Research published earlier this year in the American Journal of Medical Quality indicates that infections acquired by patients in hospitals are most often caused by poor hygiene practices in the healthcare facility, not from how ill patients were when they entered the hospital. The new findings bolster the argument that hospitals can help prevent the growing number of healthcare-acquired infections (HAIs) that occur each year in their facilities, estimated to affect some 2 million patients and causing 90,000 deaths annually, according to the Centers for Disease Control and Prevention (CDC).
By adopting best practices that govern hygiene and installing touchfree washroom technology that helps limit cross-contamination, healthcare facilities can reduce the incidence of dangerous infections. According to the CDC, these infections can add approximately $4.5 billion per year in excess U.S. healthcare costs due to expenses incurred by increased patient days in the hospital and more extensive procedures to eliminate the infection.
In fact, one hospital study1 that analyzed data on patients who acquired bloodstream infections found that insurers paid the hospital an average of $64,894 for each infected patient. The average expense of caring for the patients was $91,733, resulting in an average loss of $26,839 per patient. Another report published in USA Today (11/14/2006) compared the average cost to private insurers for patients with infections ($59,915) vs. those without infections ($8,311).
The Origins of Infections
HAIs in hospital patients can be traced to myriad sources, but the CDC has identified ordinary staphylococcus infections as one the most common infection-causing pathogens found in the healthcare setting. Public health officials are particularly concerned about the spread of methicillin-resistant Staphylococcus aureus (MRSA), a drug-resistant strain of bacteria that is particularly troublesome for patients with already weakened immune systems.
Infections stemming from MRSA are more difficult to treat, since many are incurable using commonly applied antibiotics, according to the Committee to Reduce Infection Deaths (RID). The organization also reports that more than 60 percent of Staphylococcus aureus infections are MRSA, a number that has grown from just 2 percent in more than 30 years.
Another common hospital germ leading to infections is Clostridium difficile, a bacterium found in feces, which is often transmitted by unclean hands that have come into contact with a contaminated surface or object.
In a hospital setting, contaminated environmental surfaces are often the vectors for these drug-resistant bacteria, especially those in the washroom. Surfaces such as toilets, sinks, faucets and flushing handles, door handles, stall doors and paper towel dispensers all can pick up bacterium from unwashed hands, passing it along to the next user. And unfortunately, scores of Americans leave public restrooms without washing their hands, according to a 2005 survey by the American Society for Microbiology, which found that although 91 percent of Americans say they wash their hands every time they use a public bathroom, only 83 percent were observed doing so.
That troubling statistic applies to the general public, of course, but studies have shown that even healthcare workers arent always able to wash their hands as often or as effectively as necessary to prevent cross-contamination. In fact, the Institute for Healthcare Improvement (IHI) has indicated that compliance by healthcare workers with recommended hand-hygiene procedures has remained unacceptable, with compliance rates generally below 50 percent of hand-hygiene opportunities.
According to the CDC, if proper hand-hygiene practices were followed as outlined in hospital guidelines, 30 percent to 40 percent of infections (and their related illnesses, deaths and costs) could be avoided. The CDC has recommended that in addition to traditional hand washing with soap and water, alcohol-based hand rubs, otherwise known as instant sanitizers, can be used by healthcare personnel to aid in proper hand hygiene. But hospital staff cant be expected to guard washrooms against those who use the toilet, neglect to wash their hands and then go on to touch other public surfaces, such as restroom door handles, before heading back to the hospital operating rooms or other patient areas. For this reason, even the most careful hand-washers are still at risk for contamination simply by touching a door handle used by someone who didnt wash.
For many hospitals, creating a touchless environment has boosted the level of staff comfort concerning the washroom, in many cases allowing them to use the facilities without touching even one surface from the time they enter the washroom to the time they exit. These include:
- Auto-on and auto-off faucets
- Automatic, self-flushing toilets and urinals
- Auto-on and auto-off soap dispensers
- Automatic paper towel dispensers
- Toilet seat covers activated by the touch of a button. Using touch-free restroom products and systems reduces the need to clean surfaces. These give janitorial staff more time to clean sinks, toilet bowls and floors.
Other solutions for washroom hygiene in the healthcare environment include:
- Dispensers that completely enclose paper towels and toilet paper, providing a barrier from germs. Dispensers with no levers, knobs or dials means users will never have to touch anything other than the paper product theyre using.
- Dispensers that provide usage control, such as dual-roll toilet tissue dispensers, ensuring the entire product is used in one roll before switching over to the next. This means dispensers are always adequately stocked, eliminating the need for users to search other stalls for paper.
- Doorless designs or handleless doors that swing out. Where a door handle must be used to exit the restrooms, provide door tissue dispensers and trash receptacles adjacent to the exit. This allows the person exiting to use a piece of tissue to grip the handle, and then place the tissue in the nearby bin.
Converting to a touch-free washroom environment and even installing door-tissue dispensers may require an initial investment, but given the hidden costs (both in human lives and in dollars) of an unsanitary restroom, its well worth the investment and innovation to convert.
Jacquel Kelly is the marketing manager for the healthcare segment at Georgia-Pacific.
1. Allegheny General Hospital in Pittsburgh. Washington Post, Nov. 2006.