One of the prime measurements of the standard of care is the cleanliness of the healthcare facilities. The key indicator of patient’s satisfaction is connected to his/her perception of cleanliness in health care facilities. Maintenance of hygiene and cleanliness of health facilities is not only related to aesthetics and patient contentment, but it also decreases the incidents of Hospital Acquired Infections (HAI).  Keeping a hospital clean needs participation from the hospital staff, along with the patients and their relatives.

In the health care facility, maintaining cleanliness varies from conventional cleaning. Health facilities are necessary to continue utmost cleanliness for reducing the growth of infective organisms, which can grow between patients, guests and hospital staff. Generally, public health facilities are discerned to be disagreeable and unhygienic with poorly maintained buildings, over-flowing drains, presence of dogs/cats/rodents inside the hospital, grazing cattle within the campus and patient care areas & often dirty /non-functional toilets.

There are some key factors which contribute to unhygienic conditions in health care facilities such as inappropriate facility design, obsolete equipment, consumables and erratic supplies, the gap in human resources intended to maintain cleanliness that relates to numbers as well attitudes and motivation level, deficiency of community ownership of the facility for the upkeep and maintenance, power infrastructure, non-availability of 24 X 7 water & power supply.

Good hygiene or cleanliness is a necessary factor for the promotion of good health. The significance becomes much more in a hospital setting, where ill patients come to restore their health. Hospitals provide cure to the patients. But, they also become possible sources of spread of infection if patient concerned are not vigilant sufficient. If a patient is hospitalized for several other issues, say cardiac failure, he/she has a high chance of acquiring several infections in the hospital.

The infection may spread from one patient to another patient, and it may also spread from a patient to a nurse or a doctor. A medical practitioner or healthcare personnel can also infect another patient. The microbes in charge of hospital obtained infections usually cause more intense sickness and are resistant to the more conventional antibiotics being used. The most common diseases and spread in a hospital are pneumonia, urinary tract infections, diarrhoea diseases and still chronic infections such as HIV/AIDS and tuberculosis.

There can be various ways through which the prevention of spreading the infection from one patient to another patient can be prevented

• The hospitals can make sure that the beds of each patient are separated by an appropriate distance.
• Every ward should get the right amount of sunlight as most of the disease generating bacterias are killed by strong sunlight.

Keeping the facility safe for visitors of the patient and the health care staffs should be a priority for each and every hospital. The following can also be adopted:

1. Focus on High-Touch Areas

Every hospital administrator should direct hospital staff to focus on the most-touched surfaces such as doorknobs, remote controls in patient’s rooms, bed rails and phones. As many people have touched these areas, there is a higher likelihood of hazardous bacterias presents there.

2. Less use of Chemical Content

Abrasive chemicals can annoy patients’nasal passages and damage the skin of cleaning employees and hospital staff. This means that the most effectual cleaning scheme is also safer.

3. Avoid Cross-Contamination

Almost certainly the main challenge for health care cleaning crew is detaching and disposing of contaminants right away they are in the hospital. Rags and mops are approximately guaranteed to bring bacteria to other parts of the hospital.

4. Wear Gloves Properly

The inappropriate use of gloves spreads hazardous bacteria. The cleaning crew must wash their hands after removing gloves. Gloves must always be changed between patients, should never be well-worn in hallways, and should be changed when in motion from a residential district to a shared restroom.

A health care has various stakeholders such as community, patient, hospital staff, district administration and health department. Their sensitization would be vital for ameliorating the cleanliness of the health facilities. The detail that the facility is signifying“for the people” must be appreciated by and hold-ups “by the people”.

The patients and the visitors can contribute too:

Do’s

1. More and more water bins should be set up by the hospitals
2. It is the duty of every person who is visiting the hospital to follow the guidelines of the hospital.
3. The visiting facility should be instructed to wash hands before and after a visit.
4. Use of public convenience.

Don’ts

1. A person should not smoke, especially in public or the prohibited areas.
2. A person should not spit around.
3. The person is not allowed to litter.

The Healthcare staff plays a crucial role in the implementation of these Guidelines.

1. Keep the hospital property clean
2. Use prevention measures to control Infectious Diseases
3. Spread awareness about the advantages of cleanliness
4. Follow waste disposal methods.

All the health care organizations and hospitals must devote sufficient resources to sanitation services, such as:

1. A person should be assigned with the overall responsibility for the sanitation services of the hospital.
2. Written processes for cleaning and disinfection of patient care areas and other areas.

• Defined responsibility for a particular matter and regions.
• Procedures for every day and discharge/ shift cleaning and disinfection.
• Cleaning and disinfection standards and occurrence.
• Procedures for cleaning in construction areas.

3. Continuing education and education of sanitation workers.
4. Ongoing review of procedures.
5. Supervision of the employees who are indulged in cleaning by those who are trained and knowledgeable in cleaning practices and standards.

S.K. Garg vs the State of U.P.

In Allahabad, the conditions of the government hospitals are terrible. The complainant had registered a complaint against the hospital. In his complaint, he mentioned about the conditions of the hospitals which included the pitiable nature of services available in government hospitals and inadequacy of blood banks, unavailability of medicines’, worn down X-ray equipment and unhygienic circumstances. The Allahabad High Court stated that the public hospitals in Allahabad are appalling and distressing sanitary and hygienic conditions. The public hospital needs some improvement. There are many complaints which had been registered against the Government Hospital staff. They are often in collusion with the medical practitioner who runs a private clinic.

Further, the court ordered that every individual has a right to get proper medical treatment. Also, the right to health is a part of the right to life which is guaranteed by Article 21 of the constitution of India.

The movement of micro-organisms between patients via the hands of healthcare employees is a primary contributing factor through which infections in a hospital increases. There are many products have been initiated into hospitals to assist improve patient hygienic conditions.  The hospital staff has to use lighter cleaning techniques before trying more forceful methods. The cleaning should be carefully intended to make efficient use of time. In many government hospitals, there is poor sanitation and lack of primary medical facilities such as stretcher, wheelchair and ambulance. Every hospital’s necessary function is to make sure that the hygienic facilities provided are abundant so that the patients, as well as the hospital staff and patients, are prevented from infections and other dangerous bacterias.