Hand hygiene is undeniably an essential element in any hospital infection control and prevention program. However, according to a recent STAT piece, sinks may actually be aiding in the spread of infection.
First off, the water coming out of the sinks can be contaminated with bacteria. One clinician from Canada shared an anecdotal story of an infection outbreak eventually tied back to sinks in the intensive care unit — the sinks' faucets sent water straight down the drain, causing tiny drops of water to splash up into the air and on porous surfaces nearby, thereby spreading bacteria and causing infections.
"Some of the stuff we've learned … is: Don't have the gooseneck [faucet] drain directly into the drain; have it drain off to the side of the bowl. Don't allow it to splash. Make sure it's deep enough that it can't splash on you and splash on your clothing. Make sure that the stuff around [the sinks] is waterproof," Michael Gardam, MD, director of infection control at Toronto-based University Health Networks, told STAT.
Beyond bacteria in the water, the other main infection control problem with sinks is that their pipes and plumbing are the perfect place for bacteria to grow into biofilms.
"Once you have the biofilms there, short of ripping the sinks and the piping out, it's impossible to get rid of," Alex Kallen, MD, who is with the CDC's division of healthcare quality promotion, told STAT. He did note it is yet unknown what role these biofilms can play in spreading infections, however.
Because of issues inherent with sinks, many healthcare providers are turning to alcohol-based hand sanitizers to clean their hands instead.
The CDC recommends healthcare providers use hand sanitizer instead of soap and water in most instances. In fact, it says to use hand sanitizer except in the following situations:
- When hands are visibly dirty
- After treating a patient with known or suspected exposure to Clostridium difficile or if the facility is experiencing an outbreak
- After treating patients with known or expected norovirus
- After known or suspected exposure to Bacillus anthracis
- Before eating
- After using a bathroom