By Dr. Rachna Pande
Good hygiene or cleanliness is a basic requirement for good health. The importance becomes much more in a hospital setting, where sick people come to restore their health.

Hospitals provide cure for all types of sickness of the people. But, they also become a potential source of spread of infection if people concerned are not vigilant enough. A person may be hospitalized for some other problem say cardiac failure and may become more sick after acquiring some infection in the hospital. Infections occurring in a hospital setting or nosocomial infections as they are called, usually occur by 3 modes.

The infection can spread from one patient to another, from patient to doctor or nurse. A doctor or health care personnel can also infect a patient. The microbes responsible for hospital acquired infections usually cause more severe illness and are resistant to the more conventional antibiotics being used. Germs like pseudomonas, kliebsella, etc. which produce grave illness are mostly implicated in nosocomial infections. Hence it is important for all concerned to be aware of these infections and take utmost precautions to prevent them.

Hospitalized patients are more prone to these infections as compared to those who just consult and go home. Immune compromised people (patients of HIV/ AIDS, uncontrolled diabetes, renal failure, etc.) acquire infections easily and in more severe form. The common diseases acquired and spread in a hospital are urinary tract infections, pneumonia, diarrhoea diseases and even chronic infections like tuberculosis and HIV/AIDS. Apart from this, skin diseases, common cold and cough can also be transmitted and acquired.

For prevention of infection from one patient to another, the beds are separated by a suitable distance. Those suffering from contagious illness like cholera, T.B., etc. are put in isolation. Regarding part of the hospital it is very important to maintain very good hygiene. Every room should have good amount of sunlight as most of the disease producing germs present in the environment are killed by strong sunlight. It should be remembered that a hospital room is always full of infectious agents of various kinds Adequate aeration and cross ventilation helps to minimize the concentration of germs inside the rooms. Daily washing and mopping of the hospital rooms with some antiseptic solution helps to kill the microbes prevalent in the rooms.

One should be vigilant enough to see that cobwebs and dust do not settle over the doors and windows and even on the furniture, because these harbor germs. Hygiene needs to be observed even for the hospital linen and clothes, as these also tend to gather germs. These should be always clean and changed regularly. This linen includes the bed sheets and other bedding used by the patient as well as the uniforms and coats used by doctors and other health personnel. They need to be washed and dried in strong sunlight or ironed by a hot iron. Proper disposal of the fluids of the patient like urine, blood, etc. and laboratory samples should be such that it does not become a source of infection for others. For this purpose, antiseptic solution is poured over the liquids before they are disposed off.

Every hospital designs its own infection control program which includes measures for cleanliness, hygiene and waste disposal. Ministry of health, in Rwanda has effectively taken measures to implement this in all hospitals. As people become more aware of the need for good hygiene in the hospitals, these measures will become more effective. This will definitely reduce incidence of hospital acquired infections and ensure that sick individuals visiting the hospital do not get any infection.

The author is a Specialist internal medicine-Ruhengeri Hospital

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