As mentioned last week, the original focus of my blog was going to be on the apathy of some or many (depending on your perception) toward the importance of cleaning and disinfection and the impact that choosing the right disinfectant can have on HAI rates or patient and employee safety.To some apathy may seem too strong or harsh a word to use in describing people's perceptions of cleaning and disinfection. Apathy implies a lack of interest, a lack of concern or a state of indifference. Certainly, there are many who, like me are wildly passionate about the importance of cleaning and disinfection and choosing the ideal disinfectant. The truth remains, however, that there are just as many people who do not care. There are just as many people who believe they cannot effect change so do they nothing, and just as many people again that plainly think cleaning and disinfection is someone else's responsibility.
The event that started me down this discussion of apathy was a death. A death that should not have happened. A death that could have been prevented with proper cleaning and disinfection and proper hand hygiene. It's ironic that more than 195 years ago Semmelweiss identified the importance of hand hygiene and the role that it can play in stopping the spread of infections. It was certainly a tenet that was taught to my mother in nursing school, yet one that we still struggle today with actually doing. We know we should, yet we too frequently make excuses for why we did not.
When it comes to cleaning and disinfection we are no better. In a study published in 2013, Donskey conducted a review of the literature to determine if we had sufficient evidence to prove that improved cleaning and disinfection could reduce HAIs. Donskey concluded, "although the quality of much of the evidence remains suboptimal, a number of high-quality investigations now support environmental disinfection as a control strategy. Based on these data, current guidelines for pathogens such as C. difficile, MRSA, VRE, and norovirus emphasize the importance of environmental disinfection as a control measure." It's not rocket science. In fact I was in a facility today that has seen a reduction in their HAIs by changing to a more effective disinfectant and improving their cleaning practices. They understood the need to improve their cleaning and disinfection practices, empower their staff to take pride in their cleaning and disinfection and are now reaping the rewards of reduced HAIs. Certainly a far cry from the facility who, "doesn't care what product is used because they're not the ones paying for it".
I wonder, would we still make excuses or still be apathetic if we were forced to apologize to the patient who is suffering from an HAI, or to a family member that lost a loved one as a result of our indifference toward hand hygiene or cleaning and disinfection? As parents we teach our children to own up to their mistakes and apologize for their bad behavior. Perhaps it's time we were made to own up and apologize for our bad behavior.
Just do it! Hand Hygiene works. Cleaning and disinfection works. Let's stop being apathetic. Let's work together to effect change.