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Fighting the daily battle against infections in the critical-care unit

Debra Owusu washed her hands with an antiseptic foam after cleaning a room at Sunnybrook Health Sciences Centre in Toronto, Ontario Thursday, November 21, 2013.

Kevin Van Paassen/The Globe and Mail

This is part of The Globe's months-long series on the challenges facing Canadian hospitals. All of our published material has been reported with permission from staff.

There's a row of beds before me, each one holding a patient who might soon exit this world. It's just after 3 on a Thursday afternoon in the critical-care unit at Toronto's Sunnybrook Health Sciences Centre. The department is busy. The beds are full. I am here to talk to Dr. Brian Cuthbertson, Sunnybrook's chief of critical-care medicine, about how the department works to prevent the spread of infections.

It's a critical mission. Researchers estimate that between 8,000 and 12,000 Canadians die every year from hospital-acquired infections. "These patients are extremely unwell," Cuthbertson says, explaining that their compromised immune systems put them at serious risk of contracting Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA) or other infections that thrive in hospitals.

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In the critical-care unit, each patient is assigned his or her own nurse. The ratio of patients to doctors is about two to one. Physiotherapists, respiratory therapists and other health-care professionals are also a constant presence. They can all unknowingly spread infections from patient to patient.

The threat of infection is made more serious by the fact that many of the beds are located in a wide corridor that faces the central nursing station. The beds are separated by standard hospital curtains, reminiscent of a time before SARS and superbugs and the widespread knowledge that, in an ideal world, the sickest and most vulnerable people would be kept in private rooms.

In the open corridor, the perimeter surrounding each bed is marked with red tape, reminding staff that once they enter or leave a patient's "zone" they need to wash their hands and undertake other infection-control procedures. Protocol further restricts anyone who works here from wearing rings, watches, bracelets or even having shellac manicures. Cuthbertson jokes about his wife's displeasure that his job forces him to leave his wedding ring at home. In addition to their illnesses, patients are made vulnerable by the treatments needed to save their lives. Medication lines go through a patient's skin, breaching their natural defences.

"It's almost the perfect storm, sadly," Cuthbertson says. Just outside the door, family members cluster in the waiting area, holding a silent vigil for their loved ones inside.

Follow me on Twitter: @carlyweeks

What are your thoughts? How should hospitals fight the spread of infections?

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