Healthcare-induced infections are costly but can be avoided

A doctors stitches a patient after surgery. Ethically, we truly trust that the principle of non-maleficence is at work when seeking medical intervention. PHOTO | FILE | NATION MEDIA GROUP

What you need to know:

  • The major onus of health has always been on the public and precisely so as we are responsible for our bodies.
  • The Constitution grants us the right to the highest attainable standard of health. Are we genuinely living up to this standard?

Imagine you or your relative goes to the hospital for a heart surgery.

You lie on the machine to cool your body during the operation in good faith and trusting the medical professionals will perform your surgery successfully.

Months later you develop an infection after the surgery. Years later you are informed you developed the infection after being exposed to a deadly leprosy-like bacterium from the machines.

How? Switching on the machines activated a cooling fan which sprayed microbes into the air, and some entered you through the surgical incisions.

This happened to 50,000 patients in the UK in 2012 as reported in “The Times” in December last year. The germ infested the factory in Germany where the machines were built causing the contamination.

TRANSMISSION

So just how safe are our own healthcare facilities? As defined by the World Health Organisation, healthcare-associated infection as illustrated above is defined as an infection occurring in a patient during the process of care in a hospital or other healthcare facility that was not manifest or incubating at the time of admission.

These infections are those acquired in the hospital and any other setting where patients receive healthcare and may appear even after discharge.

Interestingly, they also include occupational infections among facility staff.

These infections, often caused by multiresistant pathogens, take a heavy toll on patients and their families by causing illness, prolonged hospital stay, potential disability, excess costs and sometimes death.

The infections are transmitted through direct contact with the body or indirect contact through contaminated instruments, needles, dressings, contaminated and unwashed hands, or gloves that are not changed between patients.

PREVENTION

It can also be passed through droplets via coughing or sneezing and certain procedures such as suctioning and bronchoscopy.

There is also airborne transmission, which is the most difficult to manage because it requires control of airflow through special ventilation systems.

Commonly, there is the vehicle transmission through food which transmits salmonella, water, blood which can transmit hepatitis B and C or HIV, equipment and lastly vector borne transmission through insects.

With vector borne transmission, for example, the responsibility of controlling this infection is not on the healthcare professionals but the counties and by extension the Ministry of Health.

If the hospitals and healthcare facilities are not adequately constructed with screened windows, maintenance is not frequent and hygiene is kept to the required standard, avoidable infections will occur.

HYGIENE

How then can we avoid these infections? The major onus of health has always been on the public and precisely so as we are responsible for our bodies.

But this burden cannot be imposed on us when we seek healthcare.

We already believe we are entrusting our bodies, which are irreplaceable, to the highest standard of care available to us no matter the capacity of the health facility.

Ethically, we truly trust that the principle of non-maleficence is at work when seeking medical intervention.

Our healthcare professionals are acting not to inflict evil or cause harm to us, especially avoidable or intentional harm.

Trite as it may sound, hand hygiene is probably the most basic and direct form of infection prevention control, not just for the public but more critically for the healthcare professionals and facility staff.

Would you ask the doctor to wash their hands after examining you if they didn’t?

WATER

But, before an assumption is made, do all healthcare facilities and hospitals in this country have running water? Are there adequate hand washing facilities?

That aside, we have had the cry from our doctors and nurses calling for the constant and sufficient provision of gloves.

If gloves are not available, how can medical examinations where there is anticipated contact with blood and body fluids be made without infection transmission?

What about personal protective equipment where there is still a risk of extensive exposure to blood and body fluids and in handling specimens?

Disposable gloves are not all that is required; sterile surgical gloves, utility gloves, caps, footwear, surgical masks and protective eye wear. Are these always available?

DISPOSAL

When it comes to disinfection of reusable equipment, is it to the required standard? It is one thing to have a poorly equipped facility, it’s another to maintain the available equipment free of infection and at risk of causing cross contamination.

Let’s think about this from the aspect of patients handed bedding to lie on, on the balcony and corridor as witnessed in Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu. Are these bedding and patients’ clothes cleaned and disinfected?

The Constitution grants us the right to the highest attainable standard of health. Are we genuinely living up to this standard?

Burini works with international businesses on commercial litigation. [email protected]