Tuesday, May 24, 2016

Mexican Congreso Nacional de Infectología y Microbiología Clínica

I am currently in Monterrey, Mexico at the Mexican Congreso Nacional de Infectología y Microbiología Clínica.

The official congress program starts on May 25th, my 1st lecture on healthcare personnel attire is at 1 pm.

Here are some random images of Monterey today. Hot, humid, scenic.

Sunday, May 22, 2016

Hand Hygiene on TED- Social Learning, Mindfulness and Heartfulness

Here is the challenge of hand hygiene seen from a different perspective. In this TED Talk on hand hygiene by Dr. Sanjay Saint, the concepts social learning and mindfulness are explored.

The challenge to hand hygiene promotion goes beyond the obstacles of organizational constipators and resistors.  He argues for social learning to guide hand hygiene practice and for creating a culture that refuses to accept anything but the highest standard of care. Also, Dr. Saint argues for mindfulness, which leads to heartfulness in which kindness, compassion and connectedness motivates high quality hospital care, including hand hygiene.

The concepts are both nuanced and valid. Implementation to scale is likely very challenging. 

I am intrigued about the compliance of hand hygiene practice at Dr. Saint's hospital and about his success in advocating heartfulness as a motivator of best practices.

On Tuesday the 24th of May I am off to the Mexican Congreso Nacional de Infectología y Microbiología Clínica.

Saturday, May 21, 2016

Universal Personal Protective Equipment Pro/Con Debate: SHEA Spring 2016 Conference

Today I had the honor and pleasure to debate Dr. Anthony Harris of the University of Maryland on universal personal protective equipment (PPE) use for the control of endemic pathogens.

It was a spirited interaction, one in which I argued against universal PPE use for the control of MRSA and VRE in endemic, acute care settings.

Kudos to Dr. Harris for an excellent presentation. I enjoyed the to and fro.

We were both interviewed for Contagion magazine, to be live on their website in the next couple of weeks.

Friday, May 20, 2016

SHEA 2016 Spring Conference: Raising Awareness Through Narrative and Beyond

Inspirational lectures and presentations where on the program today, particularly on the use of narrative to expand awareness in infection control.

Maryn McKenna presented When Antibiotics Fail: A science Journalist’s Perspective.  Victoria and Armando Nahum gave a gripping personal account on hospital infection infections, from the perspective of a patient.

The take home message: Be the change!

Drs. Michael Stevens and Michelle Doll presented their research during the poster sessions.

Tomorrow is my pro/con debate with Dr. Anthony Harris on universal personal protective equipment use.

Stay tuned.

Dr. Michael Stevens

VCU Infection Prevention Nurse: Diane Heipel

Dr. Michelle Doll

Thursday, May 19, 2016

Society for Healthcare Epidemiology of America 2016 Annual Conference, Atlanta, Georgia

I am currently in Atlanta at the 2016 SHEA Spring Conference.

The scientific program thus far has been excellent, particularly this morning’s session on “Selling Your Results: To Suits, Scientists and Society”. The quote of the session was:

‘Diplomacy is the act of letting someone else have your way.’

Yesterday I sat for a video interview with Contagion magazine, to be published online. The topic was animal assisted therapy in healthcare and infection risk, based on a lecture that I gave at one of the SHEA Plenary sessions.

On Saturday I have a debate with Dr. Anthony Harris from the University of Maryland, a pro/con exchange on the universal use of gowns and gloves. Expect a spirited discussion.

Stay tuned.

Below are some pictures from the event featuring some of my colleagues and students from VCU.

Sunday, May 15, 2016

Tapeworm! A Weekend in the Hospital

Well it has been a fine weekend in the hospital, busy yet not mundane.

I strolled down to the microbiology lab to personally view the 6 foot tapeworm passed by one of our patients, an immigrant from North Africa.

A little diagnostic variety and novelty keeps us on our toes.

Thursday, May 12, 2016

Fidelity in Hand Hygiene- Need for Greater Rigor

Five Moments of Hand Hygiene. Source: WHO
We often make interventions in hospital epidemiology without having a robust measure of compliance with practice. An example is chlorhexidine patient bathing, a seemingly simple procedure which is difficult to measure both qualitatively and quantitatively.  

The degree to which an intervention is appropriately and thoroughly completed is fidelity.

Take the example of hand hygiene interventions, considered sacrosanct in infection prevention. How are these measures truly implemented? Here is a telling publication that assessed fidelity with respect to hand hygiene studies. In a systematic review of 100 studies, only 8 reported full measures of fidelity to the protocol.

If research protocols are unable to report compliance (fidelity) with implementation of interventions, then adoption to scale by other institutions is very challenging.

This is troublesome.