‘Due to Lack of Expertise and Finance, Infection Control Never got the Priority it Deserves’

The rising awareness and expectations of high quality standards are making hospitals realise the importance of infection control (IC). Edmund Paul, Deputy General Manager, Facilities Support, Wockhardt Hospital, Mumbai, discusses the challenges involved in implementing infection control measures with Express Healthcare. Excerpts:

Edmund Paul Deputy General Manager, Facilities Support, Wockhardt Hospital, Mumbai

What have been the major challenges and experiences in planning and implementation of IC in a new hospital?

Now healthcare industry is becoming biasness, but some time back it was totally overruled by charitable/trust and Government hospitals. The expectations from patients have increased. Moreover, they have become more educated and are aware about the diseases more by the influence of media and Internet. So hospitals should be designed in a way that they meet the expectation of the customer. Challenge is to run a hospital with best facility in affordable rate. So, world-class facilities in Indian price is the challenge.

Do you think IC is given its due importance in our country? If not, why?

As I indicated, in Government and trust hospitals, the importance is very much for the pricing level and not the quality. IC is definitely an important issue, but because of lack of expertise and finance it never got the priority it deserves. Few hospitals keep a watch on hospital acquired infection (HAI) and the seriousness of this is not even escalated because of that.

Are there any guidelines for IC issued by any regulatory authority?

Unfortunately, in India no regulatory authority has fixed any guidelines.

What is the need of the hour, in terms of regulations, to ensure effective IC?

In India, a regulatory authority should be set up for all hospital practices. At present, nobody knows anything about the rate of HAI in any of the hospitals. It should become a mandatory practice, so that at least the hospital processes fall in place.

What are the expectations from patients regarding hygiene?

The expectation is very high from the patient. To give a satisfactory service to the patient, hospitals should have the support facility in place. Now, even the bed pan is washed in a washer disinfector. Cleaning and disinfecting of rooms and the environment is also very important. So special filters and air cycle changers must be installed in all hospitals.

What prime factors regarding HAI must be taken care of while choosing the equipment for a new hospital?

Planning of OTs, CSSD, and ICUs etc must be done keeping in mind international guidelines. OT with laminar flow and hepafilters with 100 per cent fresh air supply, ICUs with air cycle changer and isolation room for infected patient etc are very important. In fact, at our hospital, we have a process in place to check the infection and monitor the rate of HAI also.

CSSD is a major concern. If your CSSD is in place, half the problems can be solved. In India, most of the hospitals give least priority to CSSD. One or two autoclaves should be in place, this is all CSSD means to them. Most of the hospitals do not have a good steam steriliser in place. CSSD should be designed in a way that sterile and non sterile part should be isolated and sterile store should maintain the real sterile environment. Washer disinfector, ultrasonic cleaner, drying cabinets etc are all integral part of CSSD, and with only a steriliser one cannot curb HAI. Hospitals should always buy the best equipment available, which follows all international standards.

How cost-effective are the IC measures for a hospital in the long run?

The challenge is to provide world-class facility at an affordable rate. Almost 10 per cent of the capital cost (for medical equipment) is for the IC equipment for hospitals adhering to IC standards. We cannot have many equipment in one hospital. So optimum utilisation of equipment is very important. Size and type of the equipment should be selected as per the requirement of the hospital, which will help you save money in the operation. Moreover, if a patient acquired infection whilst undergoing a treatment at the hospital, it will be an added expenditure for the hospital in terms of time and bed occupancy. So in the long run, the investment for right technology in IC is worth giving a shot.