Tuesday, January 30, 2018

Thank You Colgate University: Biology Seminar on Hospital Acquired Infections

Thank you Colgate University for a very special memory. 

It is not often that I visit my alma mater and give a lecture to undergraduate students on the prevention of hospital acquired infections.

Today I was a visiting professor at Colgate University, as a guest of the Department of Biology. This was for the Biology Seminar (seminar schedule here).

My invited lecture was titled Hospital Infection Prevention and Safety- Past to Present (Everything you wanted to know but was afraid to ask).  

The audience turnout was well beyond expectation.

Images from the event are below

Thursday, January 25, 2018

Colgate University Biology Seminar on Hospital Infection Prevention: January 30, 2018

For those in the Central New York area, I will be a visiting professor at my alma materColgate University, as a guest of the Department of Biology. This is for the Biology Seminar (seminar schedule here).

My invited lecture is titled Hospital Infection Prevention and Safety- Past to Present (Everything you wanted to know but was afraid to ask).

It will be nice to be back on campus.

Tuesday, January 23, 2018

Accountability- The Elephant in the Patient Safety Room

I have been thinking about this a lot recently.
Source: cnbc.com

I believe in a culture of safety and creating a blame free environment in which errors are assessed as part of a system failure.  This generally holds true.  But the system is not always to blame, accountability cannot be overlooked.

I dug up this paper (NEJM full text) from 2006-system failure versus personal accountability, by Donald Goldmann.

A more recent perspective, hot off the press, on leadership oversight for safety programs can be found here.  The authors hit the nail on the head.   Accountability by leaders is a critical element of a safety program.

When the vast majority of providers can complete evidence based safety measures such as wash hands, complete check lists, perform time outs, bathe patients etc, those who refuse to play by the rules generally are not victims of the system.

In a addition to a primed system, high reliability in patient safety requires leadership, which requires accountability, which at times requires tough discussions and tough decisions.

Thursday, January 18, 2018

Congratulations to Dr. Michelle Doll-VCU Internal Medicine Grand Rounds on the Epidemiology of C. difficile

Congratulations to Dr. Michelle Doll, Assistant Professor and Associate Epidemiologist at VCU Medical Center, on her masterful presentation at VCU Internal Medicine Grand Rounds.

The topic was the changing epidemiology of C. difficile infections with a focus on diverse reservoirs, current knowledge gaps and limits in C. difficile infection prevention, and strategies to maximize 'test stewardship' with respect to C. difficile diagnosis.


Tuesday, January 16, 2018

Twitter is a Legitimate Means of Engaging Medical Professionals!

Kudos to Infection Control and Hospital Epidemiology (ICHE) for publishing this article on What Makes a Tweet Fly

In an analysis of 'tweet' activity across for international infection control and Infectious diseases conferences, ID week 2016 had some of the lowest proportional use of Twitter. This is discouraging as Twitter, if done properly, particularly with an embedded link to a useful journal article or position paper, can both highlight and quickly disseminate relevant information. 

It is time for ID Week to formally encourage Twitter as one of the primary communication platforms during the meeting.

So, again, kudos to ICHE for raising awareness of the power of social media for professional societies. If social media serves to heighten infection prevention awareness and improve safety, this cannot be a bad thing. 

Thursday, January 11, 2018

Duration of Contact Precautions Expert Guidance- Published Today!

For those interested in contact precautions, specifically the duration of contact precautions for select pathogens, check out this SHEA expert guidance paper, published today.

Kudos to David Banach, Valerie Deloney and the rest of the talented SHEA Guidelines Committee.

This paper should provide guidance for a timely and relevant question: how long must this patient be isolated?

Saturday, January 6, 2018

Bare Below the Elbows: Revisited!

This recent article published in Infection Control and Hospital Epidemiology is another bit of evidence in favor of bare below the elbows as an infection prevention adjunct for inpatient care. This is now normative behavior at VCU Health.

Kudos to Dr. Amrita John and colleagues for their randomized, crossover trial involving simulated patient care interactions. With short sleeves, the frequency of transfer of a viral DNA surrogate marker to clean sites was significantly decreased. 

The goal is to minimize patient/ patient invasive device contact with an infrequently laundered fomite- white coat sleeve cuff (previously reported here).

White coat fomite! Photo Credit: Mike Edmond MD, MPH, MPA
BBE for inpatient care is simple, inexpensive, based on biological plausibility and is unlikely to cause harm (except to the ego of some physicians.)

Hang up the white coat.

Wednesday, January 3, 2018

The Man Cold: Myth or Medically Plausible?

Is there such a thing as a man cold? 

In the medical literature I dug up this article, published in 2007, that explores gender differences in the incidence of respiratory tract infections. Data were extracted from 84 relevant studies.

Men seem to develop more respiratory tract infections than females, except sinusitis, ear infections and possibly tonsillitis. The course of these infections may be more severe in men than women.

Why? Not sure, but it may have to do with anatomic differences, the impact of sex hormones on regulation of the immune system, lifestyle and behavioral issues.

Regardless, there is no need for us to overreact (as some are prone to do). A cold is generally still a cold.

Toughen up.