Evaluating the CPE Toolkit

A research group at Bristol in collaboration with PHE have just published an evaluation of the CPE Toolkit. I don’t think any of the findings are especially surprising, confirm that the Toolkit is not implementable in acute NHS hospitals, but provides useful information and guidance to build a local CPE policy.

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Nine decades of antibiotics: a story with two endings…

I did a talk today in Portugal covering the nine decades since Fleming discovered the effects of Penicillium sp. in 1928. I thought it would be interesting to have two endings to the talk: an upbeat one, and a doomsday one.

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Survey: how do you feel about the future of AMR?

I am doing a talk in Portugal later this week covering the nine decades of antibiotics since Fleming’s discovery in 1928. The last part will be about how the next decade of AMR looks globally – I’d like to know how you’re feeling about this so thought I’d run a quick poll.

Cleaning and disinfection survey

See below details of a survey that you may find interesting to complete. I had a small role in providing some feedback on an earlier version of this survey and I hope it will serve to highlight areas that require more thought and / or research…

On behalf of the International Society of Chemotherapy (ISC)  working group on Infection Prevention we would be grateful if you could complete this anonymous survey.

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Endoscope Reprocessing Survey

What-do-you-think

Recent reports of multidrug-resistant infections related to contaminated endoscopes, which have intricate mechanisms and channels that are especially difficult to clean, have raised awareness about the necessity for meticulous reprocessing of all types of endoscopes to prevent the transmission of pathogens to patients.

In response to concerns from various countries about inadequately reprocessed endoscopes and to prevent further transmittal of infections by endoscopes, the ISC Infection Prevention & Control Working Group prioritized this issue in a meeting earlier this year and created a survey on current Endoscope Reprocessing Practices that could be used to compare such practices of institutions around the globe.

We would ask you to share the link to the on-line survey and encourage as many of your colleagues from various health care facilities to complete this. To complete this survey you need to be involved in Endoscope reprocessing activities or know the guidelines and structure of your institutions with regard to Endoscope reprocessing.

Thank you for your participation and for sharing the link!

Link to survey: https://www.surveymonkey.com/r/6ZSGF5L

This checklist was created by the following members of ISC IPC working group. Andreas Voss, Alex Friedrich, Peter Collignon, Moi Lin Ling, Brenda Ang, Wing Hong Seto, Paul Tambyah, Eli Perencevich, Marin Schweizer, Leanne Frazer, Achilleas Gikas, Tom Gottlieb, Joost Hopman, Nikki Kenters, Inge Huijskens, Kalisvar Marimuthu, Rehab El-Sokkary, Yogandree Ramsamy, Margaret Vos, Ermira Tartari, Debkishore Gupta.

Single room survey: results

Following my blog last week reflecting on the debate published in the British Medical Journal on “Should hospitals provide all patients with single rooms?”, I asked the same question to Linkedin and Twitter. My informal poll received a total of 37 responses, which is not the largest survey you’ll ever see but probably a meaningful sample size. Overall, 54% of respondents answered ‘Yes’ and 45% answered ‘No’ (Figure).

single room surveyFigure: “Should hospitals provide all patients with single rooms”. Results from 37 respondents in online polls on Linkedin and Twitter.

An interesting feature of the survey was the difference between Linkedin and Twitter, with two third of respondents saying Yes on Linked vs. only 20% on Twitter. I suspect this is explained by the fact that most respondents on Twitter were frontline healthcare workers, who see first-hand the problems caused by placing patients in single rooms when they’d rather be in a bay, or when it compromises their safety.

As with most surveys, the listening to the comments that people make is probably more important than the answers they give, particularly to binary questions such as this one. The poll promoted some useful discussion on Linkedin, with several comments wrestling with the pros and cons of single rooms. I’ve collated a number of Tweets below, which illustrate the view of many frontline staff that a mixture of single rooms and bays is preferable:

  • Healthcare Infection ‏@HealthcareInfec, 4 Dec: “single rooms- a minimum requirement would be a good start & allows flexibility if needed. Certainly >50%.”
  • AllisonClaireBradley ‏@allisoncbradley, 3 Dec: “No for me too. Get so many requests from patients desperate to move out of isolation.”
  • Craig Bradley ‏@CraigBradleyF1, 3 Dec: “NO for so many reasons. We do well with 36%.”
  • Sue Millward @suemillward1, 3 Dec: “Not all patients want to be alone, Some pts need to be watched! So NO.”
  • Gary Thirkell ‏@pollygary 3 Dec: “depends on speciality. Yes for some and no for others. Ability to adapt the room a possibility.”
  • Infection Control ‏@uhcw_inf_con 3 Dec: “No. Isolation has psychological impact on patients & can effect falls risk amongst other things. Need holistic care.”

Clearly, there are some inherent problems with polls, not least the fact that those with strong opinions are more likely to respond and I have no idea how many people saw the survey and decided not to vote. The roughly 50:50 split in opinion on the single room issue is similar to the survey of patients commissioned by the Scottish government, which found that 41% of patients would prefer to be admitted to a single room.

Should hospitals provide single rooms for all patients? Whilst I would definitely prefer a single room if admitted to hospital, there are some strong arguments for a mixture of single rooms and bays in some specialties. So, I agree with the English recommendation of 50% single rooms as a minimum requirement.