Hospital Responses and Media Statements on Cleanliness

Mediclinic

Mediclinic is continually involved in the process of seeking solutions to the many daunting challenges faced by the healthcare industry, including infection prevention. Antimicrobial resistance and hospital-acquired infections are on the rise worldwide, and the prevention of these healthcare-associated infections (HAI) is a major challenge for both private and public healthcare systems.

Read Mediclinic’s full Media Statement here.

Netcare

Netcare teams up with germ-zapping robots to take the war on ‘superbugs’ to a new level

Healthcare facilities the world over face a daily challenge to prevent the spread of infections and, with increasing concern about antibiotic resistance, South African healthcare group Netcare is teaming up with robots that seek and destroy viruses and bacteria within minutes.

Read Netcare’s full Media Statement here.

Life Healthcare

Below are some questions Carte Blanche put to Life Healthcare with regards to general hospital cleanliness.

When contacted by patients with complaints regarding hospital acquired infections which they claim to contract either from ICU or from wards, what is the hospital’s response generally to these patients? 

Life Healthcare:
Infection prevention and control and Antimicrobial Stewardship (AMS) in Life Healthcare is taken extremely seriously and is a high priority for all our hospitals.

Complaints of this nature are investigated thoroughly, if necessary with the help of external infection prevention specialists or microbiologists. If a source of infection or breach of infection prevention measures is identified, these will be acknowledged and addressed. If the patient considers that they do have a case against the hospital, they are entitled to take this up with the hospital and Life Healthcare and/or pursue a route to determine the degree of liability and appropriate compensation by an independent impartial body such as a court or a statutory regulatory body.

How does Life clinically treat patients who acquire infections in hospital?

Life Healthcare:
The doctor decides on the treatment of the individual patient. Due to the many types of infections and treatment protocols, clinicians will determine what is best for the individual patient. As part of this process we consult our clinical pharmacists and infection prevention specialists.

How does Life clean the rooms or respond when the hospitals wards/ICU theatres are found to harbour ‘superbugs’?

Life Healthcare:
Life Healthcare has comprehensive work procedures in place for routine and terminal disinfection in line with international best practice. On discharge of an infectious patient for example, the room is washed down with soap and water, followed by disinfection with a hypochlorite solution. High-tech equipment is disinfected with a suitable disinfectant wipe. Following this three-step process, a technology is used to ensure that the room is clean, where-after the room is fogged with a hydrogen-peroxide vapour.

And how is Life preventing these infections?

Life Healthcare:
Each of our hospitals has an Infection Prevention Specialist (IPS) responsible for maintaining the infection prevention and control programme in an integrated way to improve clinical outcomes and minimize risk. The IPS provides infection prevention expertise to the facility based on sound evidence based knowledge. They also perform a variety of professional duties involved in the prevention and control of healthcare associated infections (HAI’s) and monitor and evaluate infection prevention and control activities throughout the facility.

Life Healthcare’s infection prevention and control policies and procedures are based on international best practice and compliance is measured in the following areas, amongst others:

  • Surveillance:
  • Refers to the regular collection, collation and analysis of information on infection prevention and control practices, events and rates, either continuously or at regular intervals, and the dissemination and feedback to relevant role players.
  • Includes the measuring and monitoring of HAI’s, community associated infections and colonisations.
  • Infection prevention and control Bundle compliance (combined measures to reduce specific HAIs)
  • Hand hygiene compliance audits.
  • Macro- and micro-scopic surveillance with regards to cleanliness of the environment. This includes ‘terminal cleaning’ (our “Spotlight on Cleanliness” programme).

The aim of Life Healthcare’s Antimicrobial Stewardship Programme, now in its sixth year of running, is to ensure that antibiotics are being prescribed responsibly by clinicians, according to the latest evidence-based literature.

Antibiotic stewardship can be defined as “coordinated interventions designed to improve and measure the appropriate use of antibiotic agents by promoting the selection of the optimal antibiotic drug regimen including dosing, duration of therapy and route of administration.”

Life Healthcare’s AMS Programme is a collaborative effort between doctors, pharmacists, microbiologists, infection prevention specialists, nurses and other healthcare professionals.

There are multiple drivers of antimicrobial resistance which have a major impact in a hospital setting. A doctor led, multidisciplinary approach in each hospital is key to the success of an AMS programme to ensure that practises are in place to minimise pathogen resistance while providing quality patient care.

What makes antimicrobials different to any other medication is that their misuse can have an impact on patients who have not even been exposed to them, with the potential for contributing to the spread of resistant organisms. Misuse of antimicrobials occurs in the community as well as in agricultural- and veterinary settings, which increases the incidence of patients being admitted with multi-drug resistant organisms. Indiscriminate use of antimicrobial agents creates selection pressure for the emergence of resistant strains of micro-organisms and development of HAIs.

Antimicrobial stewardship programs have proved internationally that, through improving appropriate antimicrobial use, treatment of infections can be optimized, and the rate at which antimicrobial resistance develops can be reduced. These programs assist clinicians with improving quality patient care and safety. Treatment failures can be reduced, infection cure rates can be increased and appropriate utilisation of antimicrobials can be ensured through a multidisciplinary team approach to AMS.

Life Healthcare Group’s approach is aligned to the National Department of Health’s antimicrobial resistance (AMR) National Strategy Framework 2014 – 2024 in response to the World Health Assembly’s endorsement of a global action plan to tackle AMR.

Where and how are hospital acquired infections spread in Life hospitals – with specific reference to the ICU theatres? We have footage from several ICUs in Gauteng (in different hospital groups, including yours) that show pharmaceutical reps often assist with surgical procedures (examples include but aren’t limited to reps crossing the red line on the floor, whip-stitching sutures, handling patients’ limbs and manipulating them for the surgeon).  

Life Healthcare:
As in any other healthcare environment, transmission of organisms that can cause HAIs can occur in many ways: environment–to-patient; patient-to-patient; caregiver-to-patient. Failure to apply appropriate infection prevention measures contribute to spread of HAIs.

 

We have seen both nursing sisters and surgeons failing to adhere to protocols designed to ensure the theatres are kept sterile (for example wearing shoes without booties, open and closing doors during surgery, anaesthetists not wearing masks). How is Life handling training, etc. to prevent this?

Life Healthcare:
Our staff are trained in the theatre technique, including infection prevention, and apply these measures.

Our theatre staff are assessed for competence in the field in which they work. This is on-going.

Doctors, as independent practitioners are advised and requested to comply with our infection prevention measures. In serious cases of non-compliance, posing a risk to patients, doctors may lose their practising privileges at our hospitals.

There is no scientific evidence supporting the wearing of booties. Staff wear dedicated theatre shoes.  All members of the surgical team should wear masks.

 What statistics do you have available regarding hospital acquired infections in Life hospitals?

Life Healthcare:
Our statistics are published in our integrated annual report and the report can be accessed here.  According to the World Health Organisation, between 7 and 10 of every 100 hospitalised patients will acquire at least one health care-associated infection. Life Healthcare’s infection rates are substantially lower than this.