Why Aren't Hospitals Cleaner?

Commentary: Not All Deadly Infections Come From Dirty Hands. Check The Lab Coats

(U.S. News & World Report)  The following is a commentary by Betsy McCaughey, chairman of the Committee to Reduce Infection Deaths, a national effort focusing on hospitals. She was lieutenant governor of New York and has published widely in health policy.

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Restaurants and cruise ships are inspected for cleanliness. Food processing plants are tested for bacterial content on cutting boards and equipment. But hospitals, even operating rooms, are exempt. The Joint Commission, which inspects and accredits U.S. hospitals, doesn't measure cleanliness. Neither do most state health departments, nor the federal Centers for Disease Control and Prevention.

No wonder hospitals are dirty. New data presented in April at the annual meeting of the 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 of the objects that should have been disinfected were overlooked. A study of patient rooms in 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.

Germ-coated. Sad to say, cleanliness is not a priority for hospital administrators or most medical professionals. A new University of Maryland study shows that 65 percent of physicians and other medical professionals admitted they hadn't washed their lab coat in at least a week, even though 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 covered in bacteria when doctors lean over the bedsides of patients who carry the organisms. Days later the bacteria are still alive, repeatedly contaminating doctors' hands and being carried to other patients.

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From admission to discharge, Dr. Bernadine Healy preps patients and their families for major surgery

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The CDC and other organizations urge caregivers to clean their hands between patients, and even advise patients to speak up and request that caregivers have clean hands.

That's a start, but it's not enough. As long as hospitals are inadequately cleaned, doctors' and nurses' hands will be recontaminated seconds after they are washed — when they touch a keyboard, open a supply closet, pull open a privacy curtain, or contact other bacteria-laden surfaces. In a recent Johns Hopkins Hospital study, 26 percent of supply cabinets were contaminated with a dangerous bacterium, methicillin-resistant Staphylococcus aureus (MRSA) and 21 percent with another stubborn germ, vancomycin-resistant Enterococcus (VRE). Keyboards are such reservoirs of deadly bacteria that a few hospitals are installing washable keyboards, including one that sounds an alarm if it isn't disinfected periodically.

Hand to mouth. 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 frequently carry live bacteria, including MRSA, and are a source of infection. In a newly released British report, one third of blood pressure cuffs were found to be contaminated with Clostridium difficile, a germ that can cause lethal diarrhea if it enters via the mouth. It's a short trip from a cuff to a patient's bare arm, then to the fingertips and into the mouth. At a hospital in Galveston, Texas, where a burn patient became infected with VRE, molecular typing traced the bacteria to an unclean EKG wire. The VRE on the wire had been left behind by a patient discharged 38 days earlier.

The good news is that a simple solution—thorough cleaning with ordinary detergents and water—curbs the spread of deadly bacteria. When researchers at Rush University Medical Center in Chicago trained the staff to soak surfaces with detergent rather than merely spraying and wiping, and to clean commonly overlooked objects such as telephones, remote controls, and faucets, the spread of VRE to patients was reduced by two thirds.

[cmp271]

Must be England has cleaned up. I remember seeing a vent on an elevator at the John Radcliff in Oxford that had dust just piles up on it, the place smelled dirty as well.

America's hospitals are getting that bad now too. It's mainly due to underpaid staff. You also see health care workers out smoking and never washing their hands when they come in. All are guilty of being dirty people. I don't want to know what their homes look like!

[puzzler125]

Go into a hospital coffee shop, cafeteria, or nearby restaurant you'll see hospital staff wearing their lab coats outside of the hospital. I never wore mine outside of work and no one else should either. The purpose of a lab coat is to protect your clothing and skin from splashes and contamination!

[erasmus6]

roxanne371

Here in Canada if we have a problem we write our government officials, but here they listen to us. From what I have picked up on the articles on this website is that pretty well everything in your country is corrupt. (no offense)

What I would be doing is writing your congressman,senator and whoever else you can think of. Get everyone you know to write and KEEP WRITING. Don't just stop at one letter. People need to start being heard. They need to start DEMANDING what they want.

As far as the hospitals go though, if they are privately owned and out of the hands of the "People" then I don't know what can be done. Surely though if enough people protest the government should be able to step in and do something about the cleanliness but the government is also part of your problems.

If it was me I would be demanding universal healthcare, regulated prices on your medications etc.

For a country that boasts at being the most powerful and greatest country in the world it is sadly lacking in a good many things that the rest of the world takes for granted.

I can honestly say that from reading all the articles and comments on this website about your country, it has made me see how very lucky I am to have great health care, great hospitals and a great government, even though I am not for the party that is in there now. Here in Canada there isn't so much HATRED and obsession for the governments.

[roxanne371]

Who do we go to as a voter? Shouldn't we all be emailing our senators and congressmen to make sure that these facilities develop guidelines so that they actually "do no harm" as per their medical oath? It would be terrific is someone would post links for us to go into and make it clear that we expect this.

[roach9703]

Gee, we are in the nineteenth century of medical barberism. I know of several people whose lives have been altered by hospital infections.
Where is the Food and Drug Administration?
Just goes to show that with insurance and doctors you better not get sick.
Or should one go to a doctor?

[michellem99-2009]

I almost lost my sight in my leagally blind eye in the 90s. I was scared. Later I gave him a talking to. Another Dr saved my eye. I am pissed at nastiness of hospitals. All VAMCs are dirty.All hospitals are dirty. I can't see it but know it is there. I don't like it.

[erasmus6]

18c6

"Clean carpets vs. supplies."

CARPETS in a hospital???? I am horrified! It is no wonder there is so much bacteria and infections in your hospitals. Is there carpeting in all hospitals? I mean I have never heard of anything so utterly stupid in my life! The floors in a hospital need to be cleaned EVERYDAY and you can't do that with carpet! Boy am I glad I live in Canada!

[sjc_1]

We pay twice as much as the next country for health care and rank way below the best on quality and outcomes.

$2 trillion per year on health care and we get NO where near the best. I would say that is not a good deal and something needs to be done about that right away!

[l8c6]

People in this country want everything right but they don't want to pay for it. So they pay no more or no less but listen to the right wing rhetoric. They vote neo con right wing republican fascists into office who pocket the tax money instead of put it into infrastructure. The county owned state run hospital I work in is dirty appearing because priorities have to be made. Clean carpet vs. supplies. Republicans have been cutting cutting cutting and cutting funding for years now...I mean years and people have kept voting them in even though they still pay as much or more tax than they ever did. Foolish lemming behavior.

Apparently the beautified private sector corporate hospitals are filthy too when placed on a petri dish...maybe dirtier.

[ioweign]

Are they saying, if the doctors don't get you, the hospital will!

[ioweign]

Are they saying, if the doctors don't get the hospital will!

[cantshutup]

i'm gonna call the hospitals here in town and ask them about their cleanliness procedures...then i'm gonna tell them i'm going to secretly video tape what i see in the hospital and contact the local news...muahahahaha!

[michellem99-2009]

I hate hospitals and know their nasty. You do learn something. I hate using the rest rooms in public as well. People are dirty and they leave it the same as them. I tell you the main reason I don't if I can help it,I can't see whats on the seat.
I asked my friend,he said Canada is cleaner than US of A. I use a liquid soap to wash my hands as it is easier for me.
Clean them up Amerca. I think as patents We must demand it. Rude noway.

[erasmus6]

paulam01

You're right. People should not be using these anti-bacterial soaps, dishsoaps and cleaners on a daily basis in their homes. It is only making things worse.

And when you do use them, you better *** well make sure you use them right and make sure you clean your hands or whatever, thoroughly!

[paulam01-2009]

This is really scary. Because of my job, I had to attend a Health Department food safety class. With everything I've learned, I don't even want to cook in my own kitchen! And now dirty hospitals?
Maybe all of the anti-microbial soaps and anti-bacterial cleaners that we're using have something to do with this. Every time someone doesn't wash their hands properly, or something isn't disinfected thoroughly with these anti-bacterial solutions, some of these bacteria become more resistant to these soaps.
The Health Department is blaming the overprescribing of antibiotics as a major source of the problem...and I'm sure it is....but I personally think that the anti-bacterial & antimicrobial cleaners are also an issue also.

[tucano2]

Hospital filth is the least of it. Post-surgery customers typically leave the surgery venue for another, such as a convalescent home, where the inkling of MRSA they were exposed to is swamped by layer upon layer of more filth and disease. Not the least of it is that so many such venueshire almost 100 percent of their staff off the street for cash under the table whether or not they speak a word of English.

[erasmus6]

Geez, I learn more and more on this website.
I cannot actually believe what I am reading.
THIS IS A HOSPITAL AND THEY AREN'T BEING INSPECTED FOR CLEANLINESS?

Are your Hospitals PRIVATELY owned? Because when a hospital is privately owned you can expect the cleanliness to go downhill.

In all hospitals it is very hard to try and keep control of bacteria and infections, that is why you need to be cleaning constantly. In Canadian hospitals everything is cleaned. They are constantly washing the floors etc. Rooms are cleaned from top to bottom. Of course there are still infections but I bet not as bad as your hospitals. Also every few feet now they have bottles of sanitizing liquid stuck on walls and posts for people to be cleaning their hands. When you come into the hospital you are supposed to use them and also when you leave, so you are not bringing germs in or taking them out.

[michellem99-2009]

Laziness. You ask did hash your hands to them that treat you. They ought do better it is our health.No that is not rude to ask. They can wash their clothes. Too busy no way.

[sjc_1]

Many times it appears that it is a matter of protocol and policy. Like the wrong medications getting to patients. Under the Clinton administration they quoted that something like 90,000 patients die in hospitals do to careless mistakes.

Republicans would like to cap malpractice awards at $250,000, no matter what happens. Then the screw ups would merely be a cost of doing business, just overhead, never mind the patient that was killed or damaged for life.

In a competitive industry, efficiency and quality go hand in hand. In the hospital business, costs are bloated and there really is no competition. That being the case, protocols and policy must be in place to insure patient safety.

Hospitals are very similar in their day to day operations. After all this time and case history, if you had continuous improvement systems in place their quality would be excellent by now. It is not, because there is really no incentive for it. If they cap malpractice awards, there will be even less incentive to make improvements.

[crowepps]

Considering that the cleaning staff are among the lowest paid persons at the hospital, even doubling cleaning hours would have a fairly low effect on the bottom line and would probably be paid for immediately by the resulting drop in payment of huge attorney's fees to defend against lawsuits.