While infection control procedures on hospital wards should be praised for making them safer places for patients, is it possible that many of these routines have made their way into our mindset and become detached from their original purpose? If you don’t believe this can happen, then may I refer you to Leviticus?
In many hospitals these days, visitors are banned from bringing in flowers for patients, supposedly because there is a risk of water carrying infections. But there is no evidence to prove this as long as water is changed regularly. On the contrary, Simon Cohn says that “studies have emphatically concluded that bedside flowers pose no particular threat to health.”1 Emphatically may be a bit strong, given that science cannot prove a null but the evidence may be taken as reassuring. One cannot but suspect that safety and the precautionary principle do not by themselves explain the ban on flowers. Frequently emptying vases can add to the already busy schedules of ward staff, as can clearing up any unexpected spillages caused by vases being knocked over, so perhaps the infection control agenda has taken on a meaning beyond its original intentions.
Visitors to hospitals may also find restrictions on the types of items allowed in waiting rooms. To reduce the risk of infection, soiled magazines would certainly have to be removed and toys should have hard surfaces to facilitate easy cleaning but if you ban these items altogether, it eliminates the need to spend time cleaning and disinfecting.
Another frustration for people coming in to a hospital hoping to visit their loved ones is the restrictions on visitor numbers. Curtailing visitors during cold and flu season reduces the risk of illnesses being brought in to hospital from the community but what about healthy family members coming to a maternity ward to meet their new brother or sister? My grandson Sammy was inconsolate when denied access to his mother and newborn sibling in the maternity ward of the Homerton Hospital earlier this month.
Sadly, these measures can lead to hospitals becoming soulless and leave patients feeling miserable. Has managing infections taken on a social role and become a means of control or a pointless exercise, rather than evidence-based practice? Us researchers are accused of ending every paper with the self-perpetuating plea “more research needed.” However, with the powerful sequencing tools now available, perhaps we really do need to establish the provenance of hospital infections once and for all2 and not give up the comfort of flowers, or visitors and cuddly toys without a fight.
01. Cohn S. Where have all the flowers gone? BMJ 2009;339:b5406 http://www.bmj.com/content/339/bmj.b5406?view=long&pmid=20015906#ref-1
02. Hospital Microbiome http://hospitalmicrobiome.com/ (accessed 7 December 2012)