People assume that as an infection control specialist I must live in a sterile environment or at least tidy. How wrong they are!
I read this poem recently. I think it’s great and this blog is a chance to share it with you. This is how I think we should live life. However, it caused my mind to wander
Author: Rose Milligan
My first thought was that if you get to the point of ‘needing’ to dust then your system is failing! If you keep an area tidy and wipe occasionally then there will be no dust.
So then dust is a systems failure.
Dust is dead skin and provides a lovely environment for bugs to grow but is it a risk?
Well that very much depends on where you are and what you are doing. I’m not undertaking any surgery in my home or office so a few piles of papers or books aren’t a risk.
The bugs have to be given access to the body. A healthy intact skin is the first barrier against infection; clean hands mean that we don’t put bugs all over the food we eat. Attending to both these aspects are fundamental to preventing infection.
Moving on from dust to another area of risk, food safety, I considered some of the choices I make on a personal level.
My team will tell you I have scant regard for sell by and even use by dates which horrify some. My perspective is that, as a healthy, informed individual, I can judge the potential impact of my risk based decision backfiring.
Pregnant, I would risk nothing. I’ve a friend who has lost a child to listeriosis and another hospitalised. Some risks are just not worth taking.
Undercooked beef burgers are a no, no for me. Salmonella, Campylobacter, E Coli 0157? No thanks! Steak tartare (raw, minced, fillet steak) from a reputable source? Oh yes!
Why? Well the mince has come from any part of the cow, including intestine where all the bugs live, fillet on the other hand is pure muscle and not where the bugs live. It’s a risk I am willing to take.
So why am I choosing to ramble on in a NHS Blog. Well as an Infection Control Team we are sometime told that our advice is inconsistent and I’d like to try to explain why sometimes this might appear to be the case.
We all have many different risk based decisions to make on a daily basis and these will depend on the vulnerability of the patient group, the activity being performed and the virulence of the organism likely to present the risk. This is why I never find infection prevention dull. It requires the application of specialist knowledge, an understanding of the patient’s clinical picture and the care being provided .There are no black and white answers, it really is 50 shades of grey (!) but whatever decision is taken, it will be made on a balance of risk.
Cleaning is important in a healthcare setting. It’s not about appeasing inspectors, it’s about risk. Dust is full of bugs but if doesn’t reach a patient it’s probably not a risk. But it does reach patients, on hands and equipment so we do need systems in place to make sure that it doesn’t build up and become a home for bugs.
So, ‘dust if you must’. Yes, there’s more to life than cleaning but let’s make a sensible assessment of what is required and if we consider the risks and do the simple things like keeping tidy then cleaning doesn’t become a major event, just the application of a simple process.
Elaine Ross is Infection Control Manager at NHS Dumfries and Galloway