Florence Nightingale approach 'could help fight infection in modern hospitals'

Her renowned nursing skills were honed on the dirty and chaotic battlefields of the Crimean war. But Florence Nightingale could still teach modern hospitals a thing or two about infection control, according to an expert. Dr Jack Gilbert, head of an international project to categorise all known bugs, said modern hospitals could lower rates of infection by being slightly less sterile. Sterile conditions in wards and operating theatres may be doing more harm than good by wiping out organisms that keep dangerous microbes at bay, he believes.

Opening windows and allowing fresh air into wards could boost populations of "good bacteria" which help keep harmful bug populations under control, he explained. Dr Gilbert said: "There's a good bacterial community living in hospitals and if you try to wipe out that good bacterial community with sterilisation agents and excessive antibiotic use you actually lay waste to this green field of protective layer. Then these bad bacteria can just jump in and start causing hospital borne infections". The theory mirrors advice from Florence Nightingale who her 1860 work "Notes on Nursing" wrote of the importance of keeping patients' windows open and allowing a breeze in.



She wrote: "Always air from the air without, and that, too, through those windows through which the air comes freshest. From a closed court, especially if the wind do not blow that way, air may come as stagnant as any from a hall or corridor." Although her advice was based on the need to clear stagnant air from sick bays and not an early breakthrough in microbiology, Dr Gilbert said it could still hold true. Speaking at the American Association for the Advancement of Science (AAAS) annual meeting in Vancouver, he said: "Florence Nightingale said if you have an open window where air from the environment is coming in, you'll have less illness."

Dr Gilbert said a colleague who moved from Chicago to Venezuela had found that his new patients acquired fewer infections even though he was conducting operations at field stations with unsterilised equipment. A study published last month by University of Oregon scientists found that rooms in clinics where windows were left open had a wider range of bacteria, while those that were kept sealed had a higher proportion of potentially harmful germs. Prof Mark Enright, a microbiology expert from Bath University, said ensuring a good air flow in hospitals was important, but said that describing them as too clean would be "quite an extreme view".