One Small Step… One Giant Leap…
“Because this is how we’ve always done it”
A familiar refrain as yet another suggestion/idea is destined for the bin before it has even been fully developed.
I’m a big fan of “if it ain’t broke, don’t fix it.” But with that comes the responsibility of being able to recognise when things are broken, or at least open to improvement.
Pandemic or none, infection control in healthcare has hit a brick wall. There are currently two main focus points: antimicrobial resistance and cleaning/hygiene. The problems are that drugs need to be prescribed for the health of the patient and even with rigorous cleaning, contamination can take place almost immediately afterwards.
So what can we change?
On the face of it, nothing; cleaning is carried out and drugs need to be issued.
But let’s step back for a moment, should we be looking at ‘as well as’, rather than ‘instead of’?
Embracing emergent technologies that are complementary to existing practices may prove to be the way out of the dilemma.
But how? What to try and what not?
Two names to take note of. One from yesteryear, one from more recent times.
Florence Nightingale 1820 – 1910
Archie L Cochrane 1909 – 1988
Most will be familiar with the first, I suspect not many with the second. Archie Cochrane was a man who questioned the thinking behind ingrained medical practices and didn’t take the response at the start of this piece as a sufficient answer. He was a pioneering advocate of the randomised controlled trial and like Florence Nightingale based his work on evidence and observation (all you people taking aspirin for a heart condition have him to thank). These two people have revolutionised healthcare beyond recognition. Where Nightingales “Notes on Nursing” brought about hygiene practices still in use today, Cochranes use of scientific methods is fundamental to the approach of NICE and other bodies instrumental in today’s healthcare system (for an insight visit https://www.cochranelibrary.com/).
So what can todays infection control practitioners learn from these two pioneers?
Quite simply, if there is room for improvement, be receptive to ideas, apply an evidence based approach to any assessment for suitability. If the facts support use of a product or process in your setting, run a trial with defined boundaries and reporting of information. Also, be prepared to fail. Knowing what doesn’t work is as valuable as knowing what does.
In this way, knowledge can be built up and shared and practices can be driven forwards.
“Because this is how we’ve always done it” shouldn’t be the end of the conversation. By recognising opportunities for improvement and exploring possibilities, we can take one small step towards achieving lower incidence of infection and a better standard of healthcare.
