ECJ EUROPEAN Cleaning Journal

ECJ’s correspondent in Scandinavia, Petra Sjouwerman, reports from Sweden on why cleaning is the most important weapon against hospital bacteria.

The Högland hospital in Sweden has received the national award for excellent hygiene routines. The prize is awarded annually to an organisation that has worked successfully to prevent bacteria outbreaks in hospitals, elderly care or dental care. The prize is awarded by the Swedish Institute for Communicable Disease Control, the Smittskyddsinstitutet, to raise awareness of the importance of applying good hygiene.

The Högland hospital in Eksjö and Nässjö in South Sweden is well known for the largest and most modern operating theatre in Europe.

The past two years the hospital (1,500 employees) has managed to reduce the number of patients with Clostridium difficile infection, also known as CDF or C.Difficile, a bacteria that causes severe diarrhoea and can lead to diseases that can be life-threatening.

Bacteria outbreaks are expensive for hospitals, as infected patients can become seriously ill and have to stay longer. Cleaning of beds and furniture is difficult. Some hospitals in the United States have been forced to discard furniture worth millions of dollars.

Had to do something

In 2010 the Högland hospital grappled with an outbreak of C.Difficile. “We saw that a lot of patients had this severe infection and we decided to do something about it,” said hospital director Christina Karlsson to the Swedish media. Karlsson invited the Canadian infectious diseases specialist Michael Gardam from the University of Toronto, who regularly works as an advisor for hospitals across Canada and the United States.

According to Michael Gardam cleaning is the most important weapon in the battle against C. Difficile. A battle that can take up to six months.

While he visited the Swedish hospital he stressed that cleaners have a very important job, as the bacteria spores can live for several years, can be easily transported across the hospital and cannot be removed by ordinary cleaning.

Changed routines

After Gardam’s visit the hospital changed its cleaning and organisational routines. The disinfectant product that had been used was replaced by chlorine, to be used on all surfaces. Also the interdisciplinary collaboration between wards was scrutinised. Furthermore, the hospital involved all personnel in the project, even those who did not work directly with care. The result has proved sustainable over time.

The national award for the Högland hospital is good news in a country that only recently was shocked by the apparent poor hygiene standards in health care. In December last year the Swedish newspaper Dagens Nyheter (DN) revealed that only seven of Sweden’s 53 largest hospitals adhere to the national guidelines for toilet hygiene, which suggest at least two toilet cleanings a day. The unsettling report showed that some hospitals only cleaned their toilet as little as five days a week.

Compared with petrol stations, fast food chains and airports, hospital washroom hygiene in Sweden is falling behind. The newspaper reported that Statoil’s petrol stations’ policy is to clean the toilet every three hours.

Some hospitals around the country have been previously hit by diseases that have spread due to poor hygiene.