People come to the hospital with various infectious diseases. All hospitals are crowded with relatives. Even after visiting patients, some of them are suffering from new diseases. Many are threatening the patient even while serving the patient. Due to the lack of effective measures to prevent infection in the hospital, the spreading germs are also affecting the patients or their relatives. The number of patients who come for treatment with one disease and return with another disease is not less. Poor infection prevention and control (IPC) systems in the country’s hospitals are responsible for this.
According to a Lancet study, 13.7 million people worldwide die each year due to infections. A large proportion of these are hospital-acquired. Another study found that such infections are 3 to 5 percent in Western countries and 30 to 40 percent in Asian countries. This means that countries with better IPC systems have lower human infection rates.
A study by six experts
Recently, a group of six expert doctors of Mugda Medical College Hospital conducted a study on the infection prevention system of 37 public-private and corporate hospitals in the country. Among them, 11 government medical colleges, 11 private medical colleges, 11 national institutes and four corporate hospitals. Every hospital has rules to have an IPC committee. However, in many hospitals, the committee did not exist.
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The study revealed that 15 out of 37 institutions (40%) do not have IPC at higher levels or committees. Another 9 institutions (24.32 %) have insufficient or committees but no actual activities. In 7 (18.91%) the IPC system is medium level or has committees and some work. Two government medical colleges and four corporate hospitals have quality IPC controls or committees and are functioning.
What the researcher says
Associate Professor, Mugda Medical College Hospital
Dr. Manjurul Haque told Jago News, ‘This research has been done based on certain questions of the World Health Organization (WHO). One of the questions was whether the IPC was running or not being properly managed in the hospitals. We find that most hospitals have IPC committees. But most of the committee has no activities. Such as regular meetings, supervision is not done.’
We need full time IPC professional. Where there is no IPC committee, IPC committee should be formed. It has been asked to increase the activities where there is a committee but the work is not done. Guidelines (wash management, antibiotic guidelines, etc.) should be followed. IPC related training should be increased. In addition, a separate person will be needed to monitor. – Dr. Manzurul Haq
Besides, the survey revealed that there is a huge deficiency in the screening of the types of infections that are more common in government hospitals. There is also a deficiency in the training of those engaged in health care. Also there are guidelines on how to use antibiotics. But it is not properly accepted in hospitals. In addition, one fourth of hospitals do not have hand sanitizing facilities. Manpower shortage is very high. According to WHO standards, there are as many patients as there are beds, but hundreds of government hospitals have more patients than beds.
What was found on the ground
Going to women’s ward number 212 of Shaheed Suhrawardy Medical College Hospital, Sherebangla Nagar in the capital, it can be seen on the ground that patients and their relatives are lying in the same bed. Hospital carelessness and carelessness can increase the risk of infection. Even though there is no rule for men to go to women’s ward, men are staying in bed with women patients. Many are sharing beds with newborns, children and elderly relatives.
Hasna gave birth to a newborn by caesarean section on January 22. She was again admitted to Suhrawardy with the newborn due to an infection in her caesarean section. A newborn is lying with the patient. The husband is sitting next to him. At that time, when asked whether Mofazzal’s husband knew about the reason for staying in the women’s ward and whether he could harm the patient or himself if he stayed together in the hospital, he said, ‘I know there are germs in the hospital. It was not accepted that way. You have to see your relatives in the government hospital. None of the doctors or nurses said anything about this.’
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Jannat is another patient next door. He died before the child was born. He is admitted to the hospital for treatment. Her husband Imam Hussain and her mother are sitting on her bed. When asked if he knew about the fact that the patient could get infected if this is the case, he said, ‘The hospital is cleaner than before. I know there are germs. But the hospital did not take action. This is how we are going.’
The nurses of the hospital’s gynecology department said that most of our nurses have knowledge about infection prevention control (IPC). But it is not applied in work. Not even possible.
Smriti, a senior nurse at the hospital, told Jago News, “Our morning starts with taking out extra visitors in the ward, tidying up if they are dirty – these things.” Patients are asked why they are dirty, if they are dirty, there will be infection. But patients and their relatives do not listen.’
Senior nurse Farida said, ‘Men come to every gynecological ward. Even if you take it out, come again. Nurses know about infections. But there is no practice of these. We cannot manage patients. He doesn’t listen even if he talks. Institutional measures need to be taken for this.’
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The head professor of part-2 of Obs and Gynecology Department of the hospital. Afroza Gani told Jago News, ‘Free presence of patients and relatives in the hospital is a major cause of infection. Many times it is seen that one brought the infectious disease, spreading it to others. In order to stop this infection, we have to stop the entry of visitors to the hospital.’
The IPC system has come to the country’s health system during the Corona period. It was initially done at the Corona Center, but later we added other hospital infections there. There are IPC committees in hospitals. – Dr. Abu Hossain Mohammad Mainul Ahsan
Shaheed Suhrawardy Medical College Hospital director Dr. asked if there is any effective committee for IPC in the hospital. Md. Shafiur Rahman told Jago News, ‘There is a committee of seven members in the hospital. A committee has been formed with doctors and nurses from various departments. They take care.’
When asked if any meeting has been held or if any plan has been made, he said, ‘There has been no meeting since I joined the service. But we are starting to work on it again. After my arrival I am working on the improvement of the hospital including cleanliness. But overload. If there are 500 beds, there are 1500 patients. For 500 people, it is not possible to serve two to three times as many patients and keep the hospital clean.’
He said, ‘People of Bangladesh are very emotional. We cannot keep visitors away from the hospital even if we want to. They come with their patients. But I am trying to take effective measures in these matters.’
On the surface, a visit to the capital’s National Cancer Research Institute and Hospital and Mohakhali Chest Disease Hospital shows the same picture. People are sitting on the floor. Relatives with the patient in the hospital ward. Uncleanness in many places. Measles is an infectious disease. However, there was no awareness about this in the chest hospital ward or outdoors.
If you want to know about this, the Director of Chest Disease Institute and Hospital (Acting) Dr. Md. Khairul Anam told Jago News, ‘We don’t have as many doctors, nurses and cleaners as there are patients here. A lot of work has to be done with outsourcing. In this case, it is not possible to maintain IPC.’
The kind of problems that will increase if there is no IPC system
Dr. Manjurul Haque said, if the infection prevention control is not managed properly, the infection from the hospital will increase. Nosocomial infections are often very dangerous. Bacteria are resistant to antibiotics. If a patient is infected at home, the damage is greater than if they are infected in the hospital. The risk of death will also increase.
Solutions to prevent hospital infections
Dr. Manjurul Haque said, ‘We need full time IPC professional. Where there is no IPC committee, IPC committee should be formed. It has been asked to increase the activities where there is a committee but the work is not done. Guidelines (wash management, antibiotic guidelines, etc.) should be followed. IPC related training should be increased. Besides, a different person will be needed to monitor.’
Stating that there is no dedicated person for IPC, he said, ‘Most of the people who work in IPC are involved in other activities. There is no one specifically for IPC supervision.’
In this regard, the director of the hospital and clinic branch. Abu Hossain Mohammad Moinul Ahsan told Jago News, ‘IPC system has come to the country’s health system during the Corona period. It was initially done at the Corona Center, but later we added other hospital infections there. Hospitals have IPC committees.’
Although there is an IPC committee, the activities are not being carried out in many cases, he said, ‘Due to the formation of this committee during the corona virus, in many cases, many of the manpower in the committee has been withdrawn to other places. Because of this, the activities of IPC have decreased somewhat. If the IPC committee is activated, hopefully the infection in the hospitals will decrease.
AAM/ASA/MS
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