Sanitary and anti-epidemic regime in healthcare facilities

Patient hygiene regimen in the ward

The basis for a safe stay in a hospital is compliance with personal hygiene rules. Upon admission, the patient's clothing and footwear are not kept in the ward: they are deposited for storage in special bags (covers) with hangers or handed over to relatives. The ward itself must provide basic supplies: individual tableware (a glass, cup, or mug), and for bedridden patients — urinal bottles, bedpans, and sputum mugs.

Patients are allowed to bring their own personal care items from home: toothpaste and toothbrush, razor, soap, as well as their usual cup and spoon.

Special attention is paid to water procedures:

• Scheduled bathing is organized at least once every 7 days (unless there are direct medical contraindications). The performance of the procedure must be documented in the medical history.
• Critically ill patients require a special approach. Their washing, skin wiping, as well as oral cleaning and rinsing, are performed after each meal and as the body becomes physically soiled.
• As part of additional care, the hospital must periodically organize haircuts and shaves for patients.

Healthcare-associated infections (HAIs): essence and danger

According to the WHO definition (1979), a healthcare-associated infection (nosocomial, hospital-acquired, cross-infection) is any clinically recognizable infectious disease that affects individuals in a hospital environment. Victims of HAIs include both patients (as a result of hospitalization or an outpatient visit) and medical staff (in the line of professional duty). An important condition: the disease is classified as an HAI even if its symptoms appear after discharge from the inpatient facility.

HAIs cause enormous damage to the healthcare system. They worsen the general condition of patients, significantly prolong the length of stay in the clinic, increase economic costs, and raise mortality rates.

Combating nosocomial strains is extremely difficult due to the specific characteristics of the pathogens themselves. They possess high virulence and have developed pronounced resistance to both antibacterial drugs (including antibiotics and sulfonamides) and many chemical disinfectants. The source of infection introduction is often patients admitted during the incubation period of the disease, or the hospital staff themselves, who are asymptomatic carriers.

Measures for infection prevention in healthcare facilities

Protection of the hospital environment relies on two directions: specific (vaccination, routine and emergency immunization) and nonspecific prevention. Nonspecific measures are divided into four major groups:

1. Architectural and planning solutions: proper zoning of the hospital territory, rational distribution of departments across buildings and floors, strict isolation of operating rooms, maternity units, and wards, as well as the separation of staff and patient flows.
2. Sanitary and technical measures: creation and maintenance of rational ventilation systems.
3. Sanitary and anti-epidemic measures: education of patients and staff, ongoing monitoring of the sanitary condition, active detection of pathogenic flora carriers, and control of bacterial contamination of the environment.
4. Disinfection and sterilization unit: mechanical cleaning, application of physical sterilization methods, and treatment with chemical disinfectants.

Advanced methods for reducing HAI incidence include rooming-in of mother and child, early breastfeeding initiation, individual delivery rooms, and early discharge. In general practice, day hospitals, mandatory rotation of disinfectants, and a strictly differentiated approach to prescribing antibiotics based on pathogen sensitivity tests are actively used.

Occupational health of healthcare workers

Modern medicine counts more than 50 narrow specialties, and working conditions in them vary drastically. In general, the profession of a physician is rarely associated with heavy physical labor, but its main feature is high strain, which places an enormous burden on the central nervous system (CNS).

In the workplace, personnel encounter harmful (causing a steady decrease in performance or illness) and dangerous (leading to acute poisonings and injuries) occupational factors:

• Radiologists and physiotherapists are exposed to physical factors (ionizing radiation, electromagnetic fields).
• Infectious disease specialists and pathologists come into contact with biological factors (pathogens).
• Surgeons and psychiatrists experience severe psychophysiological strain, and surgeons are additionally exposed to chemical factors.
• Dentists encounter the whole complex: chemical, physical, biological, and psychophysiological factors.

Working conditions are shaped by room architecture, technical equipment, the specifics of the treatment process, and the rest regimen. Basic parameters (office dimensions, microclimate, lighting, color finishing) are strictly regulated by official standards — SNiP and SanPiN.

Briefly: answers to topical questions

Class and exam questions

What else to study on this topic

• Features of architectural and planning solutions for the strict isolation of delivery units and operating rooms.
• Mechanisms of resistance development in nosocomial strains to chemical disinfectants.
• Principles of rotation of skin antiseptics and low-toxicity disinfectants in surgery departments.
• Impact of psychophysiological factors on the health of surgeons and psychiatrists during work.
• SNiP and SanPiN requirements for the microclimate and lighting of doctors' offices.

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.