Infection: An Occupational Hazard for Healthcare Workers - Part 2

Read part one of this two-part blog here.

How Hospitals Can Prevent Infection Among Staff

Public health experts agree: Healthcare workers are at significant risk for catching and spreading infectious diseases, and hospitals must take “aggressive efforts” to prevent transmission of pathogens.

Following are steps healthcare facilities can take to minimize infections among staff.

Disinfect the air.

Healthcare workers are constantly exposed to airborne pathogens, when infected patients cough, sneeze, vomit, talk, or even breathe.

While infectious patients can, to some extent, be isolated from other patients during an outbreak, they cannot be separated from the medical professionals who care for them. So hospitals must disinfect the air they share.

HEPA filtration is helpful but the filters only trap, rather than kill, the dangerous microbes, which can still colonize. And ventilation systems, when poorly maintained, can act as a source of, rather than defence against, airborne infection.

Rather than rely on these methods, numerous European hospitals have deployed a more effective approach to air disinfection: ultra-low energy plasma technology, used in Novaerus portable units.

Proven to destroy airborne pathogens on contact, the technology is safe for continuous use around staff and vulnerable patients and requires virtually no maintenance. Novaerus units are commonly installed in surgical theatres, emergency rooms, ICUs, and patient rooms.

When Dublin’s Leopardstown Park Hospital, a care facility for the elderly, installed the technology in selected wards, staff absenteeism dropped in comparison with wards that did not have the units.

“We saw a 46% reduction in staff sickness within the first year,” reported Gerard McEntee, Leopardstown’s assistant director of nursing.

Agency costs were likewise reduced, minimizing the disruption and patient upset that typically accompany the hiring of agency workers. “We had happier and healthier patients and staff,” McEntee added.

Over three years, the hospital did not have a single outbreak of MRSA, C. difficile, influenza, or norovirus in wards with Novaerus units.

As a welcome bonus to hospitals, the same technology that kills airborne pathogens also dramatically reduces unpleasant odours.

“Colleagues have reported that bad odours previously experienced in wards have been eliminated,” said László Urbán, M.D., Ph.D., director general of a Hungarian hospital, Mátrai Gyógyintézet, that installed 68 Novaerus units.

Urbán added that rates of C. difficile and other infections had dropped and that doctors and nurses feel more protected against infection when they enter an isolation room.

 Encourage staff to get flu vaccinations

Healthcare workers are at increased risk of influenza exposure and vaccinated employees miss work at a far lower rate than those who don’t. Yet in most European countries, fewer than 30% to 40% of healthcare workers get vaccinated annually.

“Vaccination rates remain very low, particularly in nursing staff,” a Swiss team wrote.

Healthcare workers skip vaccines for many reasons: a fear of adverse reactions, a belief they aren’t susceptible to influenza, and scepticism that the vaccine is effective. Hospitals must do more to combat these perceptions.

Emphasize personal protective equipment.

To lower rates of staff infection, hospitals must encourage workers to make proper and consistent use of gloves, gowns, masks, respirators, goggles, and face shields.

Improve hand hygiene.

Stricter adherence to hand-hygiene protocols would reduce healthcare workers’ odds of contracting and transmitting infection. Yet at hospitals worldwide, compliance is “abysmally low” — typically under 40%, according to the World Health Organization.

In response, hospitals have employed numerous tactics to boost compliance: training classes, videos, posters, stickers, reprimands, prizes, and campaigns like “Germs! Wash Your Hands of Them.”

Still, compliance remains inadequate.

Healthcare workers don’t use enough soap or hand rub, clean the back of their hands, or rub adequately, studies show. They leave their wrists exposed, touch dispensers with their fingers, or attempt to disinfect wet hands.

“Even those workers who fully realize the importance of hand disinfection often do not know in what cases hand disinfection should be carried out unconditionally,” concluded a Ukrainian/German research team.

A Swiss study found that healthcare workers deposit, and likely transmit, potentially harmful microbes every 4 seconds onto patients and surfaces.

It’s not because they’re uncaring or lazy; it’s because they are busy and, as human beings, engage in unconscious behaviours. “People often are unaware of what exactly their hands do while they are focused on the main task,” the Swiss researchers noted.

Hospitals must continue to incentivize hand-hygiene compliance while also recognizing the limits of this solution.

“It is time to rethink our approach and combine existing strategies with new technology,” notes Ojan Assadian, MD, an infectious disease consultant and president of the Austrian Society for Infection Control.

In other words, while hospitals work toward achieving cleaner hands, higher vaccination rates, and cleaner surfaces, they must also deploy the technology that will result in cleaner air.