Going to a hospital is like to play Russian roulette. There are no guarantees that having cured one disease, a patient will not catch something else. Director of the state department "Center for control and monitoring of diseases of the Healthcare Ministry of Ukraine" Lubov Nekrasova says that healthcare acquired infections have become a serious problem for modern medicine. According to the specialist, HAI infect up to 10% of patients in advanced countries and more than 25% of patients in developing countries. Ironically, in 70% of cases dirty hands of medical staff are the prime cause of such infections. 

Of course, it does not mean people should stop going to hospitals, but that medical institutions should be better monitored for infection safety.

Grim picture

The risk group of patients exposed to HAI includes newborns, birthing mothers and patients of surgery. According to president of the All-Ukrainian council on patients' protection and safety Viktor Serdyuk noted that for decades of work the organization have received seven thousand of complaints, and every tenths claim concerned serious infectious disease, patients happened to be exposed  to in hospitals.

"I know a family which tried for seven years to have a child. Finally, the couple managed to do this, but at the age of two, the kid was hospitalized with pneumonia and was infected by a healthcare acquired infection. They sent him to Israel for treatment, but in ten days the child died. None of antibiotics could cure him," Viktor Serdyuk told one of cases.

In turn, Lubov Nekrasova points out the problem of hepatitis. "50% of active hepatitis a patient can catch after medical interference does not manifest immediately, and people return already with chronic form of the disease.  The same concerns hepatitis C. These are the infections which hit our patients after surgery," she says.

Epidemiologists note that the main problem is that seemingly common infections sometimes cause very negative consequences. Thus, according to director of the monitoring department of the State sanitary service Viktor Lyashko, the most common infections found in hospitals are aurococcus and P. aeruginosa.

"If such infections get into an open wound, they may cause nosocomial pneumonia, which is resistant to antibiotics. In fact, such disease becomes incurable," the specialist notes.

According to Viktor Serdyuk, such cases are numerous. In 2012, for example, there were about one thousand cases of complications registered with newborns and their mothers and about 500 cases with patients of surgery.

"Chief Doctors are afraid to register HAI, so they discharge patients earlier and prescribe antibiotics treatment at home. There is certain time delay in registration of such patients, for this we have unreliable data," Lubov Nekrasova says.

Correction of mistakes

The State sanitary service of Ukraine plans to monitor all the hospitals of Ukraine for infection safety. "Due to the administrative reform the personnel of the State Sanitary Service have been cut almost twice, and the schedules of planed and random inspections have changed. We initiate social partnership and start cooperating with public organization," Viktor Lyashko noted.

According to him, the service has already signed a memorandum on cooperation on infection control and patient safety between the State Sanitary Service and All-Ukrainian council on patients' protection and safety. Within this memorandum, it is planned to launch a pilot project "Clean medicine - safe medicine" in Ternopil region. The project provides for infection monitoring in all hospitals and outpatient departments, where there are risks of infection contamination among patients.

Specialists say that inspections of hospitals now happen only once a year and of outpatient departments - once in three years, which is not enough.

"It is impossible to carry out thorough inspection and examine and analyze all clinical records to say that the administration of this or that medical institute has provided accurate report on HAI," Nekrasova says.

According to Lyashko, obstetric hospital used to be monitored quarterly, and the State Sanitary Service conducted internal control with its own microbiological labs.

"We were takings tests and observing mutation of staphylococcus, for example. If we saw that it was becoming resistant to some antibiotics, we recommended doctors not to use this or that drug to prevent development of HAI," he specified.  

Now, due to reduction of number of planned inspections, the Sanitary Service plans on paying monitoring visit to hospitals.

"There will an epidemiologist who can say what to do, how to manage flows of patients, how to improve ventilation, what sanitizers are better to be used, etc. This specialist will be able to check clinical records and control whether any of HAI cases has been missed or whether a surgeon, for example, has prescribed proper antibiotics therapy," Lyashko says.

The project will be realized in one region only, and if it is successful, it will be launched countrywide.
"We will monitor all hospitals and outpatient departments of Ternopil region. If there are problems with infection control, we will give our recommendations to heads of regional administrations and council, who in turn will have to take adequate measures - to re-plan ventilation system, for example, etc. In one year, we will come again to monitor and to see changes made. Having the results, we will have sufficient data to form a database for introducing changes to the legislation," he underlined.

However, it is impossible to put a supervisor next to every doctor and to control whether he has washed his hands before the operation. In this case, doctors and patients should take joint actions, because even doctors can end up in a hospital bed. It is important to remember that if you want to change the world start with yourself.

Tetyana Matsur


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