Within hospitals, these resistant, hardy organisms are ubiquitous. A review article last year found that 10 percent of hard and soft surfaces in hospital rooms may be contaminated with gram-negative bacteria and that 15 percent of them may be contaminated with C. diff. A study at the University of Iowa Carver College of Medicine, published online in April, demonstrated the potential infection risk posed by the privacy curtains around hospital beds. In an initial survey, 95 percent of curtains in 30 rooms harbored VRE or MRSA. When the curtains were replaced, 92 percent became recontaminated within a week.
Operation Clean Team
Recently hospital cleanliness has become a matter of reputation, especially since the federal government's Hospital Compare Web site started posting institutions' rates of health care–associated infections. Cleanliness is also becoming a bottom-line issue: in 2008 the federal Centers for Medicare and Medicaid Services ceased reimbursing hospitals for the treatment of any infections that those hospitals caused—a controversial carrot-and-stick venture that, according to new research, has successfully begun to lower infection rates.
Institutions also employ infection-control specialists, who track infections and investigate their causes. Yet when the problem is bacteria on surfaces, eliminating them depends on the building-services crews. “This is the level in the hospital hierarchy where you have the least investment, the least status and the least respect,” says Jan Patterson, president of the Society for Healthcare Epidemiology of America. Traditionally, medical centers regard janitors as disposable workers—hard to train because their first language may not be English and not worth training because they may not stay long in their jobs.
At N.Y.U. Langone in 2010, Phillips and his co-workers launched a pilot project that redefined those formerly disposable workers as critical partners in patient protection. Janitors, they realized, know better than anyone else which rails are touched most frequently and which handles are hardest to clean. The Langone “clean team” paired janitors with infection-control specialists and nurses in five acute care units to ensure that all high-touch surfaces were thoroughly sanitized. In its first six months the project scored so high on key measures—reducing the occurrence of C. diff infections and the consumption of last-resort antibiotics—that the hospital's administration agreed to make the experiment routine procedure throughout the facility. It now employs enough clean teams to assign them to every acute care bed in the hospital.
Shielded Surfaces
Even the most aggressive disinfecting regimen might miss something, though. Thus, some researchers are tackling a once unheard of goal: rooms that clean themselves. Most of their early work focuses on engineered coatings and textiles that rebuff infectious organisms or kill them.
A company called Sharklet Technologies imprints the surface of catheters with a pattern that mimics the scaly texture of sharkskin, an innovation inspired by the realization that sharks, unlike whales, do not develop encrustations of algae. In the company's peer-reviewed research, the engineered surface makes it difficult for bacteria to cling and multiply.
Other projects capitalize on the long-recognized antiseptic properties of precious metals, chiefly silver and copper. Metal ions seem to interfere with crucial proteins within bacterial cells. Those results are similar to the effect of some antibiotics, but the metals, unlike drugs, do not provoke resistance.
Research by the company EOS Surfaces shows that bacteria in patients' rooms cannot survive on wall panels sheathed in copper, and a study funded by the Department of Defense at three hospitals, including Memorial Sloan-Kettering Cancer Center in New York City, demonstrated an association between copper-coated “high touch” surfaces in rooms—the call button, intravenous pole and bed rails, among others—and lower infection rates. PurThread Technologies is developing a proprietary alloy of copper and silver, which it melts into polyester and spins into yarn that is eventually woven into textiles ranging from sheets to scrubs.
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Add CommentOnce long ago, I read an article that during WW II there were hospitals in salt mines. Infection was just about unknown in those hospitals. Perhaps our hospitals could use a salt solution as the last step in cleaning all items that the salt would not destroy and let the items air dry to maintain a salt film. It probably would be an inexpensive experiment.
Reply | Report Abuse | Link to thisDear SA and Ms. McKenna, I really enjoyed your article about the need for innovation and increased safety protocols regarding hospital cleanliness. As an industry insider, I can tell you firsthand that you are correct in your assertion that most hospitals are woefully neglectful in this area.
Reply | Report Abuse | Link to thisI did just want to point out that in your opening paragraph, you made a slight error. Gamma knife is not a generic term, but a copyrighted product name, which is manufactured by Elekta and should be noted accordingly. Also, radiosurgery equipment such as the Gamma Knife are not run by radiologists, but radiation oncologists. Actually, they are run by medical physicists and radiotherapy technicians, but this work is supervised by the radiation oncologist. Otherwise, great article.
So they're calling them "janitors" again, not "custodians" or "maintenance engineers" or some such. But, then, they're calling it "Burma", now, not "Myanmar". A right wing expression of what's what, to remind "the little guy" of his place. "You're job is what we call it, even your nation is what we call it!" You're "at the bottom", even Scientific American says it!
Reply | Report Abuse | Link to thisWith respect to the article, note contra "science" initiated intuitive interpretation of the situation.
For years, "science" has been warning about pathogens mutating to resistant forms because of a claimed overuse of antibiotics and other such treatments. The article describes these organisms as being so prevalent, they can now be found on surfaces in hospitals. "Science's" solution, carry on the same kind of super hygienic assault that "science" claimsproducxed the resistant bugs in the first place! What proof do they have that it wasn't an already overdone sanitary system that created the germs that can live on apparently eminently sanitary surfaces?
Or are they looking foward to the day the New World Order launches a pandemic to control mankind, and they want to have a scapegoat ready, those "at the bottom", the "janitors"?
I think this is a very important part of medical care, and can be considered a response to the "do no harm" part of the Hippocratic Oath.
Reply | Report Abuse | Link to thisThe blame game approach i.e. the medical staff aren't washing their hands often enough. and the cleaning staff aren't doing their job needs to be replaced with a more professional attitude. All actors in the medical system need to accept the fact that they may need to change their procedures because everyone has responsibility to bring about good outcomes for the patients. A hospital is a team
At least one company is already putting metals into their fibers to inhibit growth and spread of bacteria. Norwex has micro silver in its Enviro Cloth, not just sprayed on as most companies do, so they can be machine washed and dried. They are used extensively in Norway and Canada. Take a look at my webpage if you'd like more information:
Reply | Report Abuse | Link to thishttp://pamelaschmeckpeper.norwex.biz/?p=n§id=4
"Doah" !
Reply | Report Abuse | Link to thisIf not washed frequently enough, anything can carry germs . Luckily, cubicle curtains are easy to take care of and just simply need to be thrown in the wash. Our recommendation is to machine wash in water not to exceed 160° F. using Synthetic setting and mild detergent. Be sure to not use bleach or fabric softener. We have some other helpful tips here: http://www.covoc.com/cubicle-curtain-care
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