During this epidemic period, some known troublesome situations about the general condition of hospitals have developed. As you know, the epidemic has restricted many branches in a categorical manner and made it difficult to work. The most important of these is the increase in the patient population density seen in surgical clinics. In this process, the general intensive care units, which are deemed necessary after surgical interventions, serve patients struggling with the epidemic rather than providing services to the relevant surgical branches. For this reason, this situation has affected all branches as a chain. In addition to the patients who will be operated only, the surgical personnel’s service to combat the epidemic also creates different problems. The confusion created by the patients who cannot receive service and their relatives is the most irresponsible.
The main element of taking this process under control is that the hospitals are well disinfected and the spread of the epidemic is prevented. For this, correct and harmless disinfection processes must be done. This passes through new generation disinfection products and techniques. The more accurately the use of disinfection in hospitals and the regular controls, the faster the epidemic is brought under control.
The most risky group of the process is the Infection Specialists, who are intensely fighting the infection, and the Intensive care staff working with it. It is the most sacred duty of these two groups to fight by serving the people with one-to-one contact under the most difficult conditions.
Considering the risky branches in hospitals, not every hospital has the status of a pandemic hospital. However, they are at the forefront of emergency response needs in the process. From the emergency entrance to the intensive care, the patient must be under the control of the infectious diseases specialist at the stage of referral. Sufficient capacity intensive care beds are also an important factor at this point.
Infection Risks in Hospitals
At this stage, intensive work is taking place in the treatment branches. In recent years, as if hospitals had no problems, the fight against the Covid-19 epidemic has also entered a risky period. This situation can be seen as a very good improvement in terms of patient circulation of a hospital. It can be seen as good in terms of financial returns in the early days. However, we do not want to and will not stop recommending that you pay more attention to infection control, which you encounter over time and will increase its incidence rates.
In addition to these developments, there are some problems that attract our attention, like many hospital staff doctors. These problems are situations that may affect your patient care and treatment times, drug use times, and hospital stays. As your patients continue to stay in the hospital, your patient circulation rate will slow down. This will give your institution the appearance of both financial loss and failure.
Infectious Diseases Specialist
Some of the hospitals do not have an Infectious Disease Specialist. Naturally, the Infection Committee cannot continue its activities under the supervision of an expert. For this, committees affiliated to the provincial health directorate serve.
Use of Antibiotics
Therefore, the use of antibiotics in many hospitals is exhaustive and common. It should be remembered that bacteria (microbes) like wet (moist), warm (hot) and nutritious (protein or sugar) environment. In addition, they are divided into two every 24 hours and multiply very easily in places where there is no hygiene. The unhygienic place should also be seen as a garbage dump, and we cannot clean and get rid of the garbage dump with antibiotics or antiseptics. It makes Hygiene Teams under the control of these and infectious diseases specialist.
Hospital Quarantine System
Most hospitals do not have a quarantine system. It is necessary to detail the quarantine system a little.
30-40 years ago, there was not that much variety of antibiotics available to hospitals. For this reason, patients to be admitted to the hospital were observed in the quarantine department and admitted to the hospital before being admitted to the clinics. What would be done in this quarantine department. Patients were given all their clothes with a removable bag to be taken away from the hospital. Then, all jewelery, earrings and rings on the patient are removed. Hair shaving of the patients was done if necessary, the nails were cut and the patients were thoroughly washed from head to toe. After this cleaning process, the patient is taken to the clinic room. 1 person is allowed to stay as an accompaniment. In cases where it was deemed necessary and the patient’s condition was suspicious, patients were kept in the quarantine department for 24 hours, and after the results of the laboratory tests were obtained, the transition to the clinical environment was provided. The quarantine system would allow the patient to be isolated from bacteria that might be brought from outside. This practice should be considered both economically and as a serious measure against infections.
Using large amounts of chemicals in hospitals does not work except that a much larger amount of bacteria causes resistance to chemicals and antibiotics. Instead, new generation disinfectants should be preferred.
The following infection tables are common in our patients hospitalized in hospital intensive care units.
The methods used in tracheal aspirations should be reviewed.
It may be necessary to improve the methods used in Foley catheter follow-up.
It is necessary to review superficial venous routes and the use of deep venous routes. Patients with multi-lumen routes or multiple vascular accesses at the same time should be reviewed. Intravenous nutrition, intravenous hypertonic solutions, use of intravenous blood and blood products, application frequencies, densities, rates, and intravenous antibiotic treatments should be reviewed. Almost all of the causes of sepsis are due to contamination during IV treatment, prolonged deep vein catheters or multiple vascular access. Almost all of the sepsis cases are atrogenic.
Skin infections, pressure sores, thrombophlebitis of superficial veins, skin abrasions, edematous tissue abrasions, plaster allergy and scraping are important. This can be caused by sharp and sharp objects remaining in the mattress, and abrasions from shaving and cleaning. There are dozens of reasons such as cuts, abrasions, and fluid leakage under the skin. Continuous training of care staff on these is required.
Surgical wound infections
Surgical wound infections require a direct review of operating room conditions. Patients’ wounds should be regularly reviewed daily for wound infection.
In addition, the most striking issue in terms of hygiene is the lack of liquid soap in the liquid soap reservoirs in polyclinics and toilets. The clothes of the polyclinics are hanging behind the doors, there are many unnecessary materials, bottles, glasses, covers, etc. in the middle. In hygiene care, there are no paper towels at the beginning of the sinks to dry after hand washing. Tables and items used with computers should be regularly wiped with clean and wet cloths. Antiseptic material is not necessarily required. Water is the best cleaning material. The stains on the seats remain so for months. Cleaning is not just about mopping floors.
Hygiene and disinfectant products used in hospitals and other health institutions are generally obtained from chemicals. After the use of these products, bacteria that can survive in the environment gain resistance. To break the resistance of these bacteria, a stronger disinfectant must be used in the next process. With this application, an even stronger chemical is exposed every time.
In this process, people who are trapped have to use next generation antibiotics constantly.
Alcohol-free disinfection products are now produced with new generation technologies. Pure Anti-B is a good example of these. The product, developed with nano technology, is a disinfectant that is alcohol-free and does not leave any chemical residue.