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Healthcare associated infections


Q. What is the extent of the problem?

A. According to the 2006 prevalence survey, 8% of hospital patients in England and 6% in Wales have a healthcare associated infection (HCAI). They cause unnecessary suffering and anxiety, and may cause disability or death. Although not all of these infections are preventable, many are.


Patients can acquire bloodstream infections, surgical site infections, urinary tract infections or chest infections. Once patients acquire an infection, there is a possibility of the microorganisms which cause the infection being passed on to other patients and this is heightened by the frequency and extent of contact which staff have with patients.


Even patients who are not known to have an infection may be carrying transmissible microorganisms that can be carried on the hands of staff from one patient to another.



Q. What sort of microorganisms does hand cleaning stop from spreading?

The type of microorganisms which can be spread by the hands of staff are:

  • Staphylococcus aureus (including MRSA)

  • Streptococcus pyogenes (Group A Strep)

  • VRE

  • Klebsiella

  • Enterobacter

  • Pseudomonas

  • Clostridium difficile

Wounds will contain large numbers of microorganisms. Areas around the perineum can be heavily loaded with microorganisms, but even the armpit, trunk and hands can be frequently covered in huge numbers. Numbers of microorganisms such as Staphylococcus aureus and Klebsiella can be present on intact skin in huge numbers ranging from 100 to 1,000,000 per square cm.


It is easy to understand that the hands of staff can become contaminated even after seemingly ‘clean’ procedures such as taking a pulse, taking blood pressure readings, taking a temperature, or touching a patient’s hand.



Q. How exactly do healthcare staff play a part in the spread of microorganisms?

A. In an average day healthcare staff undertake a range of tasks. Some essential yet simple tasks like helping patients become comfortable in bed can result in thousands of microorganisms being transferred onto the hands of staff. Taking a pulse or blood pressure results in transfer of equally large numbers of microorganisms. In these instances, when none of the indicators for soap and water handwashing occur a quick application of alcohol handrub will quickly destroy almost all of these potentially harmful microorganisms in 15-30 seconds. Failure to clean hands at this point would mean that whichever patient the member of staff touches next could potentially become contaminated with these microorganisms.


Sometimes the microorganisms from patients will be transferred by staff onto the furniture or equipment in the immediate vicinity. This should not be a problem if there is good environmental cleaning. However, the microorganisms can contaminate the hands of staff and then be spread to other patients if staff don’t clean their hands at the correct moments.