Why modern medicine need to open their windows to avoid hospital acquired infections.

Sunday 5th May 2013 

  • Why putting my baby brother out in the back yard was a kindness

  • The horror of bugs having fairground rides in our hospitals

  • Throw a window wide to save a life – too dramatic or not?

     

It’s amazing what a bit of fresh air and sun can do for the mind, body and spirit isn’t it?

Last week I had mown the lawns, weeded the borders and tended my seedling crops in the garden – then I sat back on a patio chair and delighted in the warmth stealing through my bones.

I could feel myself getting healthier.

This winter has been long dark, wet and glum...

...in fact the last twelve months seem to have been spent in near darkness!

So, the bright sunny days we have just enjoyed (and not a bad Bank Holiday weekend either for a change!) are more than a welcome relief.

Seeing the golden orb has long held man spellbound and formed part of our earliest approach to healthcare – giving someone a bit of fresh air and sun has been the mainstay of all home remedies.

I remember my brother being left out in the yard at home in his pram when he was a baby and being confused about why Mum had banished him!

But it was very common practice for young and old alike to be given a ‘breath and a warm’ as the better weather arrived.

It set me thinking as I sat there with a cold beer in the late afternoon sun – our hospitals are now hermetically sealed and screened from the suns rays by elaborate shades; have they got it wrong?

A research article from The American Journal of Nursing last month is suggesting this may be the case.(1)

In her paper the researcher actually reviews a paper from 1901 which advocated ‘the purifying and tonic germ-destroying power of sunlight and pure air.’

The general advice was that nurses should open windows and blinds to facilitate airflow and access to sunlight citing that ‘patients heal better when their rooms are well ventilated and bright.’

Now to me that makes perfect sense – especially if you have been to a modern hospital recently.

Think about it we are more than 100 years on from the insight on healing from the Nursing Journal and yet our stay in hospital means we breathe conditioned air, get hidden behind curtains and blinds and rarely see the outside world.

Surely this can’t be right can it?

Air borne pathogens & HCAI’s

Back in slightly more honest and less litigious times, any infection you contracted whilst in hospital was referred to as a Hospital Acquired Infection (HAI).

Now though, in what I perceive as an attempt to shift the blame, such instances are called Health Care Associated Infections. What is beyond doubt is that they represent a bug that you are now suffering from that you hadn’t brought into hospital with you!

We expect that when we enter a main ward we are in the most sterile and controlled environment on the planet.

The reality though is that our bodies are likely to encounter much more virulent pathogens than we would encounter in our own homes.

This isn’t because the cleaning regimes are flawed, or that the nurses are lacking in their duties of care – but because they are public places with near 24/7 access 365 days a year.

Any manner of folk enters and leaves its doors, providing their own unique cocktail of bugs and nasties to the soup in the air in the communal spaces.

This air is then sucked out of the rooms, cooled and pumped back somewhere else by efficient air conditioning.

In order to make this air system as efficient as possible the windows have to be kept shut, doors sealed and air lock traps in place over all vents – this means that the bugs just whizz around like kids at the fairground.

In a major research paper published in 2012(2) the author concludes that bacteria in the air in hospitals ‘can lead to heavy, widespread, and persistent environmental contamination.’

Such contamination poses significant risk for anyone entering the area, and also those elsewhere in the building served by the same air management unit.

How much easier would it be to open a few windows and let the breeze blow through?

Not just easier, but also much healthier.

In another retrospective article published in the Journal of Advanced Nursing in January(3) this year, they concluded that Florence Nightingale’s views on healthcare were more relevant today than ever!

She proved that there were five essentials to optimal healing;

- Pure air: she said that one of the reasons for the high infection rate during the Crimean war was poor ventilation, and now air borne diseases remain a major killer and are the leading cause of deaths worldwide.

- Pure water: Waterborne diseases such as cholera, dysentery, and typhoid were observed by Nightingale in her writings and sadly they continue to be responsible for many deaths today (1•8 million annually).

- Efficient drainage: You may think that this isn’t so relevant today, and maybe here in the UK it isn’t however a sobering fact is that more people in the world have mobile phones than access to toilets.

- Cleanliness: Nightingale insisted nurses to scrub the ward clean and it is only recently that nurses are beginning to revisit these basic tasks.

- Light: Access to sunlight is key to promoting the production of vitamin D, and as more people lead sedentary lives they are being less exposed to the sun and once again the deficiency condition known as rickets is on the increase.

Amazing isn’t it – all these things were known, documented and recommended at the time of the Charge of the Light Brigade in 1854, when the lives of many of those injured were saved by such common sense approaches to health care.

Yet in this haze of modern technology we seem to have forgotten the very basics.

Well, maybe if the authors of these research papers get listened to we may see a few more open windows on a nice day in our hospitals across the land – and that has to be a good thing.

 

Yours, as always

 

Ray

P.S. Don’t forget to break out the sun cream if you are intending to spend more than 30 minutes outdoors – right now I have a limited supply of really good protection creams that are absolutely free from the parabens and other nasties so often found in commercial product.

Get yours now right here

References
(1) Brent, Louise C. "Fresh air and sunshine." The American journal of nursing 113.4 (2013): 60-61.

(2) Muzslay, Monika, et al. "Dissemination of antibiotic-resistant enterococci within the ward environment: The role of airborne bacteria and the risk posed by unrecognized carriers." American Journal of Infection Control (2012).

(3) Lee, G., Clark, A. M., & Thompson, D. R. (2013). Florence Nightingale–never more relevant than today. Journal of advanced nursing, 69(2), 245-246.

 

 

 

 

 

 

 

 

 

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