Hygiene. What's That?

The public inquiry into Scotland's worst outbreak of clostridium difficile has been of interest to me.  A total of 55 patients developed C.diff and 18 died after admission to the Vale of Leven Hospital in West Dunbartonshire.  C.diff was blamed for nine deaths and was a contributory factor in nine more.

On Wednesday the Herald reported the evidence of two daughters of an 84-year- old woman who was put in a room with patients who had already had the deadly infection.  Their mother survived, but they noted that on three separate occasions hand-gel dispensers in the ward were empty.  It was three days before they were replenished. Mrs Jones' daughters also told the inquiry that they weren't informed that other patients in the room had C.diff and they only found out through conversation with other relatives.

Although I appreciate that Mrs Jones should not have been put in a ward with C.diff patients, it would certainly not have been appropriate for staff to discuss other patients with her family.

Mrs Malcolm told the inquiry there was no literature about C Diff at the hospital and that visitors were not told to wash their hands or given any advice on how to prevent spreading the infection. (my emphasis)

Yesterday the inquiry heard from relatives of Walter Scullion, 69, who was admitted with a urinary tract infection.  By the time he was discharged he had contracted herpes from an oxygen mask, tested positive for C.diff and lost 22lbs in weight.  Mr Scullion said his family were not told by hospital staff he had C.diff and they only found out after he told them himself.  Mr Scullion reported other serious breaches of hygiene in the hospital for which there is no excuse.

Walter Scullion’s relatives were also allowed to visit him in his single room without being told to wear any protective clothing or being given any advice on hand hygiene or on how to safely wash his soiled clothing, which they took away in supermarket carrier bags. (my emphasis)

Both families complained to the inquiry about not being told to wash their hands.  I shook my head in despair when I read this. Have we become such a nanny state that hospital visitors need to be told to wash their hands to prevent infection?  It seems so.

Of course this attitude has been encouraged by the laxity of hospitals allowing visitors at any time of day and having no firm rules about their behaviour.  Visitors should not be allowed into wards unless they do wash their hands and if that rule was firmly applied throughout Scotland's hospitals, the general public would quickly realise that thorough hand washing is the best way to prevent infection.  It does sadden me that so many people rely upon modern gels which are only basic chemical disinfectants.

Mr Scullion has since returned to the Vale of Leven as a visitor and commended the upgrading.  It's all very well having new beds and painted walls, but if patients, staff and visitors don't treat the basic hygiene rule of hand washing, such expenditure is a waste of money.

Hospitals need to provide hand washing facilities at either the entrance to the building or the entrances to wards.  That is where money should be spent long before they think about decor.

Until I see this happening I will continue with my own hygiene system.

I've lost any hope of the public understanding the importance of hand washing. Is it laziness or complacency or a mixture of both?  The answer lies with our hospitals. In European hospitals visitors adhere to a very strict code of behaviour which includes hand washing on arrival and departure. We spend millions on hospital infection control yet permit the public to use hospitals like general meeting rooms.

It's long past time we stopped the casual approach.

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