The WHO method for hand hygiene is very well embedded as the ‘gold standard’ for hand hygiene technique. But is it feasible to perform every time in the busy clinical environment? A new study in Clinical Infectious Diseases seems to suggest that a shorter, simpler hand hygiene method be just as effective and more feasible in the real world.
BMC Medicine has published some research from our group reporting the findings of a mathematical model comparing various approaches to screening for CPE carriage. The model compared how several operational metrics varied with different approaches to screening (‘slow and cheap’ laboratory culture vs. ‘fast and expensive’ PCR) and in various specialties with variable levels of compliance with CPE admission screening and at various levels of admission prevalence of CPE. The main conclusion was that culture proved to be the best approach in most scenarios, balancing risk and resource.
I made a flying visit to HIS today in Liverpool to have a debate with Prof Mark Wilcox on whether or not antibiotics are the most important factor in healthcare-associated C. difficile infection. Mark was arguing for the motion, and I was arguing against it. And the result…well you’ll have to read to the bottom!
The global dynamics of antimicrobial resistance (AMR) are extremely complex, but we usually focus on the selective pressure created by antibiotic consumption and spread of resistant strains. The brave ones amongst us (or the ignorant) try to disentangle all the facets of global AMR dynamics, and even attempt to quantify the relative contribution of each of these factors. Well, some brave investigators tried to do just that and published their findings in Lancet Planet Health. Perfect Journal Club material. Continue reading
The 2018 ESPAUR report was published a few weeks ago. It’s freely available for your perusal here, and packed full of juicy info. Here’s a few reflections on the report.
Compared with the general population, healthcare workers (HCWs) have an increased risk of being exposed to respiratory pathogens including flu, causing a potential threat for their own health and their patients’ safety. At present, the problem of HCW vaccination seems to get the main attention when dealing with influenza prevention, whereas the problem of HCWswho work while feeling sick, seems to be far less addressed. That is, until recently when Chow et al. studied hospital-acquired respiratory viral infections, sick leave policy, and a need for culture change.
The ISAC Infection Control Study group had already piloted a survey on the topic and wishes to poll your thoughts with the present survey.
While there is nothing to earn, except of the good feeling of having helped someone, we kindly ask you to take the questionnaire (takes 4-5 minutes) and send it to others, including friends or family not in healthcare, as we are especially interested in possible differences.
Link for the survey: https://www.surveymonkey.com/r/ISAC_Influenza
Thanks for helping and of course results will be back on this blog.
A paper has just been published in ARIC as the first academic output of the Healthcare Cleaning Forum. I blogged earlier this year to relate the inaugural Healthcare Cleaning forum, and this paper expands on the key themes: establishing environmental hygiene as a patient safety initiative, providing an overview of the importance of environmental hygiene in healthcare, exploring the human factors driving the standards of environmental hygiene along with the need for effective education, the possibilities and challenges of automation, and the cost and value of environmental hygiene.
One of the key aims of the forum is to be a champion for environmental hygiene professionals. There’s a famous story of when president JFK visited NASA and asked a janitor who was mopping the floor what they were doing. The answer was simple and profound: “I’m helping to put a man on the moon.” If you asked somebody working in environmental hygiene in your hospital what they were doing, would the response be: “I’m helping to maximise patient safety and prevent healthcare-associated infection.” Probably not. We need to champion the cause of environmental hygiene professionals, who lack professional status, are often not paid enough, and often have limited options for career progression.
Is environmental a treasured investment priority in hospitals?
Related to this is our perception of the cost and value of environmental hygiene in hospitals. Is our level of investment appropriate given the risks associated with inadequate environmental hygiene in hospitals? Would we really find highly valued cleaning and disinfection materials in the metaphorical safe of a hospital manager (see the cartoon above)? Probably not! We need work towards better evidence to understand the value of environmental hygiene in hospitals in the context of other investment priorities.
