Hospital Infection Control: Guidelines for Health And Safety

Healthcare | 23/5/2024

Understanding and managing the risk of infection in healthcare settings is a fundamental concern for both public health and hospital epidemiology. The ability to control infections is crucial for hospital infection prevention and improves overall patient outcomes. This article delves into various aspects of infection control, highlighting the essential roles that hospital staff, infection prevention services, and specific precautions play in mitigating these risks.

Colonisation, often a benign but crucial factor in the spread of infectious diseases, requires sophisticated strategies to limit its impact. We explore the science behind colonisation in infection control, examining how effective cleaning methods can prevent the potential spread of pathogens. 

Additionally, we will discuss the broader implications of these practices in public health, aiming to enhance healthcare-associated infection control measures within the hospital setting and beyond.

A hospital corridor

Understanding Infections in Healthcare Settings

Firstly, let’s discuss what a healthcare-associated infection (HAI), otherwise known as a hospital-acquired infection, is. Essentially, HAIs are infections that patients acquire while receiving treatment for other conditions within a healthcare setting. 

As you might infer from its name, they can develop in any health care environment, including hospitals, outpatient clinics, long-term care facilities and all types of clinical services. 

Types of Healthcare-Associated Infections

HAIs encompass a wide range of infections. The most common examples are:

  • MRSA (Methicillin-resistant Staphylococcus aureus) is known for its resistance to many antibiotics, making it a tough pathogen to control in hospital environments. 
  • VRE (Vancomycin-resistant Enterococci) is another challenging bacterium that is resistant to vancomycin, often used to treat serious infections when other antibiotics fail. 
  • C. difficile (Clostridium difficile), primarily linked to prolonged antibiotic use, causes severe diarrhoea and more serious intestinal conditions such as colitis. 
  • Other common HAIs include surgical site infection and, urinary tract infection, which is often associated with catheters, and pneumonia, which can develop in patients using ventilators.

How to Prevent Healthcare-Associated Infections?

Next, let’s look at the most common steps you can take by focusing on prevention, infection control and improved hygene practices. 

This is what you can do to prevent the occurrence of HAIs:

  1. Practice hand hygiene: Wash your hands regularly and thoroughly with soap and hot water or use alcohol-based hand rubs. Endorsed globally by health authorities, including the World Health Organisation (WHO), hand hygiene is the cornerstone of infection prevention.
  2. Utilise Personal Protective Equipment (PPE): Every healthcare worker should use gloves, gowns, masks, and eye protection to shield themselves from infectious agents and prevent patient-to-staff cross-contamination.
  3. Conduct environmental cleaning:Make sure that all facility surfaces are regularly and meticulously cleaned to minimise infection risks.
  4. Follow infection control procedures: Adhere to standard precautions, including safe injection practices and handling potentially contaminated equipment or surfaces properly.
  5. Implement antimicrobial stewardship: Encourage responsible use of antimicrobials to combat antimicrobial resistance and prevent the spread of infections from multidrug-resistant organisms.
  6. Enhance education and training: Train healthcare professionals in the latest infection prevention protocols and best practices to maintain a safe healthcare environment.

Healthcare facilities can greatly lower the frequency of HAIs by implementing these preventive measures, preserving patient health and raising the standard of treatment. This dedication to strict infection control improves community health and strengthens the resistance of the healthcare system to infection.

Red blood cells

Principles of Infection Control

To tackle infections effectively, hospitals need to implement clear and effective strategies. Start by setting up comprehensive surveillance to monitor infection rates and resistance to antibiotics. This data helps to swiftly address outbreaks and assess the effectiveness of current infection control efforts.

Make sure every part of the hospital is consistently and thoroughly cleaned, with a focus on areas that are frequently touched and equipment shared by staff and patients. Also, isolate patients with infections to prevent the spread of pathogens and ensure staff are well-trained in these protocols. Strengthening antibiotic stewardship and ongoing staff education on infection prevention — especially hand hygiene and the proper use of PPE — are crucial for keeping both patients and healthcare workers safe.

Hand Hygiene

 Touch-free hand dispenser

As we mentioned earlier, hand hygiene is an essential practice in the battle against HAIs; it's a frontline defence in stopping the transmission of harmful pathogens. Regular and diligent handwashing and the use of hand sanitisers are proven to significantly lower the incidence of infections.

These are the best practices for health professionals to follow for effective results:

  1. Proper handwashing steps:
  • Wet hands with clean, running water before applying soap.
  • Lather soap thoroughly, covering all hand surfaces.
  • Scrub hands together for at least 20 seconds — the equivalent of humming "Happy Birthday" twice.
  • Rinse hands well under clean, running water.
  • Dry hands using a clean towel or air dry them.

  1. Using hand sanitisers:
  • Apply a product with at least 60% alcohol to the palm of one hand.
  • Rub the product over all surfaces of your hands until they are dry.
  • Use sanitisers when soap and water are not available, especially after touching potentially contaminated surfaces.

Both handwashing and sanitising are essential after activities that raise infection risks, such as before and after patient contact, before handling medication, after touching contaminated surfaces, and when entering or exiting healthcare areas.

Water running from a tap into a hand

What Is Colonisation In Infection Control?

Colonisation is defined as the presence of multiplying micro-organisms on a host but without any evidence of the micro-organisms having invaded the host or caused observable disease or damage. For example, swabs taken from an individual may show the presence of Staphylococcus Aureus on their skin or elsewhere, but the bacteria isn't causing any of the symptoms typically associated with infection (such as pain, swelling or redness at the site where the S.Aureus is present).

Difference Between Infected and Colonised Individuals

An infected individual is not the same as a person who is colonised by a micro-organism. Infected individuals show signs that their body is interacting with the microorganism. For example, if someone is infected by a virus, such as COVID-19, they will show symptoms such as a cough, raised temperature and/or a change in taste or smell. In contrast, someone who is colonised by the COVID-19 virus will test positive for the presence of the virus, but not display any observable symptoms.

Colonisation isn't necessarily a static state — an individual may initially be colonised, then, as the micro-organisms or viral particles replicate, observable infection (interaction between the host and the pathogen) occurs. In other cases, infection is occurring, but the symptoms aren't noticeable or observable.

In terms of infection control, it's important to remember that colonised individuals are still capable of shedding pathogenic micro-organisms in the same way as an infected person can. Whilst an infected person may (but not always) be host to a higher number of micro-organisms, asymptomatic individuals may also carry a high number of pathogenic micro-organisms, which can be spread through contact, shedding, coughing or similar mechanisms. People colonised by micro-organisms act as carriers, without necessarily being infected.

Challenges in Controlling Pathogen Spread from Colonised Individuals

Controlling the spread of pathogens from colonised individuals presents particular challenges for infection control. Unlike infected individuals, colonised people show no symptoms of infection. Without testing, it's impossible to establish whether they are hosting pathogenic micro-organisms or not. The picture is further complicated by people who may be in the early stages of infection - the micro-organisms are interacting with the host, but no clinical symptoms are present. The difficulty for infection control professionals is to find a way to eliminate the opportunity for micro-organisms to pass from person to person when individuals display no outward signs that they are colonised.

In the majority of environments, where it's not possible to identify colonisers quickly, infection is best managed by working on the principle that everyone in the environment could potentially be a colonised individual. Minimising the risk of micro-organisms being passed from person to person requires the implementation of an infection control strategy that combines chemical and mechanical cleaning methods.

Managing Colonisation In Infection Control

The simplest way to manage colonised individuals and their role in shedding micro-organisms is to treat them in the same way as infected individuals in terms of infection control. By working on the basis that everyone has the potential to harbour pathogens, and cleaning accordingly, it's possible to keep cross-contamination risks low.

The Australian government has produced a comprehensive set of infection control guidelines. Rubbermaid has used these guidelines as a basis for the development of our guidelines and checklists for cleaners working in aged care facilities and healthcare settings.

Note that colonisation isn't solely confined to healthcare settings — it can occur in any environment, including the hospitality sector and the childcare sector.

It's also important to remember that cleaners can also be colonisers, which is why wearing PPE whilst premises are being cleaned is a vital part of the process.

A nurse and a doctor talking

Where Does Colonisation Present The Biggest Challenge?

Colonisation risks are usually greatest in environments that large numbers of people access. Although the risks colonisation poses are usually greatest for vulnerable groups (the old, young and ill), the process of colonisation isn't confined to these groups. Any individual has the potential to be a coloniser. 

This means that cleaners working in high-traffic settings (such as healthcare, public sector buildings or multi-occupancy buildings) need to be particularly aware of the potential for colonisation and subsequent shedding. Just because users of a space appear disease-free doesn't mean that dangerous pathogens are absent.

Implementing rigorous infection control cleaning procedures consistently is the best way to not only reduce the risk colonised individuals pose but also minimise the chances of other, non-colonised individuals being exposed to dangerous micro-organisms. In addition to ensuring that appropriate cleaning takes place, prompting positive changes in individual behaviour also makes a noticeable difference in the likelihood of colonisation. 

Simple precautions such as regular hand washing, disposing of waste appropriately and limiting contact between individuals (such as reducing the numbers in waiting areas) can all help to keep colonisation levels low.

Rubbermaid Provides The Equipment Needed To Tackle Colonisation

From everything you need to enable individuals to maintain hand hygiene to top-quality microfibre cloths and mop systems, Rubbermaid has the right products to enable effective infection control.

If you're not sure what you need to ensure the highest standards of infection control, the Rubbermaid team is happy to advise you based on your individual cleaning requirements and priorities.

Contact us with an enquiry or for further information about our products