As far back as the 19th century, Ignaz Semmelweis was able to reduce maternal mortality rates in Vienna significantly through the simple measure of hand washing. However, these days this appears to have disappeared from our consciousness, as the disinfectant dispensers visible on all wards do not reduce the contamination of door handles and other surface in the hospital with germs. Says Tabori: ‘We have moved along the way a little bit but haven’t quite arrived.’ Why? Lack of time? Ignorance? Lack of staff? The hospital infection control specialist believes that, even in modern buildings, the hospital pathogens infection rate cannot be further reduced because two thirds of all these pathogens come from the patients themselves. Therefore the term ‘indirect contact infection’ is imprecise and out-dated.
One solution could be for their ments. To ensure that all clinical departments can be fully operational, even during construction work, the interior layout should be as flexible as possible – for example, few primary structures and flexible interior walls. According to Prem, the clinical buildings must comply with a number general practitioners (GPs) to examine patients for pathogens before hospital admission, as carried out in the Netherlands. Alternatively, new admissions could be separated from other patients until the results of their infection status are known. However, even small building-related issues can help, such as installing several, smaller wash basins in different locations rather than central washrooms with many basins for instance. Electronic water installations are susceptible to legionella, and the installation of elbow levers instead of water taps avoids contact with germs. There are many, detailed examples relating to water and air systems.
Specialists at the BZH can answer all enquiries on these subjects. As so nicely put by Ernst Tabori: ‘Hygiene begins between the ears’.