The idea that cleanliness is next to godliness is ancient, long predating John Wesley’s 1778 sermon.
Listening to Maryanne McGuckin, however, it is evident that while parents expect cleanliness of (and for) their children, American adults and health care workers often give themselves a pass.
They should not. Giving short shrift to cleanliness — frequent and thorough hand washing and wound cleaning — is an invitation to infections causing serious illness and increasingly death. So, too, is the overuse and misuse of antibiotics.
At 3 p.m. Saturday in the Hall of Philosophy, McGuckin, founder and president of McGuckin Methods International and an international authority on infection prevention, will talk about “Staying Alive in the Healthcare System.”
Author of The Patient Survival Guide: 8 Simple Solutions to Prevent Hospital- and Healthcare-Associated Infections, with Chautauquan Toni Goldfarb, McGuckin is a leading proponent of patient advocacy and empowerment worldwide. In addition to these eight infection-related solutions, she will present practical strategies for anticipating and preventing error in hospitals and healthcare-associated facilities.
“There are genuine tools that will help people feel empowered during their next doctor’s visit, in the hospital, and before surgery,” McGuckin said. “They should definitely know what to ask aside from, ‘Do you take my insurance card?’ ”
People should also be cognizant of the infection potential in other healthcare-associated facilities. For example, when her son was a baby, McGuckin received a grant to look at day care centers in her area.
“Really early in the morning and late in the day — when parents are dropping off and picking up their children — they look like really nice places,” she said, “but not in the middle of the day. For instance, cribs that must be three feet apart are crowded together, and babies are lifted across other cribs.”
McGuckin said she recommends parents drop by day care centers when they’re not expected to be there. She also advises mixing up visiting days and times for family and friends in nursing homes and rehabilitation centers.
All three venues are notorious for infections, McGuckin said.
“People have no idea how soft the guidelines are,” she said. “Workers are not paid well, so there’s real fast turnover.”
She also said routines are noted; hygiene is typically at its best when visitors are anticipated.
The opposite is true for baby nurseries, which McGuckin said are the best places for infection control.
“If there’s a problem, parents will say something and healthcare workers are vigilant,” she said. “In infants, they see years of life ahead. In nursing homes, they see years behind.”
For more than 40 years McGuckin has been on a mission to help patients avoid infections from pathogenic microorganisms that invade the body through the eyes, nose, mouth and skin breaks. In the American healthcare system, preventable infections caused by viruses, fungi and “bad” bacteria are common.
Although antibiotics are used in the treatment of bacterial infections, McGuckin said they are not effective for viruses. Bacteria are microscopic cells; viruses are much smaller molecules of DNA or RNA that live within cells, where antibiotics cannot penetrate.
Throughout the world, bacteria are generating new strains that are immune to ordinary antibiotics. Often referred to as “antibiotic-resistant bacteria” and “multidrug-resistant pathogens,” they are especially troubling. The most common of these super bugs are the bacteria MRSA (methicillin-resistant Staphylococcus aureus), VRE (vancomycin-resistant Enterococcus) and Clostridium difficile (C. diff.).
In day care and rehabilitation centers, nursing homes, outpatient clinics and hospitals, “you can see ants,” McGuckin said, “but you can’t see bacteria with the naked eye.”
Left unchecked, these unicellular bacteria reproduce by growing, dividing in two and creating colonies comprising many cells. Misuse and overuse of antibiotics, and poor hygiene, have created the conditions for turning science fiction horror stories into real life.
McGuckin will share several science- and evidence-based recommendations for minimizing exposure to harmful healthcare-associated infections.
After earning her undergraduate degree in medical technology, a master’s degree in microbiology, and a doctorate in science education from the University of Pennsylvania, where she specialized in hospital epidemiology and infection control, McGuckin focused on improving healthcare quality, hospital safety and patient advocacy.
She has been on the faculty and staff of the University of Pennsylvania for more than 40 years, a visiting researcher at Oxford University in England, and a faculty exchange professor at Belgium’s Katholieke University. McGuckin has also published numerous articles in peer-reviewed journals, and served as an expert source for several prominent U.S. print and broadcast media, such as The New York Times, The Washington Post and “60 Minutes.”
With funding from Dial, McGuckin moved away from collecting statistical information about infection rates and putting out infection-related fires. She sought a more proactive and patient-centered approach and, in 1999, created Partners in Your Care at the University of Pennsylvania, a hand-hygiene program used in hundreds of hospitals to reduce the spread of infections and infectious diseases.
McGuckin’s success has been recognized nationally and internationally. She served on the U.S. Centers for Disease Control and Prevention task force that developed Guidelines for Hand Hygiene in Health Care Settings in 2002, and was lead author of the patient empowerment section of the World Health Organization’s 2009 Guideline for Hand Hygiene in Health Care.
Whether or not cleanliness is next to godliness, McGuckin is convinced that hand cleaning is imperative.
“In 1847, [Ignaz] Semmelweis showed that, with hand washing, you don’t get infections,” McGuckin said. “Healthcare workers forget, or say their hands get irritated. Gloves don’t replace hand washing; they’re easily contaminated.”
People need not die from a hospital- or healthcare-associated infection to be seriously affected. They can be put on an IV, lose six weeks of work, and see $40,000 to $50,000 added to their bills.
“Not everyone dies, but the outcome is bad,” McGuckin said.
There are ways of making frequent hand washing fun, or at least less onerous. According to McGuckin, in restrooms in the Atlanta International Airport one can hear “Row, Row, Row Your Boat” or “Happy Birthday to You” played repeatedly. While she hasn’t seen any signs explaining why, both tunes last 15 seconds, the minimum time one should spend washing one’s hands.
“We don’t need to use soap and water,” McGuckin said. “In Europe children are given a rough paper towel and told to rub their hands. Friction causes bacterial cells to break down. In the U.S. we have gone to extremes with antibacterial soaps in the house. Soap and water is fine, and hand sanitizers when we’re in public places like airports.”