The evidence base and infection risks from flowers in the clinical setting

The need for evidence-based practice in health care is now well accepted. Best practice is likely to change over time with the emergence of new research evidence and may be influenced by other factors, such as acceptability to the general public.

Controlled clinical trials supply the most robust evidence, but in the field of infection control trials are often difficult to conduct because of expense (large sample sizes are usually necessary) and ethical constraints. Infection control guidance is frequently based on less robust research evidence and common sense. Occasionally new practices become part of clinical routines despite the lack of supporting evidence. Banning flowers from general hospital wards falls into this category.

Although the water in which flowers stand can become a reservoir of potentially pathogenic bacteria, there is no evidence that they have ever caused hospital-acquired infection and simple precautions can be taken to reduce potential risks. Banning flowers from general wards is not popular with the public and is unnecessary according to the evidence available.