – although sadly this is not in all hospitals and care facilities.
The Health Act 2006: Code of Practice for the Prevention and Control of Healthcare Associated Infections requires healthcare providers to take this into account as part of their duty to provide the patient with “so far as is reasonably practicable, patients, staff and other persons are protected against risks of acquiring healthcare associated infections, through the provision of appropriate care, in suitable facilities, consistent with good clinical practice...”
Of concern are the number of experts who now confirm that many of the major threats from infections in both the hospital and care home environment is risk from airborne bacteria.
We believe that by being airborne this gives as much, if not more chance, of contaminating the environment where there are patients and healthcare works carrying the bacteria on their hands.
We know that those who have had MRSA or Clostridium difficile are potential carriers and we know that, particularly in the case of Clostridium difficile, once in the environment it is very difficult to remove it.
This is why every effort should be made to eliminate these bacteria from the air, after all if its airborne then it lands on surfaces, and may be responsible for many deaths from pneumonia – often the micro-organism that causes the pneumonia, for example MRSA, is not recorded on death certificates. We believe more research should be conducted to establish why it is that MRSA is often found in the throat, the sputum and in the nose.
With threats from MRSA, MSSA, Clostridium difficile and others, the duty to provide and maintain a clean and appropriate environment for healthcare becomes even more important. Yet not all healthcare facilities are making use of the technology that exists to alleviate this problem. More attention needs to be placed on the risks from airborne bacteria, Clostridium difficile spores have been found on the tops of curtain rails, therefore air handling equipment should be used routinely in cohort wards and isolation units, and may prove to be beneficial if used in the care environment, as prevention is better than cure.
The Dutch take the risk of airborne bacteria very seriously. Isolation facilities have negative pressure rooms, and those giving clinical care routinely wear masks. Guidelines in care homes are far more stringent than they are here in the UK. Masks are worn for changing bedding if a patient is colonised with MRSA or other contagions.
Used in conjunction with regular deep-cleaning there are portable devices that use biocides that can remove harmful pathogens from the air, and other technologies such as UVGI.
Policies for the environment relating to the fabric of hospital buildings, including air handling systems, is one of the many requirements of the Hygiene Code, and we believe a significant requirement to combat the problem.
More investment is needed to implement innovative solutions that exist to help healthcare providers meet their duty to protect against risks of acquiring healthcare infections.
This important element of keeping the environment clean and safe should not be overlooked when spending Infection Prevention and Control budgets. Prevention is always better than cure.
Saturday, 18 August 2007
The Valued Use of Probiotics
At a time when antibiotic resistance to bacterium is as prevalent as it is today there is a need to stand back and look at prevention rather than cure. If we don't we run the risk of leaving our children and future generations a legacy that our grandparents faced when there were no antibiotics to rely on.
Antibiotics should be used efficaciously, that is as a last resort when all efforts to prevent an infection occuring have failed. Technologies, both natural and man-made are proven to work in the fight to reduce the risk of acquiring an infection in the healthcare setting, not least the human body's own defence mechanism.
It is widely reported that immune suppressed patients are more susceptable to healthcare infections, although we know from bitter experience young, fit healthy people have contracted infections which have killed and maimed. I believe that if we are to give everyone a chance of making a good recovery from any surgical procedure then we should look at the armoury we have to protect ourselves from the risks of infection. A lot of people are regularly taking probiotics in their diets as they have looked at the research, and this has been backed up recently in the BMJ, and they are safeguarding themselves for whatever eventually they may have to face in terms of staying healthy. Taking probiotics regularly can help to shore up the system to help you fight infection naturally. If you do succumb to an infection during a surgical procedure and antibiotics are given then the probiotics can help with balancing your own immune system.
Research has shown that even when probiotics are capable of establishing a colony of beneficial bacteria of the large gut it has to be regularly topped up with fresh beneficial bacteria - if it is to retain the foothold it has established. This may mean taking the probiotics at least daily and in some cases a twice daily regime is recommended.
The advantages are that once the beneficial bacteria are established from the probiotic the gut is likely to work better, nutrients will be more easily absorbed, vitamin production will be unaltered and, unwelcome gut symptoms such as irritable bowel syndrome will be lessened in many cases, ultimately resulting in the patient's immune system and defence against infections being enhanced.
Probiotics may have a special role when antibiotics have been prescribed. They reduce the chance of other infections settling in the gut after the antibiotic has upset the patient's usual gut flora. Implanting beneficial bacteria may prevent these antibiotic induced gut changes leading to serious disease. Some hospitals are now giving probiotics to patients to bolster the gut's normal flora. They've also been used to manage recurrent infection with C.Diff. The probiotics most frequently used to treat C.Diff include Lactobacillus GG, which is a concentrate that can be added to skimmed milk and Lactobacillus acidophilus, found in yogurt.
I believe that in the battle against ever prevalent healthcare infections we should be relying on our bodies natural defenses to antimicrobial resistance more and more, and making the best use of natural technology to help this process.
Antibiotics should be used efficaciously, that is as a last resort when all efforts to prevent an infection occuring have failed. Technologies, both natural and man-made are proven to work in the fight to reduce the risk of acquiring an infection in the healthcare setting, not least the human body's own defence mechanism.
It is widely reported that immune suppressed patients are more susceptable to healthcare infections, although we know from bitter experience young, fit healthy people have contracted infections which have killed and maimed. I believe that if we are to give everyone a chance of making a good recovery from any surgical procedure then we should look at the armoury we have to protect ourselves from the risks of infection. A lot of people are regularly taking probiotics in their diets as they have looked at the research, and this has been backed up recently in the BMJ, and they are safeguarding themselves for whatever eventually they may have to face in terms of staying healthy. Taking probiotics regularly can help to shore up the system to help you fight infection naturally. If you do succumb to an infection during a surgical procedure and antibiotics are given then the probiotics can help with balancing your own immune system.
Research has shown that even when probiotics are capable of establishing a colony of beneficial bacteria of the large gut it has to be regularly topped up with fresh beneficial bacteria - if it is to retain the foothold it has established. This may mean taking the probiotics at least daily and in some cases a twice daily regime is recommended.
The advantages are that once the beneficial bacteria are established from the probiotic the gut is likely to work better, nutrients will be more easily absorbed, vitamin production will be unaltered and, unwelcome gut symptoms such as irritable bowel syndrome will be lessened in many cases, ultimately resulting in the patient's immune system and defence against infections being enhanced.
Probiotics may have a special role when antibiotics have been prescribed. They reduce the chance of other infections settling in the gut after the antibiotic has upset the patient's usual gut flora. Implanting beneficial bacteria may prevent these antibiotic induced gut changes leading to serious disease. Some hospitals are now giving probiotics to patients to bolster the gut's normal flora. They've also been used to manage recurrent infection with C.Diff. The probiotics most frequently used to treat C.Diff include Lactobacillus GG, which is a concentrate that can be added to skimmed milk and Lactobacillus acidophilus, found in yogurt.
I believe that in the battle against ever prevalent healthcare infections we should be relying on our bodies natural defenses to antimicrobial resistance more and more, and making the best use of natural technology to help this process.
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