Hospital washroom hygiene is a critical yet often overlooked aspect of patient safety and infection prevention. Contaminated washrooms can become breeding grounds for pathogens, significantly increasing the risk of Hospital-Acquired Infections (HAIs). These high-risk areas — with constant moisture and frequent use — can harbour a wide range of bacteria, fungi and viruses, posing a serious threat to immunocompromised patients as well as healthcare staff. Dr Smrutilata Sahoo, Consultant Microbiologist & Infection Control Officer, Ashwini Group of Hospitals, shares her insights on ways to safeguard everyone in a hospital environment.
Hospital washroom hygiene is not just about cleanliness; it is about patient safety and infection prevention. When protocols are lax or monitoring is inconsistent, we put both patients and healthcare workers at risk. A well-designed strategy, regular audits and awareness among all stakeholders are key to keeping these high-risk areas safe.
— Dr Smrutilata Sahoo
The primary challenge lies in hospital washrooms themselves. Surfaces such as toilet seats, taps, flush handles and door handles can easily harbour dangerous microorganisms. Inadequate cleaning and poor hand hygiene can facilitate the spread of gastrointestinal pathogens through faecal-oral transmission.
Pathogens can also spread through contact with contaminated surfaces, affecting both patients and healthcare workers. In addition, flushing toilets without lids can aerosolise microbes, dispersing them onto nearby surfaces. Stagnant water in sinks or on floors can also become a breeding ground for waterborne pathogens such as Pseudomonas and Legionella.
Having a Strategy
A robust hospital strategy for infection management in washrooms requires a multi-faceted approach, beginning with proper infrastructure and design. Hospitals should have non-porous, easy-to-clean surfaces for floors, walls and sanitary fixtures. The use of hands-free fixtures, such as sensor taps and foot-operated flushes, can significantly reduce the risk of cross-contamination.
Proper ventilation and exhaust systems are crucial to prevent the build-up of bioaerosols. In addition to design, strict cleaning and disinfection protocols are essential. Washrooms in critical patient care areas should be cleaned hourly, while those in general wards should be cleaned every two to three hours or as needed.
The choice of cleaning agents is also vital, and effective disinfectants such as 1% sodium hypochlorite should be used for commodes and sinks.
Lack of Standardised Protocols
Without clear and documented procedures, washroom hygiene can be inconsistent and ineffective. The absence of a systematic schedule for preventive maintenance and sanitation can lead to overlooked areas and a higher risk of contamination.
Hospitals must establish a clear strategy for infection management that includes documented schedules for cleaning, disinfection and maintenance. This includes providing adequate hand hygiene facilities such as soap, hand rub and paper towels.
To ensure accountability, the administration and infection control teams must work together to conduct regular cleaning, disinfection and monitoring of high-touch areas. Periodic audits of washroom hygiene and infection control compliance are also essential to identify and address any lapses.
Inadequate Monitoring
Even with protocols in place, continuous monitoring and training of staff are often neglected. This can lead to non-compliance and a false sense of security regarding hygiene standards. Moreover, patients and visitors may not be aware of their role in preventing infections, leading to improper use and contamination of washroom facilities.
To maintain a high standard of cleanliness, periodic audits of washroom hygiene and infection control compliance must be conducted. These audits help identify non-compliance and ensure corrective actions are taken promptly. In addition, educating patients and their attendants is a vital component of infection prevention.
Visual instructions on proper hand hygiene should be displayed in washrooms, and patients should be encouraged to report any soiled or malfunctioning facilities. By ensuring that staff are well-trained and that patients are aware of their responsibilities, hospitals can create a shared environment of hygiene and safety.
