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Hygiene regulation: miracle cure in the fight against hospital germs?
The hygiene scandal at two clinics in Hesse has drawn public interest to a topic that has been the subject of intensive discussion in specialist circles for a long time. Infection with so-called hospital germs.
According to the health authorities, up to 600,000 people in Germany fell ill each year from an infection with the so-called hospital germs during a hospital stay. According to the federal government, up to 15,000 people die from such an infection every year. The German Society for Hospital Hygiene (DGKH) even assumes a significantly higher number of annual deaths. But although the problem has been known for a long time, little has been done so far. However, in view of the recent hygiene scandals in Hesse, public pressure is growing and the federal government has long been calling on the federal states to issue a corresponding hygiene regulation.
Hygiene regulation so far only in seven federal states So far, only seven of the 16 federal states have drawn up a hygiene regulation in order to meet the hygienic requirements in the hospitals and to intensify the corresponding control. As the eighth federal state, Hesse is also planning to issue a hygiene regulation this year, said Hessian Minister of Social Affairs Stefan Grüttner. Although the recently discovered contamination of the surgical cutlery in the Fulda and Kassel clinics did not endanger any patients, the lack of hygiene could have been avoided with an appropriate hygiene regulation, said the Hessian Minister of Social Affairs. Studies and pilot projects have shown that strict compliance with hygiene regulations can result in a significant reduction in infection rates. Dr. Klaus-Dieter Zastrow, hygiene expert at the DGKH, emphasized how important a uniform hygiene regulation would be for all German hospitals.
800,000 infections a year from hospital germs The DGKH expert explained that "hospital germs" are by no means understood to mean only pathogens that occur in clinics, but germs that everyone carries around with them. However, the risk of infection in hospitals is particularly high, since the pathogens can enter the body through open wounds, for example, and the patient's immune system is usually already weakened. The problem arises when the germs “get into areas of the body where they have no business, for example into the blood or into sterile rooms such as the bladder and lungs,” explained Petra Gastmeier, director of the Institute for Hygiene and Environmental Medicine at the Berlin Charité. According to Klaus-Dieter Zastrow, an average of about five percent of hospital patients become infected with the so-called hospital germs, which, contrary to the information provided by the German government, would correspond to more than 800,000 illnesses per year. According to Zastrow's estimates, between 20,000 and 40,000 patients die in Germany per year from the consequences of infections with hospital germs.
Imminent infection from multi-resistant pathogens According to the DGKH experts, multi-resistant pathogens such as MRSA, VRE and ESBL, which are resistant to almost all common antibiotics, are particularly threatening for the health of the patients. "They cause no other infections than the other germs, but they are much more difficult to treat and are usually much more difficult," because the treating physicians "have to look for an (effective) antibiotic for longer," explained Zastrow. Petra Gastmeier added as justification for the fluctuating information of the patients concerned that the "assessment of deaths (...) is very difficult". Because it is often not possible to determine exactly whether “a patient died in the hospital because of a certain infection” or whether he succumbed to his other illnesses.
Compliance with the hygiene regulations could prevent infections Overall, the experts assume that a majority of the infections could be avoided by better hygiene measures. Not only in the operating room, but also during the rounds, wound inspections and the hospital as a whole, the hygiene regulations should be strictly implemented. However, the experts also emphasize the importance of uniform regulations and their monitoring in order to achieve a functioning, nationwide implementation of the hygiene measures. In addition, the patients were also asked to deal with the hygiene situation in the hospital they visited. According to the experts, the patients can only contribute little to hygiene, but they should inform themselves about the hygiene measures there before a planned hospital stay. According to the health consultant at the consumer center in Karlsruhe, Julia Nill, "the admission interview (...) is a good opportunity to talk about hygiene." There is also "in every hospital with more than 400 beds a hospital hygienist who can be scheduled can ask. ”In the smaller clinics, a specialist for hygiene was approachable.
Patients should inform themselves about hygiene standards. However, it is not only because "a hospital has a department for hygiene management" that "in-house hygiene must be excellent", explained Petra Gastmeier. For the patients, "quality reports or websites are more meaningful, showing which departments with which regularity the occurrence of infections or multidrug-resistant pathogens is statistically recorded and analyzed", the expert notes. Even if the patients have hardly any direct influence on hospital hygiene, the discussion with those responsible is particularly important, as this is a clear signal that hygiene is important to the patient. "The more patients ask, the more the staff is sensitized," explained Petra Gastmeier. Ultimately, better implementation of the hygiene measures would not only significantly reduce the treatment costs, but also significantly reduce the risk of serious illnesses for the benefit of the patients, the experts explained. (fb)
Read about hospital, hygiene and germs:
Hessian hygiene regulation this year?
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Image: Gerd Altmann / pixelio.de