Sanitation and hygiene

Hygiene of healthcare facilities (HCFs)

Healthcare facilities include hospitals, outpatient clinics, ambulatories, maternity hospitals, dispensaries, feldsher-midwife stations (FAPs), as well as sanitary-antiepidemic stations. Their main task is to reduce morbidity, improve public health, and provide highly qualified care using the latest scientific achievements.

HCFs must be exemplary facilities in terms of hygiene. This is necessary to maintain the therapeutic and protective regimen, which is designed to:

• Provide patients with maximum physical and mental peace.
• Prevent the emergence and transmission of healthcare-associated infections (HAIs).
• Facilitate patient care and servicing by the staff.
• Serve as a kind of "school of hygienic habits" for patients.

At the same time, HCFs represent a working environment for medical and engineering-technical staff, where the operation of various equipment creates specific occupational risk factors.

The problem of healthcare-associated infections (HAIs)

The prevention of HAIs is one of the most important tasks of hospital hygiene. Official statistics in the Russian Federation show a low morbidity rate, but these figures do not reflect the true situation due to the systematic underreporting of urinary tract infections and purulent-septic complications in operated patients and puerperas.

The complexity of combating HAIs is associated with the characteristics of microorganisms circulating in the hospital environment:

• High degree of virulence.
• Pronounced resistance to antibacterial medications (including sulfanilamides).
• Insensitivity to many disinfectants.

Prevention of HAIs and staphylococcal infections

Measures to combat infections are divided into specific and nonspecific. No effective means of specific prevention have been developed for staphylococcal infections.

Nonspecific prevention includes four groups of measures:

1. Architectural and planning: competent territory zoning, rational placement of departments, isolation of units (operating rooms, maternity wards, wards), strict observance of patient and staff flows.
2. Sanitary and technical: organization of rational ventilation systems.
3. Sanitary and antiepidemic: monitoring the level of bacterial contamination of the environment, identifying carriers of pathogenic microflora, health education work.
4. Disinfection and sterilization: use of modern antiseptics and disinfectants.

Special attention is paid to the identification and eradication of bacterial carriage among staff in surgical and maternity departments. For the eradication of carriage of methicillin-resistant S. aureus (MRSA) strains, intranasal administration of the antibiotic mupirocin is prescribed.

Occupational hygiene in agriculture

Labor in livestock and poultry farming, despite the introduction of mechanization, retains a number of occupational hazards.

• Pig-breeding complexes: operators face physical overexertion due to manual operations, noise from animals and feed distribution transport. A specific irritating smell is easily absorbed by skin, hair, and workwear. The provision of shower facilities is mandatory for prevention.
• Dairy farms: the main specifics are related to cow milking. Wide mechanization of water supply, feed, and the milking process itself improves the hygienic situation. Milkmaids must be provided with workwear and carefully care for the skin of their hands to avoid pyoderma.
• Poultry farming: workers are exposed to dust and down when air quality is poor. These substances have a sensitizing effect and suppress immunobiological reactivity. Poultry workers frequently exhibit hypersensitivity to ornithosis and toxoplasmosis allergens. There is also a high risk of infection with zoonotic and fungal diseases.

A separate problem is the disposal of agricultural waste. Livestock runoff is saturated with rapidly decomposing organic matter and may contain helminth eggs and pathogens of dangerous infections (brucellosis, leptospirosis). In addition, the widespread use of pesticides requires increased attention to protecting the health of the entire rural population.

Class and exam questions

What else to study on this topic

• Requirements for zoning the hospital site territory
• Rules for isolating sections, wards, and operating units in HCFs
• Methods for monitoring bacterial contamination of the hospital environment
• Methods for cleaning and neutralizing liquid waste from livestock complexes
• The impact of pesticides on the health of the rural population

Other topics in the section "Chapter 8. Hygiene of Healthcare Facilities"

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.