Wringing Our Hands Over Infection Control
February 07, 2008 05:19 PM ET | Avery Comarow |
A number of thoughtful comments arrived concerning my January 23 hand-washing post, about a study showing that a much-increased rate of hand-washing is no guarantee that a hospital's infection rate will budge, let alone dive. A couple of correspondents (notably anesthesiologist-blogger Counting Sheep and hospital-CEO-blogger Paul Levy of "Running a Hospital") contributed thoughts that might prevent a few infections here and there.
The following came as a real letter, if also as an E-mail attachment, from Kathy Warye, another CEO. She runs the Association for Professionals in Infection Control and Epidemiology, whose obvious interest in this subject makes her note very welcome.
"Mr. Comarow makes a critical point that even the single most effective intervention (in this instance, hand hygiene) alone can't solve the problem of healthcare-associated infections. Certainly, even the best hand hygiene compliance only gets us so far.
Lessons learned from our 12,000 members who manage infection prevention programs in healthcare facilities around the world tell us that to reduce the risk of infection and protect people coming into hospitals means adopting a full range of strategies. The first step, from a facility-wide perspective, is conducting a proper risk assessment. Good infection prevention and control professionals don't just know their patients—they know their hospital, they know which areas are at high risk and where there may be hidden reservoirs of bacteria, be it the ER or the OR.
System-wide adoption of proper hand hygiene, contact precautions including use of gloves and gowns, and the "checklist" for device-related care that is receiving so much attention of late are among the tools known to be effective in preventing healthcare-associated infections."
Amen! The single largest source of untreated water in any hospital is its HVAC system. For Critical Care Units aerving the most immune compromised patients, we must eliminate the HVAC as a reservior for pathogens. While VIGILAIR is not a panacea, neither is washing hands. Our technology needs to complement other technologies and institutional efforts for infection control.