Hygiene is a topic of hot debate within the hospital environment, there has been a huge perceived increase in HAI’s (Hospital Acquired infections or Healthcare Associated Infections). While attempting to control this phenomenon the NHS are sinking precious fund and resources, costing the NHS £150 million per year. (Harvey et al, 2008)
There has been notable media interest in this subject. Between 1997 and 2007 the top US newspapers published 177 articles about MRSA compared to over 4,300 in the top UK newspapers(Boyce, 2009). Also journalists are increasingly going undercover in hospitals to report on hygiene practices. These programs have been shown on national television channels, such as BBC and Channel 4, reaching a widespread audience and increasing the awareness of these infections.
Victims of HAI’s are most commonly the elderly and the very ill; patients with low immune systems. The most common infections are:
MRSA(Methicillin-resistant Staphylococcus aureus), this germ can cause an infection if it gets into a wound, bloodstream or lungs.
C.Diff(Clostridium difficile), some people have this living in their bowel naturally, however in some people it can develop into diarrhea and fever.
Norovirus, this virus causes sickness and diarrhea, it can last a couple of days and has no lasting effects, however it is very infectious. (Macnair)
The medical imaging department in a hospital is at very high risk of becoming a breeding ground for these infections. In the recent years the prevalence of infection in the department has increased due to new modalities such as CT and MRI, and as a result in patients. The department caters for inpatients, accident and emergency patients, and outpatients, therefore a wide cross section of patients enter daily bringing with them different germs. (Üstünsöz, 2005)
An HAI is any infection that did not originate from the patients original admitting diagnosis. Within hours after admission a patients flora begins to acquire characteristics of the surrounding bacteria pool. Most infection that become evident after 48-72 hours of hospitalization are considered HAI’s. Also, infections that occur shortly after the patients discharge can be considered to have a nosocomial origin.(Nguyen, 2006)
X-ray cassette’s are a possible vector for these Nosocomial infections as they come into contact with many patients.
Studies into the infection control of X-ray cassette’s have shown when large cassettes from mobile radiography, A and E, and Inpatients were swabbed for bacteria 38 out of the 40 (95%) were contaminated with bacteria; micrococci, Diptheriods, Baccilus and Caoagulase - negative staphylococcus were found.(Harvey et al, 2007) These finding correlate to those of Ochie et al, a study of 7 different diagnostic imaging equipment and accessories, out of which X-ray cassettes recorded the highest levels of bacteria; 38%. The disinfectant most effective was sodium hypochlorite, commonly known as bleach.
Although these two studies show similar trends in X-ray cassette hygiene, Harvey’s study was only carried out in one hospital and only in two areas of the diagnostic imaging department, limiting the number of samples. Like wise there are flaws in the study by Ochie et al as it was carried out in Nigeria where the cleaning protocols are different therefore it cannot be generalized.
In the department everyday cleaning techniques need to be efficient but effective. There is a high turnover of patients and deep cleaning with sodium hypochloroite is impractical when providing a service such that the NHS does. The most widely accepted cleaning practice is disinfectant wipes.
The use of disinfectant wipes is a preventative measure to overcome HAI’s. The two wipes put to the test were Sani-cloths which are regularly used in UK hospitals, do not contain any alcohol or disinfectants and Clinell a mixture of quaternary ammonium…