The future of infection control
One of the biggest challenges to safe and effective healthcare is making sure that patients don’t pick up infections while they’re in hospital and that they don’t bring new infections in with them. Infection control is a major priority now, even more so since the era of Covid-19, and it’s the job of infection control nurse Christine Moody at Addenbrooke’s hospital in Cambridge, who spoke with Katie Haylor...
Christine - The infection control healthcare burden is absolutely huge. Infection control has fingers in many pies. We look at absolutely every aspect of a hospital setting. It isn't just about the patient coming into the hospital, it isn't just about the staff caring for the patient. It's looking at the fabric of the hospital, the environment, the cleaning practices, the waste disposal, providing safe clean water, and ensuring that our patients are given a healthy, nutritious diet to eat while they're with us. So there's many aspects to infection control that really do impact on every little bit of a patient's stay.
Katie - So you kind of hinted at it there, but could you just tell us a bit about how infections spread and therefore how you try and mitigate that? Are there some sort of really key features that you have to focus on?
Christine - There is something called the chain of infection, which is really key to sort of helping you think about how patients may get an infection while they're in hospital setting, because it does happen, or whether we can prevent that happening in key areas, or if they do come in with infection how we can prevent that being spread to other patients. So it's something called the chain of infection, and that talks about looking at the different viruses, bacteria and other small microbes that can be spread either from person to person or from person to the environment and therefore then to other patients or even staff. And it does work the other way also from staff to patients and visitors. So we want to try and prevent that. The good thing about the chain of infection is it has really clear pointers where you can break it. So one of the key things that we can do is wash our hands, ensure that we wear the right personal protective equipment when dealing with patients, even looking at the environment itself and trying to minimise the potential for patients having contact with one another. And there's something that we do called isolation nursing or barrier nursing.
Katie - So how well does this system, of tracking the chain of infection and then breaking it at certain points, how well does that work?
Christine - It works reasonably well because ideally when a patient comes into the hospital setting and they are clocked in through the accident and emergency or what we call ED now, Emergency Department, you'll get a feel, and you'll get a list of things that you can look at and think, right, this is what we think might be going on with this patient. So therefore if you suspect there is an infection on board and whether it's something like flu, you know, having just been through the winter season, or a Norovirus, which we know are easily transmittable between people, then we want to try and prevent that from happening. So therefore we would move a patient into an isolation or barrier nursing room. So by putting up that barrier, if they are unwell, the chance of it being spread to another patient is far reduced. Also then the staff would take the correct precautions. So good hand washing, making sure that they put their apron and gloves, all the things that you see nurses wearing - and doctors as well - before they're going in to see their patient when they deal with their patients, to make sure that they're safe and clean and comfortable. Then removing that, so we call it doffing, aprons, their gloves, and there's disposing of them and then washing their hands again. So it's about trying to break the potential for spread.
Katie - What would you like to see in a hospital of the future with regards to infection control?
Christine - So if I had my infection control hat on and I was able to design a brand new hospital, it would be all side rooms, all with ensuites, actually have showers, toilets, and have every piece of equipment that I potentially could need in that room itself. By having the fact that normally, in a normal ward, you can see patients in a bay all together and they can see the nursing staff and the doctors, staff, and the cleaner, unfortunately, with a side room, it does mean that that is quite difficult. So having the technology to be able to sort of, almost like we're doing now, having a Skype call, being able to at least call a member of staff and have that visual would be a really great thing. To have your equipment for all your monitoring that you needed, being able to make that stay for that patient as comfortable as possible. Because one of the things with this isolation nursing is that some patients take to it very well, they like the peace, they like the serenity, and others do not - others miss that communication with other patients and having a bit of support that way. So we need to make these rooms as comfortable and at home-like, as we possibly can without obviously making it difficult for us to clean. We need to make sure that the environment is as clean as possible so there's no spread of infection.