Infection control ‘undercover’: a patient experience

Abstract

Please cite this article in press as: Dancer doi:10.1016/j.jhin.2011.12.003 As a National Health Service microbiologist and former editor of the Journal of Hospital Infection, most of my professional time is spent managing nosocomial infection. Becoming a patient was not part of the job plan until a sudden accident on holiday compelled hospital admission. It was an opportunity to experience infection control in the real world and one that could not be ignored. Bedbound, and ‘undercover’, this patient witnessed the ward-based impact of infection control in hospitals in two countries. The accident dislodged three intervertebral discs, warranting immediate admission into an acute trauma ward in Italy. There were no privacy curtains; no lights other than a fluorescent ceiling strip; no nurse call button; no electrical equipment; no soft furnishings; and no alcohol gel. There is an expectation that relatives provide basic hospital care in this part of Italy, and this, in part, reflected the paucity of nursing staff. The ward sink was used only by visitors. None of the doctors cleaned their hands during the ward rounds, despite moving from patient to patient. No hand hygiene opportunities were offered to patients after toileting, nor before or after eating. If hands were ignored, basic cleaning certainly was not. Given minimal clutter in the bay, two domestic personnel obtained easy access to all dark corners. The floor was vacuumed, then mopped, and all beds and lockers moved for cleaning purposes. Window blinds, cupboard, door handles, wall fixtures