Weekend reading: the life and spread of microbes in the average hospital room

July 6, 2017 | by

We in healthcare and health tech know how deadly nosocomial or hospital-acquired infections are. Current CDC estimates are that in US hospitals, there are 1.7 million infections and 99,000 associated deaths each year (up from a previous estimate of 75,000) PatientCareLink. Most of us know that visiting a patient in a hospital room means also making sure hands are washed, clothes and shoes are clean, and that we bring a container of industrial strength bleach wipes for cleaning surfaces versus flowers.

However, it was news to this Editor that few studies have been done on the actual hospital room environment–the microbiome–and how the microbes in the room interact with the patient and the staff.  Sue Barnes, an RN who spent 30 years as the National Leader for Infection Prevention for Kaiser Permanente, reviews a newly published study in Science Translational Medicine (24 May, abstract available only). The study collected bacterial cultures from the ‘patient zone’ around the bed, every surface in the hospital room, and swabbed the hands and noses of patients and staff, along with the shoes, shirts, and cell phones of staff members. The problem is much more complex than simple cleaning.

  • Patient skin and the microbial makeup of room surfaces became more similar over time. Non-ambulatory patients were less so, as they had less contact with external surfaces.
  • The longer patients were in the room, the more genetic resistance to antibiotics the organisms acquired. This is despite the lack of association with antibiotics save topicals. The author suggests that regular cleaning may be the reason–only the strongest survive.
  • The hospital room is most threating to the most vulnerable, such as babies in a neonatal ICU
  • “In the Lax study, several bacterial samples taken more than 71 days apart were identical,  (more…)

Nursing homes vs. hospitals for primary senior care

April 29, 2015 | by

Another way to reduce unnecessary hospitalizations? A recent New York Times article has kicked off a debate on whether many procedures for older adults can be better delivered in a nursing home or skilled nursing facility (SNF) setting rather than in-patient hospitals. Already serving many seniors for rehabilitation and residential care for multiple chronic conditions and old age-related debilities, the dreaded transfer to hospital may be lessened by a combination of outpatient procedure and installation of 24-hour nursing at these homes. Unbelievably (to this Editor) many of the 16,000 nursing homes in the country do not have round-the-clock nursing staff; only five states require 24/7 registered nurse coverage on site and there is no Federal requirement. An advantage is that minimizing hospital stay also minimizes hospital-acquired infections, patient distress (more…)