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Gerência da prática - limpa é como limpo

February 20, 2015
From the January/February issue of HealthCare Business News magazine

By Amber Hogan Mitchell

Why innovative engineering is needed to reduce transmission of germs

In the August 2014 issue of HCBN, “Fighting dirty: the war on germs” author Gus Iversen explores the ability that health care systems now have to reduce the transmission of superbugs that can cause infection or illness in patient populations by practicing “medicine in the cleanest environment(s) possible.” He highlights several new commercially available technologies including “germ zapping” robots and antimicrobial scrub uniforms. The proverbial elephant in the room, however, is lower than acceptable compliance rates with protective actions like hand hygiene and the use of personal protective equipment (PPE). As such, we find ourselves relying more and more on advances in technology for fighting the war on bugs — engaging in stealth fighting tactics rather than hand-to-hand combat.

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Longstanding practices like hand hygiene (to include the proper use of gloves) and wearing PPE, protect both health care worker and patient alike; they serve as a disruption to a superbug’s cycle of life — either washing them down the drain or preventing them from taking a free ride. In his article, Iversen identifies that hand hygiene compliance rates fall below 50%. Newly available data through the International Safety Center illustrate that compliance with PPE use is even lower. In fact, the highest risk types of exposures to health care workers are blood and body fluid splashes to the eyes, nose, and mouth. These exposures essentially have the ability to infuse harmful viruses or bacteria into a new host. From a group of nearly 60-plus U.S. hospitals that contributed to The Center’s Exposure Prevention Information Network, of the blood and body splashes that occurred simultaneously to the eyes, nose, and mouth, in only three of 152 cases were personnel wearing the appropriate PPE. That’s a measly 2 percent!

Defining clean in health care
A focus only on clean environments and bug zapping technologies is only as successful as their ability to kill what they can manage to kill. There must be something first that eliminates the heft of blood and body fluids, whether that is PPE or some other form of engineering like sharps safety devices, closed system suction canisters, or fluid repellent barriers for soft or mobile surfaces. Because antimicrobial technologies alone are not effective against all of the bugs that live in a spray of blood or a pint of vomit, they must often rely on two or more mechanisms of action where fluids can be repelled and whatever bugs are left can then be killed.

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