There can be no excuse for unhygienic practices that cause the deaths of patients. It is nearly 10 years since former minister for health Mary Harney described hospitals as “dangerous places”. Special guidelines on best hygienic practices were introduced. Since then, a series of critical reports by the Health Information and Quality Authority have charted the failure of hospital managements and their medical staff to protect patients against life-threatening infections by way of basic hand-washing. The most recent case involved Beaumont hospital in Dublin.
Staff at the hospital availed of hand hygiene opportunities in fewer than 50 per cent of cases. Most doctors were not compliant with best hand hygiene practice and the report noted they “neither changed their protective aprons nor undertook hand hygiene when moving from patient to patient. There was complete non-adherence with standard precautions…”. Those findings are an appalling indictment not just of the medical personnel involved but of management at the hospital.
Hospital-based infections, particularly clostridium difficile, represent a serious threat to the lives of patients and are extremely difficult and expensive to treat. That is why hygiene practices have to improve. Management must ensure that all visitors use gel dispensers before they are admitted. If that involves stationing a porter at the hospital entrance, so be it.
Medical and administrative staff have particular responsibilities. Hand hygiene is such a basic, stand-alone issue for those directly involved that it cannot be conflated with over-crowding or hospital resources. If additional gel dispensers are needed, their correct and frequent use in preventing life-threatening infection would quickly cover the cost involved.
Consistent failure by a very large number of doctors and nurses to follow healthcare guidelines suggests the need for special measures to promote compliance. Leadership can only come from the top of the profession. Responsibility for compliance should also rest there.