After years of no recent international guidelines to prevent SSI, today (November 3rd,2016), WHO published the first ever Global guidelines for the prevention of surgical site infection. They include a list of 29 concrete recommendations that are available on the WHO website (link). The recommandations are also available as publication in Lancet ID, split into 2 documents: 13 recommandations specific tot he pre-operative period (link); 16 recommendations specific to the intra-operative and post-operative periods (link).  I have seen drafts of the HICPAC guideline and would assume that this guidelines should be released soon, too, which will be interesting as I can’y wait to see the differences.

Working on the principle that what goes up must come down is logical and I was interested to see the result of a small investigation into non-slip socks, currently in vogue for reducing harm due to falls. Nik Mahida and Tim Boswell collected socks from seven wards over two hospitals, collecting 54 pairs and sampling them the same day. The results were interesting. Continue reading →

In the mood to up your epi skills?  This is the new ESCMID-SHEA course that was given for the first time in Australia last year (at least the first two tracks). It consists of a plenary part and 3 separate tracks. The first track is a practical exercise how to analyze a high rate of surgical site infections. Based on the results you have to draw conclusions and decide on an intervention. Finally you will determine if this has been effective.

The second track is a practical exercise how to analyze a possible outbreak with Clostridium difficile. Based on the results you will identify possible risk factors and routes of transmission. Finally you will take control measures and determine the effects.

The first two parts will require the use of a laptop with SPSS (for at least some of the participants) as participants will actually solve the problems. Don’t worry help is around, data-sets cleaned and the syntax is (just in case) written. It is actually a great way to get back into SPSS use.

The third track consists of four interactive master-classes. Faculty members will show some practical situations, which they have encountered during their careers. It will include outbreaks, high endemic rates of healthcare related infections, infections in the operating theatre and other topics.

Have a look at the folder:  Training Course in Healthcare Epidemiology and Infection Control. While part of the faculty, Eli and I will probably not be around this year, as we transfer the old course (October 2016, Vietnam) to a new faculty of (even) younger colleagues.

I’m always interested in why people don’t do what they know that they should or why things don’t happen as we think they will. Interventions that are demonstrably effective, evidenced in the literature and incorporated into guidelines are not implemented even though ‘it’s in the policy’. We have to remember that implementation often has many sides. We can spend a lot of time designing an effective intervention based on the most robust evidence and then it just doesn’t happen on the shop floor. Sometimes this is failure to engage the staff that will actually implement the measure, but what about the involvement of those to whom the deed is done? A simple two-letter word can stop healthcare provision in it’s tracks. That word is ‘No’.

Continue reading →