Healthcare Associated Infections have become an insurmountable challenge.  Tens of thousands of patients die every year around the world, despite the best efforts of dedicated professionals. Numerous international conferences are held and experts dedicate their lives to searching for ways to reduce the number of deaths. Progress is being made. In Britain, it’s now reported that the antibiotic resistant MRSA is causing fewer infections than MSSA, its more antibiotic susceptible equivalent.

How relevant is that to a family who has just lost a loved one to MSSA? It isn’t. Their family member is dead and that’s final. It’s actually confusing if they’re told their relative died because of a bacterium that was easier to control than the more antibiotic resistant version. The whole topic raises questions, most of which the infection control profession finds it a challenge to answer. After all, those professionals are almost certainly following best practices. Is it their fault if they’re doing the best possible and people still die from needless infections? Is it reasonable to ask them to do more?

I ask them to do less! I argue that with less effort they would achieve a lot more, if that reduced effort was directed differently. There is ample evidence-based-research showing the number of deaths from HCAIs when professionals use the best practices perspective. It takes an enormous amount of effort to reduce the death count by 10, 20 or even 50%. And even if you achieved 50%, it still leaves thousands of needless deaths. We can’t say how many patients are saved by current best practices but we know how many were failed by them. All that work, effort, dedication and best practice; and still patients die in their thousands. That’s dispiriting with frustrated professionals frantically looking inwards for even more answers. Sadly, that viewpoint hasn’t protected the victims.

I suggest another viewpoint which is, by definition, different to the one which is failing. This is a mental exercise intended to raise new questions in the expectation of new answers that will make a difference. Try looking at the HCAI issue from the perspective of the infection cycles being broken so these infections were very rare events. Remember, this is a mental exercise and one which most infection control professionals have never tried. Give it a go. What would your reaction be if we expected no needless infections and a few hundred happened anyway? Would you be looking for clues in different places than you are now? If so, you now have more ideas than you did before the exercise. Some of those ideas will induce new questions, a proportion of which will reveal useful answers.

Would the new answers require less effort? If not, try the exercise again. If so, implement the answers.

Now ask a question about your past efforts. Had you been following best practices or just the best of the available practices?

Dr Harley Farmer PhD BVSc(hons) BVBiol(path) MRCVS

CEO NewGenn Ltd, author, public speaker, Master Practitioner in NLP

 

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