Antimicrobial resistance is an increasingly serious threat to global public health, requiring action across government and society. The consequences of superbugs spreading through hospitals are extremely serious, but help is at hand, says Mike Sullivan, managing director of GOJO Industries-Europe.
It is impossible to overstate the significance of antimicrobial resistance (AMR). The danger that superbugs – micro-organisms which have evolved to overcome the effects of antimicrobial drugs, such as antibiotics – present to the health and well-being of humanity is serious and growing. Without effective antimicrobials, the success of major surgery and other treatments, such as chemotherapy, is highly compromised. Infections that develop resistance to treatment can prolong common illness, lead to complications and in the worst event even death
The World Health Organization (WHO) estimates that globally, 480,000 people develop multi-drug resistant tuberculosis each year, while drug resistance is also starting to complicate the fight against HIV and malaria. The WHO also says that the cost of healthcare for patients with resistant infections is higher than care for patients with non-resistant infections. This is due to a longer duration of illness, more intensive care requirements, additional tests and use of more expensive drugs.
With existing antimicrobial medicines becoming ineffective in the fight against infection, it is of paramount importance that their misuse and overuse is reduced. They should be limited only to those cases where they are absolutely necessary, while funding for research into new antimicrobial drugs must be prioritised. At the same time, it is crucial that existing superbug infections are prevented from spreading.
A hands-on approach
Antimicrobial resistant-microbes are found in people, animals, food and the environment (in water, soil and air). They can spread between people and animals, and from person to person. Poor infection control, inadequate sanitary conditions and inappropriate food-handling encourage the spread of antimicrobial resistance, according to the WHO.
The WHO says better hygiene and infection prevention measures are essential to limit the development and spread of antimicrobial-resistant infections and multidrug-resistant bacteria. Effective sanitation, hygiene and infection prevention measures, including good hand hygiene, are simple but highly effective ways of preventing the spread of superbugs, and reducing the incidence of infection in the first place.
In new recommendations,1 the WHO highlights hand hygiene as a core element to infection prevention and control (IPC) programmes fighting the challenge of AMR. It considers hand hygiene as a cornerstone of clinical practice, and essential for the prevention of healthcare-associated infections and the spread of superbugs.
The recommendations are clear:
At your fingertips
Given the importance of hand hygiene in the fight against AMR, the correct choice and positioning of hand washing and sanitising solutions around a building should be high on the list of all healthcare and hospital facilities managers, along with appropriate signage and awareness-raising campaigns.
The right systems play a critical role in the promotion of healthy hand hygiene behaviour. To be truly successful, they need to combine good aesthetics, accessibility and ease of use, whilst being equipped with pleasant and effective hygienically advanced formulations. Innovative technology also helps, and that’s why touch-free dispensers are proving popular. Intuitively sensing the presence of hands, they dispense just the right amount of product every time, and the fact that they are touch-free also increases their hygiene rating
Factory-sealed refills for soaps and sanitisers can also help in the fight against infection. The product inside is protected from contamination as it is sealed at the point of manufacture. This means that the soap or sanitiser is never open to the environment and so cross contamination from the air or other sources is prevented.
The efficacy of soap and sanitiser formulations is, of course, another crucial issue. Suppliers should be able to prove the effectiveness of their soaps or sanitisers against germs through independent scientific testing. Formulations that have been tested and passed in accordance with key hospital norms EN 1500, EN 14476 and EN 12791, provide assurance that they are safe for use in healthcare locations.
Hospital-grade product efficacy is only part of the solution in helping improve patient outcomes. The high frequency with which many healthcare workers have to use hygienic hand rub means that it is imperative that formulations are accessible throughout a facility, as well as gentle on the skin. Having a wide range of hand washing and sanitising options located throughout a healthcare facility can help boost hand hygiene behaviours in healthcare staff, who already make this part of their daily lives, and – more crucially – in visitors and patients.
Unfortunately, while more than 80% of illnesses can be transmitted via the hands,2 research shows that 25% of people don’t wash their hands after using the washroom,3 while a further 46% don’t wash for long enough for it to be effective.4
These startling facts highlight a need for education and awareness on why and when visitors and patients should be cleaning their hands.
Notices and posters at key germ hotspots, such as the washroom and waiting areas, are a good start when it comes to improving hand hygiene behaviours. Eye-catching signage, posters and other visual displays can be very effective, and good hand hygiene companies can offer sound advice on the most effective approaches, and provide materials, based on their knowledge and market insight.
The implications of superbug outbreaks in healthcare settings are wide-ranging – from danger to patients in already vulnerable positions, to the disruption to normal services, such as the enforced closure of hospital wards.
The WHO has called for coordinated action in the fight against AMR. It is a complex problem affecting the whole of society, driven by many interconnected factors. As such, single, isolated interventions have limited impact and a joined-up effort is needed to minimise the emergence and spread of AMR. Hand hygiene compliance is a cornerstone of this effort, helping to break the chain of infection and minimise the damaging impact of superbug outbreaks.
Combining the most advanced formulations and state-of-the-art dispensing systems with education, awareness and support is the best approach to help healthcare facilities in the fight to reduce the spread of AMR.
2 http://www.cdc.gov/workplacehealthpromotion/ implementation/topics/immunization.html
3 “Clean Living.” News Center, Press Releases. American Society for Microbiology and The Soap and Detergent Association, Sept. 2007.
4 2008 SDA Clean Hands Report Card® sponsored by the Soap and Detergent Association.
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