Hospitals and Cleanliness

Do you know there is no law to require cleanliness in our hospitals? Do you know that is why we get infections while we are in the hospital? Shouldn’t we have laws that require our hospitals to be as clean as a meat packing plant? They have laws to require cleanliness.

Did you know that our hospitals are exempt from inspections for cleanliness? That is a fact, restaurants, cruise ships, food processing plants all are inspected for cleanliness but not our hospitals. The Joint Commission which, inspects and accredits hospitals doesn’t measure cleanliness. Neither does state health departments, nor federal Centers for Disease Control and Prevention.

New data presented at the annual April meeting of Society for Healthcare Epidemiology of America documented the lack of hygiene in hospitals and its relationship to deadly infections. Boston University researchers who examined 49 operating rooms found that more than half the objects that should have been disinfected were over looked. A study of 20 hospitals in Connecticut, Massachusetts, and Washington D.C found that more than half the surfaces that should have been cleaned for new patients were left dirty.

A new University of Maryland study showed that 65 percent of physicians, and other medical professionals admitted they hadn’t washed their coat in at least a week even thought they knew it was dirty. Nearly 16 percent said they hadn’t put on a clean lab coat in at least a month. Lab coats become contaminated when doctors lean over the bed of a patient, and they spread infections to other patients. Days later the bacteria is still alive infecting the doctors hands, and patients

Stethoscopes, blood pressure cuffs, and EKG wires are used on successive patients without being cleaned. Studies published as long ago as 1978 warn that blood pressure cuffs carry live bacteria, including MRSA, and are a source of infection. In a newly released British report one third of blood pressure cuffs wee found to be covered with clostridium difficile, a germ that can cause lethal diarrhea if it enters the mouth. It isn’t far from the patients cuff to the bare arm, to the fingertips and to the mouth.

There is a simple solution, and that is, a through cleaning with detergent and water. That’s all it takes to curb the spread of deadly bacteria. When researchers at Rush University Medical Center of Chicago trained the staff to soak surfaces with detergents and water rather than spraying and wiping, and to clean commonly overlooked objects, such as telephones, remote controls, and faucets, the spread of VRE to patients were reduced by two thirds.

Do we believe it is more important to test for cleanliness in a hot dog factory than in our hospitals? Testing is essential because bacteria are invisible. You would think a hospital accredited by the Joint Commission would be clean but it is no guarantee. California hospital inspectors, investigating complaints from the public, found that 25 percent of hospitals where conditions were unsanitary had been inspected and accredited by The Joint Commission within the previous year.

Congress has been virtually silent about hospital infections, and no member has shown any interest in improving the situation.

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  1. Its a lame excuse really. When my nephew was in hospital afew days, we never saw a cleaner once. This is so wrong especially for a hospital.

  2. You’re absolutely right, Ruby…in 1987 I was a patient in Hutzel Hospital in Detroit and I came out of surgery with pseudomonis (which is a form of staph infection). My wife Jan saw a broken bottle of human blood in a nearby hallway that wasn’t cleaned up for several days…

  3. It is downright scary. My better half and I both have been through surgeries and there is no gaurantee against infections. Lionel had a bad infection in his leg when he had by-pass surgery that required a nurse to come to the house for two months. We should be safe in the hospital from bactrria.

  4. Good article..

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  6. I didn’t know any of this. Thank you, Ruby, for enlightning us. I don’t have the first idea what we can do about it, but now at least we have been informed.

  7. I will be afraid to take my kids to the hospital. I didn’t know any of this but I will ask questions the next time any of my family goes to the hospital.

  8. This is so wrong, but what can we do to fix it/ We should all call our state representive, and senator.

  9. I know I will incur the wrath by posting on this topic. I am a physician, just in case anyone was wondering. I won’t disagree with what some of you are saying either.

    There are no laws about cleanliness, per se. But considering how many health care institutions are sued daily for absolutely monstrous amounts of money, please believe me when I tell you that people are on top of enforcing cleanliness. The administration of one of the hospitals I work with will fine someone who does not maintain a certain level of cleanliness. We are lectured daily on the best ways to keep clean.

    Part of what people need to understand is that hospitals by their very nature are filthy places. Let me explain: out in the neighborhood bacteria can still be hurt by things like penicillin and simple cleaners. In the hospital these kinds of sensitive bacteria are a thing of the past. Although they are the same species, they have adapted to many of the antibiotics and cleaners so that these things do not phase them. In fact one of the major problems these days isn’t the fact that they are immune to one drug. It is that there are some bacteria in hospitals which we just can’t kill with any number of drugs. Sure, MRSA is scary (Methicillin Resistant Staphylococcus Aureus), but just (well, no completely) because the media hyped it up. Hand washing with soap does help, but it’s not perfect.
    A recent university study showed that in order to pretty much eliminate the contamination risk, heath care personnel needed to use new masks, gowns, and gloves on every patient they met. And then somehow have a family.

    If all of you are looking for something to be scared of, look at multi-drug resistant tuberculosis. (thanks to AIDS and the number of people who are NON-COMPLIANT with their meds, this thing just won’t die). Before the advent of antibiotics, was THE leading killer in the US. It still is one the major ones in the rest of the world. And it isn’t found in hospitals.

  10. I agree that hospitals can be a scary place in terms of infection. But I think it needs to be emphasised that this in not a result of complacency or indifference on the part of the hospital.

    As for the people who comment about never seeing someone clean, well, I have worked in dozens of hospitals and I really don’t know what to tell you. The cleaning crews in most of these facilities do champions work.

    As for the need for specific laws, I really don’t think that is the answer. JCAHO (Joint commission on the accreditation of healthcare organizations) is far more powerful (and scary to a hospital) than any arbitrary new set of legislation could ever be. JCAHO inspects facilities and basically goes over them with a fine toothed comb. This is already a far more comprehensive motivator than having some new branch of the health department come in.

  11. What a bunch of half-trutha and scare-tactics. For example: “clostridium difficile, a germ that can cause lethal diarrhea if it enters the mouth.” This is actually a bacteria that lives in almost every gut in America, and only causes infection under special circumstances. There are many other examples of irrelevant, if not wrong, statements in the above article. When will people stop being scared of what they don’t understand? Sure there are things that can be done to increase cleanliness in hospitals, as there are in any place. However, articles like this are what force new policies like “wash your hands before and after entering a patient’s room even if you don’t touch anything,” when excessive hand washing has actually been shown to increase the risk of being a carrier of pathogenic bacteria (you wash all the good bacteria off and the bad bacteria have a better chance to grow).
    I don’t agree with censorship, but I do agree with keeping your mouth shut if you don’t know what you are talking about.

  12. Oh yeah, and if you think health care is expensive now, just wait until hospitals have to treat EVERY room like an operating room because of the fear of the masses forcing politicians to make ill-informed laws. We are digging our own graves faster and faster.

  13. …and in response to Nick Kenney, Pseudomonas (not pseudomonis) is NOT a type of staph infection. Pseudomonas and Staphylococcus are two different bacteria. Staphylococcus is part of the normal human flora in various places while Pseudomonas is not.

  14. whaaaaa! boohhooo! look what happened to me and my unique example…I saw blood on the floor, nobody cleaned it up, boohhoooo….

    If you people buy all this BS then go vote for McCain.

    Seriously, even if there were NO federal guidelines for cleanliness they are a free enterprise operation. the best product wins! thus they try harder.

    Yea I need my tax money spent on another agency that checks how often the janitor cleans my toilet. sounds great.

    You people are freak’n lemmings.

  15. shawn, I agree with you for the most part, but I’m confused about your McCain comment… He’s not the one pushing for complete government control over healthcare.

  16. Considering sometimes I am up to my elbows in patients feces and other bodily fluids as well as a number of major diseases and illness; it may come as a major surprise to everyone that I have a 100% pure clean bill of health and have not had so much as a cold in over 3 years!!!! Thank you Traveling Physician for explaining everything.

  17. Thank you all so much for your comments. I am impressed that doctors, nurses, and cleaning staff have enlightened us on the subject of cleanliness in our hospitals. I certaily appreciate everything you have to say.

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  19. very informative really

  20. good and informative

    Msc.Biostatistics ( 611-09 )
    Punjab University

  21. I am a Canadian living in Europe and a visitor to Ottawa, nursing my sister back to health. While visiting the Ottawa Hospital (no particular mentioned) , I was shocked with the cleanliness of the toilets, patient rooms and especially the canteens. My sister complained that the toilet hadn’t been cleaned once in her 4-day stay. When visiting the coffee shop and canteen, I noticed the that the tables were absolutely filthy, the floors full of rubbish and there were fruit flies on the food behind the serving counters. And that in the middle of winter! I am sure the cleaning staff is very sufficient, but the government seems to be saving in the wrong place! There is no need for this situation. On the otherhand, although the waiting list for medical service in Canada is sometimes a mile long, the nursing staff were very friendly and helpful and the doctors took their time treating and explaining the medical situation and answering questions. They do their jobs as best they can considering the shortage of staff in Canada and all the cutbacks.

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