Hospital Staff Cuts and its impact on hospital cleaning

Source: Pixabay

Healthcare-associated infections (HAIs) are one of the biggest risks in healthcare today and Canada is no exception to this. In fact, Canada has one of the highest occurrences of HAIs out of all developed nations, with 200,000 cases per year and consequently, 8000 deaths (Statistics Canada, 2016). The spread of HAIs can be prevented, as we have seen on this blog, with proper handwashing techniques as well as proper disinfection protocols for equipment and patient rooms. The problem is that hospitals need A LOT of staff in order to properly disinfect, and control and prevent infection. And yet, Canada, as well as other countries, are seeing cuts in hospital staff.

According to a report prepared by Venrock (2018), one of the predictions for trends in healthcare for 2018 was the continuation of cutting and hiring less hospital staff. This is mostly due to hospitals working to balance their budgets. But at what costs does this balancing of budgets come at?

Although not a recent report, CBC’s Marketplace investigation of hospital cleanliness from 2012 does a good job at showing the consequences of hospital staff cuts (see video below). They interviewed nurses, doctors and hospital cleaners to find out more about staff cuts and its relation to infection control.

One hospital cleaner described the following:

“They’ve really cut staff, and we don’t have a lot of time to actually get done what we’re supposed to get done in a day. We used to have one person to one wing of the hospital to clean, but now we have three floors to clean.”

Anonymous, Hospital Cleaner (2012)

According to the report, in order to sufficiently clean a hospital room, it would take just over an hour. However, with the staff cuts being made, hospital cleaners are only getting on average 15 minutes for each room. This leads to a lot of uncleaned surfaces, leaving harmful pathogens in patient rooms. Furthermore, sometimes the harmful bacteria will even be spread from one room to another, since cleaners either don’t have the time to change cleaning materials or there aren’t enough cleaning materials. One example given in the report is that a cleaner will mop a patient’s room and then continue mopping into another room with the same water, simply because they don’t have the time to change the water.

Hospital staff cuts may save hospitals money, however, the potential risks that result from staff cuts are very significant and should not be overlooked. Leaving surfaces infected by pathogens can be detrimental to both patients and staff, and that is why it is essential to have an adequate number of educated staff to control the spread of infection.

To learn more about the consequences of hospital staff cuts, refer to this CBC Marketplace video:

Sources:

https://www.youtube.com/watch?v=UIOHKrfzJzI

https://www.cnbc.com/2017/11/27/venrocks-health-investors-make-predictions-for-2018.html

https://www.cbc.ca/news/canada/sudbury/health-sciences-north-funding-meeting-1.4902836

Are hospitals disappearing?

Hospitals have always had ups and downs, according to the New York Times (2018). During the 19th century, wealthier people preferred being treated by doctors in their homes and hospitals were seen as a place for poorer people. Hospitals were not known for having good conditions. However, research led hospitals to learn some of the best practices and new technologies, such as anesthesia, which allowed hospitals to give better treatment than at home.

These new pratices and technologies caused more people to start going to hospitals. But now, people are once again shifting towards medical assistance at home or choosing to go to small clinics rather than going to hospitals. Why are these changes happening and what has been the implications for healthcare facilities?

hospitals

Source: Wikimedia Commons

Why are hospitals shutting down?

According to the New York Times (2018), the maximum number of hospitalizations in the US was over 39 million, in 1981. Even though the population has increased, hospitalizations have decreased by 10 percent! (New York Times, 2018). There are many different reasons explaining these numbers.

Aside from less patient admissions, the number of days a patient spends in a hospital is much shorter than before. Previously, a patient who had surgery could spend a week or longer in the hospital. However, now patients who have surgery sometimes stay only one day! This is one of the reasons for the reduction of hospital beds. According to Modern Healthcare (2015), new technologies and better medications can either reduce the length of the stay of a patient, or receive the necessary treatment outside of a hospital.

Second, one of the biggest problems that hospitals face today are hospital-acquired infections and trying to control the spread of infection. Hospital-acquired infections are becoming an increasingly serious problem, especially with the rise of drug-resistant suberbugs.

According to the Center for Disease Control and Prevention, in 2002, there were 1.7 million cases of HAIs, and that number has only been increasing. Controlling the spread of bacteria in hospitals has become increasingly challenging and, as you have seen on this blog, researchers are constantly finding new sources of infection. As people are becoming more aware of this risk, they are opting for either smaller healthcare facilities with less risk or at-home care.

One of the biggest causes for hospital closures is lack of funding; some hospitals simply cannot sustain themselves. In the US especially, this is in part due to patients being unable to pay hospital fees or having complications with insurance companies and, therefore, postponing their treatments. Hospitals are now scrambling to cut costs, however, this does not always work and has led to many closures.

The costs of shutting down hospitals

The majority of hospitals being shut down are in rural and small town areas, where people are far from cities. These closures can lead to many problems for these people. Doctors may lose their jobs or have to relocate to other cities to practice. Similarly, patients no longer have the option of having a regular, family doctor and need to relocate themselves in order to seek medical attention. They will also incur higher costs to reach the hospital, since they have to travel to hospitals. They lose time travelling, which may even be deadly in some cases. Finally, in the video example below, we see that the loss of jobs from a hospital closure can be detrimental to a small town’s economy, leading to the closure of other companies.

What does the future for hospitals look like?

So what is going to happen to hospitals? Will they eventually all disappear? Although a total disappearance is highly unlikely, it seems that hospital closures are becoming unavoidable, due to the risks associated with hospital-acquired infections, changing consumer preferences and lack of funds to maintain hospitals. There has already been a signifcant number that have been closed since 1981; in 1981, the US had 6933 hospitals and by 2017 this number had dropped to 5534 (New York Times, 2018). And this trend is expected to continue in Western countries. We’ll just have to wait and see what the outcome will be…

Sources:

http://www.huffingtonpost.ca/michelle-cohen/ontario-rural-hospitals_b_16290384.html

http://www.modernhealthcare.com/article/20150221/MAGAZINE/302219988

Surface Damage and its implications for healthcare facilities

Preventing and controlling the spread of contamination and infection is of very high importance for healthcare facilities, and it is safe to say that many measures have already been taken in order to reach these goals. However, like many things, there is still much room for improvement moreover when it is about surface damage.

medical equipment surface damage

Source: Shaw Air Force Base

Evidently healthcare facilities use a wide variety of equipment, from monitors to surgical instruments to cleaning tools, and over time, this equipment wears down. Sometimes, equipment will break completely and be unusable, however sometimes there will only be a few scratches or other small damage.  But what happens when these scratches or other forms of damage become shelters and areas of growth for microorganisms? This is an example of how surface damage may not only impede the prevention of bacteria growth, but also provide the microorganisms with a place to grow.

What is surface damage?

According to Infection Control Today, surface damage is defined as:

a quantifiable physical or chemical change from the original manufactured state of an object (surface or device).

While it is recognized that surface damage of medical equipment poses a potential threat in the spread of bacteria in healthcare facilities, there is no standardized method for healthcare workers to determine what is considered surface damage, and at what point the damage is likely to cause the spread of bacteria. In a later blog post, I will discuss the ideal surface damage testing protocol, proposed by Peter Teska et al. in “Infection Control Today.” In this article, the authors discuss ideal methods of avoiding the problems that surface damage presents.

Are your surfaces damaged?

At Lalema, when we talk about hygiene and cleanliness, we offer a wide range of technical and consulting services. Find out more.

You can also read this article about The complete guide for hospital cleanliness.

Source: Infection Control Today. Vol. 21. No. 12. January 2018.

Hospitals, here and there

Hospitals here and there around the world

The saying goes, the grass is always greener on the other side of the fence. Let’s see what’s going on on the other side!

Sierra Leone

sierra-leone

Maternity hospital in Sierra Leone. Since 2010, more and more women are choosing to give birth in hospitals.

Source: http://www.theglobeandmail.com/news/world/in-west-africa-the-birth-of-a-notion/article4105570/

Taiwan

taiwan

Colors & Hospital seems to be an international concept!

Source: http://www.theglobeandmail.com/news/world/in-west-africa-the-birth-of-a-notion/article4105570/

Sudan

soudan-du-sud

Sometimes budgets do not include beds …

Source: http://www.theglobeandmail.com/news/world/in-west-africa-the-birth-of-a-notion/article4105570/

Russia

russie

Some Russian hospitals beyond the Urals are still waiting for post-Soviet modernization.

Source: http://www.viralnova.com/awful-russian-hospital/

Poland

pologne

Poland is modernizing its hospitals to override the memories of Soviet rule.

Source: http://polandpoland.com/polish_hospitals.html

United Arab Emirates

dubai

Modern hospitals in Dubai, nothing too good!

Source: http://www.arabianbusiness.com/saudi-german-eyes-q1-launch-for-dubai-hospital-361565.html

US

etats-unis-1024x768

If you have the means, the US private hospitals offer great luxury!

Source: http://imatter.silvercross.org/uncategorized/room-view-2

Quebec

hospitals-quebec-1024x768

Although hospitals are not all young or renovated, we can be proud of the quality of care in our hospitals!

Source: http://imatter.silvercross.org/uncategorized/room-view-2

Hospitals Cleaning Supplies

We have those! www.lalema.com