Why Aren't Hospitals Cleaner?

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

(U.S. News & World Report) 
Even the cash-strapped British National Health Service recognizes that intensive cleaning is a bargain compared with the cost of treating infections. By nearly doubling cleaning-staff hours on one ward, a hospital in Dorchester reduced the spread of MRSA by 90 percent, saving 312 times the added cleaning costs.

Hospitals once tested surfaces for bacteria, but in 1970, the CDC and the American Hospital Association advised them to stop, saying testing was unnecessary and not cost effective. MRSA infections since then have increased 32-fold, and numerous studies have linked unclean hospital equipment and rooms to infections. Yet the CDC's latest guidelines still deem routine testing for bacteria unnecessary. "If you culture on a regular basis, you're always going to find something," says Denise Cardo, who runs the CDC's division of healthcare quality promotion. "You don't want the labs to be used for that instead of tests on patients."

Are we to believe that it is less important to test for bacteria in operating rooms than in hot dog factories?

Testing is essential because bacteria are invisible. A study in the Journal of Hospital Infection showed that 76 percent of various hospital sites checked by researchers had unacceptably high levels of bacteria, although only 18 percent of them looked dirty. In another study, Boston University researchers found that cleaning improved significantly once they sampled surfaces for bacteria and showed cleaning personnel the areas they had missed.

Unreasonable standard? You'd think that a hospital accredited by the Joint Commission would be clean, but it's no guarantee. California hospital inspectors, investigating complaints from the public, found that 25 percent of hospitals where conditions were unsanitary had been inspected and accredited by the Joint Commission within the previous year.

If Joint Commission inspectors walk into a noticeably messy and unclean patient room, they will trace back to find out how that happened, explains Robert Wise, vice president for standards and survey methods. Otherwise, Joint Commission standards don't specify how rooms should be cleaned or what bacterial levels are unacceptable. Asked whether bacterial levels should be measured, Wise answers: "You can only ask hospitals to do so much."

That seems to be the CDC's attitude as well. For over 30 years, the CDC has been collecting monthly data recording a sharp rise in drug-resistant hospital infections. A new report from a nursing organization, the Association for Professionals in Infection Control and Epidemiology, shows that the CDC has consistently underreported MRSA in hospitals, giving them an excuse to do too little.

In 2005, health officials in Ireland and Scotland began rating hospitals annually for cleanliness — red (the dirtiest), amber, or green — and publishing the ratings. The first-year results made headlines, putting pressure on the worst Irish hospitals to clean up and earn higher marks in 2006.

In England last month, Gregory Barker, a member of Parliament, rolled up his sleeves and worked a shift with the cleaning staff at a hospital in his district. "Hospital cleaning is a vital part of patient care," he said in a statement released by his office. Where are his counterparts in Washington, D.C.? Congress has been virtually silent about hospital infections — and no member has displayed any interest in picking up a mop.

[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.