There are times when I hate knowing what I do about infection prevention. A few weeks ago a friend reached out to learn more about C.diff. Her mother-in-law had gone to the hospital with an UTI and pneumonia and contracted C.diff. We talked about transmission, proper cleaning and the need to ensure that proper hand hygiene was being followed - as in if you didn't see the nurse or doctor squirt some hand sanitizer into their hands, ask them to do so! We were going to meet so I could give her some disinfectant wipes that the family could use in the room to clean the bedside rails and other high touch areas.
We never met so I could give her the wipes. Instead last week I attended a visitation. Her mother-in-law at the age of 67 had died of an HAI and her sons, 4 and 6 were wondering what was going on and asking when Grandma was coming back. A life was lost, senselessly. There was a break in infection prevention. Another statistic can now be added to the growing number of deaths that occur each year due to HAIs.
I'm really not sure where to begin. I think we all know what C. diff is. Lee wrote a blog about C.diff back in 2011 that includes links to fact sheets and guidelines. I think we all also know that cleaning and disinfection works to stop environmental transmission. In Sept of last year in a blog titled "Cleaning and Disinfection Works" we reviewed a study looking at just that. In fact, cleaning alone can remove sufficient spores from the surface to minimize transmission (refer to our blog "SOS- Spores on Surfaces" that reviewed a paper by Rutala et al).
It's really not that difficult.
- We need to wash our hands following the principles of the moments of hand hygiene: BEFORE touching a patient, BEFORE an aseptic procedure, AFTER body fluid exposure risk, AFTER touching a patient and AFTER touching the patient's environment.
- We need to clean and disinfect the patient's environment thoroughly and frequently using elbow grease, taking enough time to do the job correctly and not cutting corners because the surface looks clean to the naked eye or because someone is pressuring the housekeeping staff to "hurry up".
- We need to clean and disinfect shared patient care equipment every time after each use.
- We need to practice judicious use of antibiotics.
Sometimes the loss of a single life can be the catalyst for change. As expressed by Mary Elizabeth Frye in a poem in 1932 "Do not stand at my grave and cry; I am not there. I did not die." Let's not accept loss of life from an HAI as the cost of doing business. Let's not accept the fact that while there was a death due to an HAI the overall facility's infection rates are below their standard baseline or lower than similar facilities in the area. Let's work together to target zero. Let's work together so that you do not have to attend a visitation for a friend or family member who was one of the unlucky ones.