Infection control is one of the areas of hospital, which is directly or indirectly associated with patient outcomes as far as infections acquired in hospitals are concerned. Quality care of the patient involves multiple factors and hospital acquired infections are one of the important perspective which is coming in spotlight after the accreditation of hospitals. In India, we are relatively young as far as journey for infection control, patient safety and quality care is concerned, yet at same time we are well geared and also we know our stuff in infection control well. The challenges are manifold which includes Multidrug resistant organisms, running out of antibiotics, global travel, ageing populations and improving survival rates, challenges in disinfection and poor hand hygiene practices. The major concern and challenge is to percolate this same knowledge to grass roots where actually ground work is performed. For example, is to train a housekeeping staff for cleaning the equipment. We have SOPs (standard operating procedures) but we must teach them how exactly to clean. Our knowledge and understanding of cleaning may not be same as that of our staff, so we need to figure out a way and means by which we exactly let them know what is meant by cleaning of equipment. We don’t just want a shiny looking equipment, but really, we need is well cleaned, dry, and properly disinfected equipment which is ready to be used for a patient and we are assured that yes, it can be used for our patient. There are lumens, crevices and edges which need to be more focused than just gross cleaning. There are various equipment’s like proper brushes and other cleaning devices which can be made available and appropriate guidance about using those instruments should be provided. Secondly, using exact dilution of disinfectant and use of material safety data sheets(MSDS) and training for same is crucial factor for using the disinfectants. Some of fundamental understanding of cleaning, decontamination, disinfection and sterilization are different processes. Each of them can be simply taught and we can encompass all measures of infection control. Slowly and repeatedly, skills can be imparted and teaching about infection control can be given. Slowly, culture of quality can be inculcated in practice, just by training on each and every minor aspect of patient care related to infection control practices.
Dr Dhruv Mamtora,
Consultant Microbiologist and Infection control, S. L. Raheja Hospital, Mumbai.