Rising ICU infections: Blame it on everyone

Jaipur: Intensive care units (ICUs) in hospitals have guidelines and regulations to prevent infections from spreading among patients. At the Sawai Man Singh (SMS) Hospital, however, one can see attendants of patients and the hospital staff flouting ICU guidelines and, thereby, turning carriers of hospital-acquired infections (HAIs).
According to studies conducted by health experts at the SMS Hospital, 10% to 18% patients admitted to the ICU get HAIs.If a patient is admitted to the hospital with some health-related problems, there are considerable chances of him acquiring infections from the hospital. Some of the major micro-organisms found in ICUs are Staphylococci, Streptococci, E.coli, Klebsiella and Psuedomonas.
While one can find posters on hospital walls that demand attendants and others to wear caps, masks and shoe covers before entering ICUs, the rules are violated by the hospital staff themselves. Doctors can be seen entering the ICU without wearing a cap. By flouting these rules, they risk the spread of infection. The nursing staff too does not wear caps to cover their hair.
The attendants of patients to have easy access to the ICU and can be seen entering the ICU on barefoot. They do this after roaming around hospital corridors without covering their feet.
An attendant enters the ICU with 18 beds every single minute. Outside the ICU, there is a waiting room for attendants which remains completely occupied as patients come here not only from all over Rajasthan but also from neighbouring states.
To top it, the hospital does not have a fixed fumigation schedule to kill bacteria and micro-organism in ICUs. “We do not conduct fumigation in ICUs these days. The main reason is because we have other methods to keep ICUs free micro-organisms. Also, conducting fumigation is difficult as the ICUs are always occupied with patients all the time. For fumigation, we have to vacate the ICU completely, which is a difficult task. Moreover, fumigation does not have long-term benefits. As soon as the ICU is occupied, the situation returns to the situation prior to the fumigation,” said Dr Sushil Bhati, in-charge of medical ICU, SMS Hospital.
He said that they follow all processes to reduce chances of spread of infections in the ICU.
“Hand hygiene is more important in ICUs. For that, we have sanitizers for each bed,” Dr Bhati said.
Besides that, the hospital is using a certain kind of acid to clean the beds once a patient is shifted out of the hospital.
The doctors too are worried over the spread of HAIs. “Treating a patient becomes a challenge, if it is multidrug resistant HAI,” said Dr Raman Sharma, senior professor (general medicine), SMS Hospital.
Hospital officials said that HAIs were not a problem exclusive to the hospital but a worldwide one.
Box 1: Hidden dangers
*Major micro-organisms found in ICU are Staphylococci, Streptococci, E.coli, Klebseilla and Psuedomonas
*Healthcare providers, particularly in medical-surgical and critical-care settings, need education regarding organism specific guidelines. Aggressive hand hygiene, use of gloves and gowns, patient isolation and dedicated patient equipment are some of the recommended strategies
*ICUs have patients who are generally under heavy antibiotics, have invasive lines and catheters and are 'hotbeds' of drug-resistant organisms
Box 2: Swine flu patients susceptible to septicemia
A study conducted by SMS Hospital doctors on swine flu patients showed that a total of 76 deaths occurred due to confirmed H1N1 influenza in 2015. Among them, 21.12% got septicemia during treatment
Box 3: Post-surgery infection rate is high
A study conducted on 100 post-operative cases in 2014 by doctors of the general surgery department at SMS Hospital found that the infection rate was 21% among post-surgery patients. Commando Sohan Singh, who was wounded in an encounter with gangster Anandpal Singh recently, too caught post-surgery infection from SMS Hospital
Vox Pop:
Shakeel Ahmed, advocate: “The SMS Hospital has become a crowded place these days. The hospital administration should come up with more stringent methods to prevent the spread of infections in ICUs, operation theatres and other wards.”
Harish Agarwal, social worker: “The nursing staff and other healthcare providers should ensure that ICUs are safe from infections. One of my relatives admitted to the hospital was asked to lie on the floor as there were no beds available. It is not just the ICUs but the entire hospital that needs to upgrade its facilities to prevent the spread of infections.”
Ramu Ramdev, artist: “My daughter’s father-in-law was admitted to the SMS Hospital. He stayed there for a day. Though, he did not contract any hospital-acquired infection, I feel there is a need to be more strict about cleanliness in this hospital.”
Mudassar Ali, businessman: “My uncle was in SMS Hospital ICU for more than 20 days. On many occasions we felt that cleanliness was a major problem. We informed the administration several times about it as it was a major reason for infections.”