Hospital attire is part of basic hygiene routines

Md. Shahidul Islam

shaisl@me.com

2

3

University Hospital,Uppsala, Sweden

Number of visits to doctors in the out patient department: 328 051Number of visits to non-doctors in the out patient department: 300 139Number of beds: about 1000Number of admissions : 55 202Number treated in the day care centers: 43 139 Number of operations: 30 293Number of employee: 7 998 (6 198 women, 1 790 men)

What are these about?

Primum non nocere

Above all, do no harm!

“Doctors spread more diseases than mosquitoes do”

“Doctors carry resistant bacteria from patient to patient, and from hospitals to the homes and the communities, and from clinics to clinics”

Mayon-White RT et al. An international survey of the prevalence of hospital-acquired infection. J Hosp Infect, 1988, 11 (Supplement A):43–48

Prevalence of hospital acquired infection 8.7%

Eastern Mediterranean regions 11.8%

South East Asian regions 10%

1.4 million people world-wide suffer from hospital acquired infections

Hospital acquired infections

(Data from 55 hospitals of 14 countries in 4 WHO regions)

Methicillin-resistant Staphylococcus aureus(MRSA)

Lidwell OM, et al. Transfer of microorganisms between nurses and patients in a clean air environment. J Appl Bacteriol 1974;37:649–656.

Hambraeus A. Transfer of Staphyloccus aureus via nurses’ uniforms. J Hyg(Camb) 1973;71:799–813.

Spread of infection through contaminated hands is mostcommon, and next common is spread throughcontaminated clothes

We spirit hands up to the elbowsBEFORE and after we touchany patient

We do not put on rings, bangles,bracelets or wrist-watches

Our nails are short and unstained

Speers R et al . Contamination of nurses’ uniforms with Staphylococcus aureus. Lancet 1969;ii:233–235

Clothes of hospital staffs can transmit an infectious dose from patient to patient that is 50 times more than the air-borne transmission.

We do not carry home the clothesthat we use in the hospital

We do not use private clothesin the hospitals

The first thing we do on arrival at the hospitalis that we change to our hospital attires

Long-sleeved white coat is a risk for spread of infection

Wong D, et al. Microbial flora on doctors’ white coats. BMJ. 1991;303:1602–4.

Loh W, Ng VV, Holton J. Bacterial flora on the white coats of medical students. J Hosp Infect. 2000;45:65–8.

Short-sleeved attire makes correct hand-disinfection possible

White color enables easy detection of dirt and contaminations

Doctors, nurses, nurse-aids, medical students, nursing-students, pharmacists,all have same attire

Hospital attires are washed at 60 degree C

S. aureus can survive at least one week one week on clothes.MRSA can survive up to six weeks.

Hospital attires are contaminated after six hours use (in intensive care)

Nystrom B. The contamination of gowns in an intensive care unit. J Hosp Infect 1981;2:167–170.

We change hospital attire every day

We use disposable plasticaprons almost routinely

Our Infection Control Unit

• Monitors infection situation

• Monitors outbreaks and inform about actions

• Developing and follow up of hygiene routines

• Registration of hospital acquired infections

• Check if the rums and instruments conform with hygiene routines

• Teaching the prevention of hospital acquired infections

Our nurses monitor the adherence to the hygiene rutines

Contract

I agree that I shall follow the basic hygiene routines and in this respect, if I am remindedAbout the routines repeatedly, I will not feel unhappy.

Signed Date

Right or wrong?

WRONGBraceletWrist watchRingNo plastic apron--------------Hair?Gloves?

Right or wrong?

WRONGThe doctorLong-sleeved white coat

Private clothes under the white coat

Ring-------------------------------------------------

NurseWRONGNo plastic apron

A psychologist and her patient.Right or wrong?

http://www.ihi.org/

Prof. Mohammad Omar Faruq has received SGM Chowdhury Memorial Gold Medal

Dr. A.S.M Areef Ahsan, Associate Profesor & Head of ICU, BIRDEM has complited his MD in Critical Care Medicine first time in Bangladesh.