April 26, 2011

Superbug: Doctors can hang their white coats

Doctors and white coats. For years, the white coat has been the iconic symbol of doctors. But, the state health department may restrict the use of white coats for doctors at government hospitals as the coats have been shown to increase infection rates.

A recent study by the liver transplant team at Government Stanley Hospital showed that doctors' coats, ties and stethoscopes carried mircrobes including superbugs,' which are antibiotics-resistant bacteria. It showed that even if doctors follow stringent handwash protocol, the microbes may settle down in their sleeves, watches, finger rings and ties.

As part of a pilot study, doctors in the team were then asked to use disposable aprons and gloves or simply be naked below the elbow. They washed their hands thoroughly, separated patients with infections, restricted visitor entry and ensured clean air flow in sterile wards. Patients who came to the hospital with infections or who had developed them at the hospital were shifted to a septic ward to prevent others from getting infected. The department reduced infection rate by 80% in six months and reduced antibiotic prescriptions to 6%, says pathologist Dr Rosy Vennila, who worked on the project. "It's a practice we are now addicted to," she said.

In other wards of the hospital the use of antibiotics is at least 70%. The team submitted its recommendation for infection control in all government hospitals. It has said that doctors must be allowed to hang their coats. "We may ban white coats in all government hospitals. It's safe to prevent than cure," said health secretary VK Subburaj, on the eve of the World Health Day. The theme for this year is anti-microbial resistance, and international agencies like WHO have called for action.

At the Global Hospitals, for instance, doctors in the hepatology unit remind staff nurses to use antiseptic sanitisers. "There is a nurse on duty just to do infection audits," said Dr Olithselvan, hepatologist, Global Hospitals. If patients are infected, most hospitals are now insisting on a blood culture test to ensure they are giving the right antibiotics. "When we choose the right antibiotic, we kill the bug. If we don't, there are chances we will teach the bug to fight some drugs," said Apollo Hospitals medical superintendent Dr Bhama. "In some cases, giving wrong antibiotics can be fatal," she said.

Hospitals say that rules for infection control are constantly evolving. For instance, Apollo hospital has only selectively restricted white coats. They are not used in intensive care units. Apollo wants to do away with white coats in wards, too. "But coats have for long been identified with doctors. We fear it may become difficult for patients identify doctors in a crowded ward," said Dr Bhama.

Link: Original Article

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