Hygiene and infection prevention in gynecological practice. Requirements and observations

In gynecological practices a wide variety of patients are treated including healthy pregnant patients, patients with as a rule unknown colonization by multiresistant pathogens, patients with infectious diseases, in particular sexually transmitted diseases (STDs) and patients with severe cancerous diseases. Appropriate hygienic measures are necessary to avoid transmission of pathogens and infectious diseases to the medical personnel and subsequent patients. The most important aspect is hand hygiene. Gynecological practices are in a special situation in that a large number of examinations are carried out with contact to mucous membranes which necessitates adequate hand hygiene (e.g. protective gloves and hand disinfection) and reprocessing of instruments (e.g. specula). During inspections by the Department of Health in Frankfurt am Main nearly 50% of practices were found to have substantial problems in cleaning and disinfection of instruments which had to be corrected either by improved reprocessing of medical products or by using disposable materials. The guarantee of good hygiene is the responsibility of the owner of the practice and the personnel themselves for the protection of the patients and personnel from infections and last but not least also for protection against complaints or legal processes.