Low standards of hygiene is a major cause of health care associated infections which has increased the mortality and morbidity level among hospitalized patients. The health care associated microorganisms are transmitted mostly through contamination of the environment. Contaminated hands is the leading cause of these infections. Hand washing, for a long time, has been considered as a way to personal hygiene and a means of controlling health care associated infections (Mani, Shubangi and Saini, 2010). This paper reflects on general hygiene in the health care setting, factors influencing hygiene, its effect in the health care delivery and also what people feel about hygiene.
In my understanding, diseases are naturally caused by a couple of factors in relation to human behavior, systems and processes of health care delivery (WHO, 2009). Spread of health care associated infections occur through either direct or indirect contact with the pathogens, contaminated fluids or contamination present in the air. This makes these infections preventable. To begin with, hand hygiene is a primary measure in controlling disease causing pathogens. Hand washing is just a simple act whose non-compliance in the health care sector could be dangerous. Under their new slogan, “Clean Care is Safe Care” the WHO have proposed different policies and strategies focusing their attention of improving and promoting hand washing. The WHO have also come up with guidelines on hand washing. I therefore recommend that hospitals should be encouraged to adopt these guidelines as it would improve their understanding and awareness on the issue of hand washing. Low compliance in hand washing rates has been reported mostly in developing nations with an average of 38.7 percent. Health care professionals have to make hand washing a routine activity if health care associated infections are to be brought under control.
In my thinking, I presume that the patient’s room, including bedside tables and bedrails, could be a means of transmitting infections in from one patient to the other or to the nurses (Carling, 2016). Chemical disinfectants such as sodium hypochloride, are used to clean surfaces in the health care facilities. The effectiveness of these disinfectants depends on their antimicrobial activity, the cleaning and application adequacy, the disinfectant’s concentration and application on the contact lines. Some health care facilities have implemented the no touch models of cleaning surfaces as the concern on inadequate disinfection grows even after application of interventions to improve surface cleaning especially after patient discharge (AHRQ, 2014). This includes the use of UV light (Jinadatha et al. 2014) and use of self-cleaning surfaces by coating the surfaces with copper or germicides (Salgado, Sepkowitz and John, 2013)
Personal hygiene is crucial in patients’ health and well-being with nurses playing the core role in ensuring that patients’ hygiene is maintained. Howell, Rafferty, Wall and Snaith (2013) call the health professionals “agents of imperial hygiene”. Personal hygiene includes shaving, skin care, mouth, nails and hair care, and bathing. These types of personal hygiene are related and the nurses’ intervention in patient’s hygiene depends on the self-care ability and level of dependence of the patient (Pegram, Bloomfield and Jones, 2013). When undertaking bed bathing, essential risk assessments should be maintained in handling and moving the beddings. I would also ensure that infection control principles are adhered to according to given standards. I would also review the patient’s plan before offering the hygiene care to ensure that I address any cultural needs which could hinder the safe delivery of the care (Pellowe, 2007). Surgical also need to be maintained clean. Used and soiled devises should be immediately taken for decontamination and cleaning so that body fluids do not dry on the surfaces (Chobin, 2017). This would ensure that diseases transmission and infections are put under control.
Most health care facilities lack adequate equipment and materials to maintain hygiene standards (Hancart-Petitet et al. (2011). Other factors such as formal and informal rapport in the health care settings influence hygiene practices in hospitals. Some other health officer see cleanliness as non-essential. Hospitalization affects the hygiene level in patients. Hospitalized patients could be unconscious and therefore rely on nurses and family members for the hygiene needs. Social practices have an influence on the hygiene of patients. The people around the patient, his friends, parents, co-workers affect the patient’s level of hygiene. When we were young, our parents influenced our hygiene practices especially oral care, timing and frequency of bathing (Dhazer, 2017). This also applies to the patients.
Physical conditions of a patient, like some form of disability can affect they level of hygiene. A patient suffering from arthritis or paralysed is in need of hygiene care. Socioeconomic status, like lack of finances, and cultural variations, like being customary according to some cultures to bath once in a week, are other factors influencing hygiene. All these factors are solvable. Availability resources in the hospitals need to be addressed a fresh. I call upon the government and any other stakeholder to take charge and avail the relevant material to the hospitals. They too should employ enough and qualified nurses and carers to help provide the quality care to the patients. Cultural factors affecting hygiene should be addressed boldly, as all health care professionals are obliged to respecting the culture of every patient. On socioeconomic and physical condition, I would urge the nurses to ensure that these patients receive quality care irrespective of their social class, age, race or body condition. I also recommend that surgical instruments are cleaned and disinfected in the required time so that safety of patients is guaranteed. Hygiene and cleanliness is all about one being responsible. If nurses are responsible then they would know how to maintain high levels of hygiene in their environment.
If health facilities would buy the principle of hygiene, then health care associated infections would be a talk of the past. Hand washing should be much emphasized in every hospital setting. Nurses and carers should ensure that patients’ materials and beddings are attended to appropriately. Introducing the self-cleaning technology in health care would boost the levels of hygiene a great deal.
References
Agency for Health Research and Quality (AHRQ). (2014). Effective health care program: Environmental Cleaning for the Prevention of Healthcare-Associated Infections (HAI). Retrieved from: https://effectivehealthcare.ahrq.gov/topics/healthcare-infections/research-protocol
Carling, P. C. (2016). Optimizing health care environmental hygiene. The NCBI, Vol. 30, No. 2, pp. 639-660. Doi: 10.1016/j.idc.2016.04.010
Chobin, N. (2017). Decontamination of surgical instruments begins in the OR. Retrieved from: https://www.infectioncontroltoday.com/sterile-processing/decontamination-surgical-instruments-begins-or
Dzaher, A. (2017). The many factors influencing patient hygiene practices, and how nurses can help. Retrieved from: https://today.mims.com/the-many-factors-influencing-patient-hygiene-practices–and-how-nurses-can-help
Hancart-Petitet, P., Dumas, C., Faurand-Tournaire, A. L., Desclaux, A. and Vong, S. (2011). Social and cultural dimensions of hygiene in Cambodian health care facilities. BMC Public Health, Vol. 11No. 83. Doi: 10.1186/1471-2458-11-83.
. Howell, J., Rafferty, A. M., Wall, R. and Snaith, A. (2013). Nursing the tropics: nurses as agents of imperial hygiene, Journal of Public Health, Vol. 35, No. 2, pp. 338–341, https://doi.org/10.1093/pubmed/fdt016
Jinadatha, C., Quezada, R., Huber, T., Williams, J. B., Zeber, J. E. and Copeland, L. a. (2014). Evaluation of a pulsed-xenon ultraviolet room disinfection device for impact on contamination levels of methicillin-resistant Staphylococcus aureus. The European Journal of Medical Research, Vol. 14, No. 187. Doi: 10.1186/1471-2334-14-187
Mani, A., Shubangi, A. M. and Saini, R. (2010). Hand hygiene among health care workers. The NCBI, Vol. 21, No. 1, pp. 115-118. Doi: 10.4103/0970-9290.62810
Pellowe, C. M. (2007). Standard principles: Hospital environmental hygiene and hand hygiene. Retrieved from: https://www.nursingtimes.net/clinical-archive/infection-control/standard-principles-hospital-environmental-hygiene-and-hand-hygiene/291499.article
Pegram, A., Bloomfield, J. and Jones, A. (2013). Clinical skills: Bed bathing and personal hygiene needs of patients. British Journal of Nursing, Vol. 16, No. 6, pp. 355-358. Doi: 10.12968/bjon.2007.16.6.23009
The WHO. (2009). WHO Guidelines on Hand Hygiene in Health Care: a Summary. Geneva: World Health Organization.
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