A Vat of Porridge

porridge.gifOlivia O’Leary in her political column this week explains why she doesn’t like waking up these mornings. She is suffering from survivor syndrome. I admire her honesty.

http://www.rte.ie/podcasts/2008/pc/pod-v-040308-5m15s-drivetime.mp3

You see Olivia has private health insurance which allows her to skip the queue in order to get a quick diagnosis, while public patients must wait. She is uncomfortable with this fact, she knows it’s wrong but given the dangers of hanging around on a public waiting list, she feels she doesn’t have any other choice. She describes the Irish health service as being like a great big vat of porridge – a squidgy bureaucratic mass in which our Minister for Health is floundering around, desperately looking for something to hold on to.

I was disgusted yesterday to listen to Mary Harney and Brendan Drumm apologising to the women involved in the breast cancer misdiagnosis scandal of last year. Of course those women have my sympathy but this was obviously just a publicity stunt to distract from the appalling deficiencies within the HSE, as shown in the recently published reports. The apologies were so insincere as to be nauseating. Where are the apologies for the thousands of Irish patients who have been let down by our health service? Nobody has ever apologised to me for the fact that my life was turned upside down as a result of contracting an MRSA infection from the Irish health service. And of course nobody has been blamed for any of the failures in the service, we’re told that it’s a ‘system’ failure. It’s a whitewash – there is no accountability within the HSE.

Poor Goldilocks. I can’t ever see a time when her porridge will be ‘just right’.

20 Responses to A Vat of Porridge

  1. Grannymar says:

    It sounds like Mary Harney and Brendan Drumm should be dumped into a vat of cold porridge.

  2. Steph says:

    Hi Grannymar

    Were you able to listen to that podcast okay? Olivia says it like I wish I could 😦

  3. Grannymar says:

    Sorry Steph I was unable to get it to work for me.

  4. Steph says:

    Thanks GM – I think I have it fixed now.

    I had to remove the http:// to get the far end of the link showing but I’m sure everyone will know to include it.

  5. Grannymar says:

    Great you sorted the link. Well worth the listen. The ideas are good but how many lives will be lost before proper action is taken?

  6. roy123456789 says:

    I wouldn’t be without my private health insurance, no guilt either……. sorry

  7. Steph says:

    Cheers Roy.

    I wouldn’t be without my health insurance either and I make no apologies for it.

    VHI are good when it comes to in-patient cover but pretty useless for out-patient costs. I’ve been with them since the year dot yet when it came to applying for cover for surgery in UK (as not available in IRl), they initially refused to cover me. That advert on the radio “VHI – we’re here when you need us” has driven me mad ever since! They made me grovel for cover when I was fully entitled to it. In the end they gave me cover for all in-patient charges but nothing for travel, accommodation or check-ups.

    I have a friend who needed heart surgery in a specialist centre in France. VHI refused him also so he took legal action against them and eventually won cover for everything including his wife’s accommodation costs, his travel, and all medical expenses. They also paid for his Irish surgeon to attend the operation to learn more about it.

    My own Irish surgeon wanted to do likewise for my op as he had not seen the procedure before but unfortunately he was abroad with an Irish team of doctors at the time, carrying out life-saving surgery on children for a charitable organisation.

  8. curiouserANDcuriouser says:

    I feel bad for you that you had such a hard time with an MRSA infection. I must ask however, how you know that it was definitely from the healthcare system?

    Over 30% of people in the community carry MRSA on their skin or in their nose with all the rest of their body flora and never know it until somone swabs them and sends it for testing-which only happens in a hospital. How are you sure you weren’t a carrier prior to admission and became infected from yourself? Or one of your visitors not washing their hands? I am asking out of curiosity, not anything else.

    I now work in New Zealand where there is a very low rate of MRSA, both asymptomatic colonisation and infection. We swab every single patient when they are admitted, and strict isolation and eradication if they are found to be positive. We have however, a policy of open disclosure, and we tell the patients as soon as we know, that they are colonised, and why they are isolated. The level of distrust, suspicion and bad feeling that exists between patient and staff in Ireland is not present here at all. We even include MRSA status in our discharge letters to the GPs, as they can often spontaneously recolonise in the future (I might add with no contact with either hospitals or healthcare professionals).

    We also educate patients with regards to MRSA. If they are not immunocompromised, diabetic, on immunomodulatory drugs etc, then we explain that they are extremely unlikely to be harmed by it, no more so than any of the rest of the bacteria they carry on their bodies. We also explain that the “M” stands for Methicillin, not “Multi-drug resistant” as some think, and that there are still several drugs that will be effective to treat them should the unlikely event of an infection occur. The media here has not done the damage that the Irish media has done with regards to this infection, and so it is not an emotive issue for people here unlike in Ireland. I have seen in the past Irish journalists referring to MRSA as “a deadly virus” which is both factually inaccurate and a tactic used to incite emotion and fear. It is not any more deadly to the average punter in good health than any other bacterium. It can cause infections that are as hard to treat as any other infection, but because it is caused by “MRSA” people experience emotional trauma which is detrimental to their wellbeing and recovery. I would personally be much more worried if I found out I was inefcted with say, Pseudomonas, than MRSA.

    I blame the media for this. I read a story in which an actress was suing because she became infected with “MSSA” while in hospital. MSSA??? Methicillin SENSITIVE Staph Aureus. In other words, plain old everyday staph aureus, the same bacteria that causes zits. Now arguably, whatever procedure was done on her should have been under strict aseptic technique and she should not really have had any bacteria introduced to cause an infection, so it is possible that she has a case. But the disingenuous use of the made up term, “MSSA” was what shocked and disgusted me. There is a perception, forcibly aided by the media in Ireland and the UK, that MRSA is perpetuated and passed on SOLELY by dirty negligent healthcare professionals. This erodes trust in the healthcare profession and affects staff morale and performance.

    I also believe it is a distraction tactic used by the government. If they firmly entrench the idea that filthy bad doctors and nurses cause MRSA, then they will not have to pay for EXTRA ISOLATION ROOMS, or an effective VENTILATION SYSTEM in every hospital, or REDUCE OVERCROWDING IN WARDS which would mean opening more wards and hiring more staff (very expensive!!) or increase NURSE NUMBERS. These factors are what affect MRSA prevalence in hospitals. I feel strongly that people should know these things. Ireland will never achieve what New Zealand has achieved in terms of infection control until they change both the governments expenditure and policies and the public attitudes.

  9. Steph says:

    Hello Curious and welcome!

    Thank you for your detailed contribution. I agree with a great deal of what you say and most especially, with your last paragraph.

    In answer to your question about the source of my MRSA infection – I don’t know where it came from and I’ve always made it absolutely clear that there is little to be gained in pointing the finger of blame. Better education all round is the way forward. See the attached link.

    https://biopsy.wordpress.com/2007/11/15/mrsa-whos-to-blame/

    The only reason I mentioned that I’ve never had an apology was to emphasis the point that there is a great deal wrong with our health service and to hear Mary Harney apologising profusely about one area, is like an insult to everyone else who’s suffered. It was purely a tactic she used to distract from the reality of the disarray in the health service.

    The reason I don’t know the source of my infection is because screening on admission, is not routinely carried out in Ireland. There is no funding provided for this and even if it were, we have neither the facilities or staff in place to cope with the increased workload. The present diagnostic process utilised takes 48 hours! It’s like a bad joke and totally defeats the purpose. Detailed infection control protocols were drawn-up and agreed upon several years ago but they’ve never been implemented due to lack of funding.

    All I know about my wound infection is that it caused huge consternation amongst the medics when first diagnosed and my case was closely monitored by a top microbiologist for several years. I later discovered by chance that I’d shared a room immediately post-op with an infected MRSA patient so I think it’s highly likely that this was the source of my problem, but who knows? I realised very early on that it was a fruitless exercise to try to attach blame. There is huge ignorance and hype about MRSA and I feel that best way forward is better education for everyone. That is why I chose to write about my MRSA experience and I have always made it my business NOT to be dramatic or to incite fear. A journalist from our own Irish Medical Times (a leading medical paper) recently wrote a highly inaccurate piece about MRSA, referring to it as a virus and very obviously not knowing the difference between colonisation and infection. I immediately challenged this inaccuracy and a subsequent apology was published. Personally, I find a great deal of ignorance about MRSA everywhere, at all levels, both professional and otherwise.

    I have to disagree with your comment about distrust in Ireland between patients and medical staff as generally, I feel this is not the case. The distrust, suspicion and bad feeling is felt against those who ‘manage’ the health service i.e. the Health Service Executive and the Dept of Health. They have let our health service crumble to the point of collapse and patients are suffering terribly as a result. They are determined to privatise health care to minimise their own responsibilities. I have rarely had any cause to take issue with hospital staff. They have a hard job to do in difficult circumstances and I feel it’s up to the individual patient to make sure they’re well-informed and to work with, not against those in charge of their care. Sadly, morale in the Irish healthcare system is at an all-time low for both staff and patients.

    Thank you for your valuable contribution to the debate. I welcome your opinion.

  10. Knipex says:

    curiouserANDcuriouser

    I have to agree with the majority of the post and am full of praise for the NZ health service and have used it as an n example of what we would be aiming for in Ireland.

    There are a number of things which make the Irish situation much different that in NZ.

    Patients are not routinely screened. Currently there is an attempt to screen high risk patients such as those coming from long term residential care, being readmitted and being admitted from another hospital. I say attempt because this is just not possible due to the lack of resources.

    I also know that the hospitals do not want to screen every patient. The reason is simple. If they are colonized then what do you do. There is a severe lack of isolation facilities so they cannot be isolated even if it is known they are colonized. So what is the point? Those are not my words by the way.

    Even with the limited isolation rooms we do have only a very small percentage are pressurized be it negative pressure or positive pressure.

    (For those that do not understand. A negative pressure room is kept at a lower pressure than ambient buy using air handling units with more extraction then incoming air. What this means is that every time a door is opened the air is pulled into the room rather than allowed to escape thereby preventing any airborne pathogens leaving the room. Positive pressure is the reverse of this where a room is kept at a higher pressure than ambient so when the door is opened the air is forced out not allowing bugs etc in. These would be used for people that do not have an infection but are at high risk of infection.)

    The other issue is lack of information. Colonized patients are not informed they are colonized and up until recently infected patients were not told they were infected. Even now infected patients are discharged without being told.

    I agree with you on the media. The entire problem of MRSA has been blown out of proportion with headlines such as FLESH EATING SUPERBUG etc and unresearched tabloid coverage. It is a disgrace and should be illegal. In fact MRSA rates in Ireland are low when compared to our European neighbors a fact that is never emphasized in the media.

    Even worse is the scare advertising of bleaches and disinfectants where people are now sterilizing every surface in their homes. The problem then is that these surfaces are now wide open to colonization by “bad” bacteria where the natural bacterial colonization of these surfaces would in the past have prevented these from taking hold.

    I would argue with you regarding air filtration. Most of the HCAI’s including MRSA have little or no airborne transmission (unless carried in dust) so air filtration would be of minimal if any benefit.

    I would also argue with you regarding the current HSE advertising on asking health care workers to clean their hands.

    All the scientific evidence shows that patient to patient transfer by health care workers hands is the prime route of patient acquisition of HCAI’s. No one will dispute this.

    Hand hygiene guidelines were introduced stressing the need for health care workers to wash their hand between patients. There have been many reviews done on the actual compliance to these guidelines (some published others not). Typically the results have shown less than 20% compliance. In other words 4 out of 5 health care workers are not washing their hands between patients. There have been a number of appeals made to Health Care Workers regarding this issue and all have failed. If the public are constantly reminding them then things can only get better.

    In my mind the current guidelines do not go far enough. Repeated studies have shown that health care workers hands become contaminated from touching surfaces within hospitals. Surfaces such as bedrails, TV remote controls, light switches, door handles and medical equipment. Some studies have shown that over 50% of surfaces can contaminate healthcare workers hands after touching them for just 3 seconds.

    It may also interest you to know that Irish nursing numbers are actually very high. Over twice that of the UK and higher than that of any other European country. It may also surprise you to know that most Irish health care workers are extremely well paid with our Nurses the highest paid in Europe and our consultants likewise.
    I agree that if we are serious about tackling HCAI’s in Ireland we need the following

    More laboratories.
    More microbiologists.
    More infection control nurses.
    Ring fenced funding for infection control.
    More beds.
    More isolation rooms.
    Enhanced emphasis on hospital cleaning.
    Focus on decontamination the hospital environment not just removing dirt and dirt but removing environmental contamination by hospital pathogens.
    Ruthless enforcement of hand hygiene rules.
    Ruthless enforcement of isolation protocols (and not allowing isolated patients to wander the hospital at will as is currently the case). Forcing medical staff and visitors to obey isolation procedures, gowning, gloves etc.

    Its needs everyone patients, visitors, healthcare workers, the HSE and private industry to come together and work together which is not happening.
    Healthcare staff and the HSE need t communicate with and educate patients and staff on the seriousness of infection control.

  11. Steph says:

    Well done! Knipex

    I can always rely on you to produce the facts.

    Thank you for taking the time to outline all of that.

    Mary Harney take note!

  12. curiouserANDcuriouser says:

    Hi Knipex
    I wasn’t specifically referring to ventilation to eradicate MRSA per se, but microbes in general. Things like Norovirus, SRSV etc that are aerosolized from vomit or faeces are transmitted through the air, as are pathogens like TB or the influenza virus when someone coughs. Ventilation systems have been shown to reduce overall microbial contamination of rooms. MRSA is shed, like skin cells, and WITH skin cells, and can lie around the room waiting for you to pick it up on your hands or legs again. C.Dif can actually form spores and lie around forever. In a ventilated room this is much less likely to happen, as dust stirred up is filtered out. It’s not going to reduce transmission specifically of MRSA anywhere near as much as the other factors I have outlined, but it does help, and helps a lot with other microbes that are spread through the air.
    All hospital rooms should be well ventilated anyway. I was so shocked when I first started work in Ireland and people were stuck on these cramped wards that often STANK and not even a window open! After working there I can still distinguish the smell of anaerobes from the scent of C.dif to the stench of…well you get my drift! One more reason I’m glad I left……
    HCWs washing their hands won’t matter a tick if you share a room with an MRSA positive patient. That’s disgraceful. In NZ not only is there strict isolation they actually supply special stethoscopes, tendon hammers, ophthalmoscopes, sphygmanomometers-the works, all kept in the isolated patient’s room to be used only on that patient. You leave your stuff outside. The rooms are ensuite so no sharing bathrooms and infecting others. It’s really excellent and stops us from picking it up as well. HCWs are screened too and put on eradication Rx if necessary.

    Unfortunately, Steph, I have to disagree with you about distrust and suspicion between healthcare staff and patients in Ireland. I’m sure you weren’t like that so you find it hard to see how others could be, but I worked three years as a doc in Ireland before I threw the towel in and came here, and the hostility and suspicion we encountered from patients was substantial. Whenever I was bleeped to talk to a family I would feel sick as I knew I was going to be verbally abused for something I could not control. When someone bleeps me here to do the same task I look forward to meeting the patient’s family, who are always a pleasure to deal with. The problem is multifactorial back home-there is poor public health education and a media campaign against healthcare workers at the moment, and there is a lot, a LOT of mismanagement, inefficiency, unacceptable delays, lack of funding, lack of staff, so patients families are understandably frightened, upset and lash out at the frontline staff instead of the invisible managers, but understanding that does not make it any easier on us to have to take it. My days are so stressfree here, I don’t know how I’ll ever return home.
    All aspects of healthcare are better here-there is no overcrowding of hospitals. There are services such as a Home Intravenous Antibiotics Service so people who are staying in hospital just for IV antibiotics can get them at home instead-they have a PICC line inserted and off they go-and a bed magically is freed up! Doctors are on shift work, the longest day I do here is only 15 hours long-as opposed to the dangerous 40 hour long sleepless shifts we were forced to work at home or lose our jobs and references. Here we have job security also-when you are hired you decide when you leave, not fixed term labour till age 40 like Ireland. Many on the management side of things think that keeping workers tired and in fear of their jobs will keep them in line-but actually it does the reverse. Productivity decreases, and expensive errors are made. And many of us leave. They might do well to think of that in the HSE. Not many workers will remain loyal to an institution that does not do right by them.

  13. Steph says:

    Curious

    I accept your point that many patients react to the deficiencies in the system by showing hostility towards healthcare staff but I would add that this anger is misplaced. That’s like shooting the messenger. Patient’s would be better served if they directed their anger towards management, not those in the frontline. I’m not in the least bit surprised you left these shores for a better deal elsewhere. Our loss is NZ’s gain.

    The NZ healthcare set-up sounds fantastic. Send us some sunshine will you 😀

  14. Knipex says:

    curiouserANDcuriouser

    I agree with the vast majority of your post especially that with regards the treatment of non consultant doctors and especially our younger more junior doctors.

    I also feel that the Health Care Workers in General and Doctors in particular have to accept some (Some but not all) of the responsibility for the problems in communicating with patients.

    In the past (And I have to admit that it is improving and improving drastically) doctors in Ireland tended to be arrogant and talk over their patients.

    When i was younger I remember a consultant on rounds with a group of doctors come to my bed. It was the first time I had met a doctor since my admission (well met him in a condition in which I could actually talk to him) and he proceeded to give a 15 minute lecture to his team, poke and prod me like I was a lab specimen and never once speak directly to me. When I asked him a question he looked shocked, patted me on the head, smiled and told me not to worry as they would look after me. I asked him a question regarding long term prognosis (I had been admitted with meningitis and been completely unresponsive for 3 days and was still suffering from severe headaches when exposed to bright light or when reading) he just smiled and walked away. I was 20 years old and deserved a bit more respect.

    Lucky for me I was with the VHI and requested a different consultant.

    This was endemic in Irish health Care and left a bad taste in peoples mouths. I agree that the newer younger doctors are different and get abuse they do not deserve but people have long memories.

    It is simethign that is changing in Ireland and as more and more new doctors com onstream things will get better. I also agree that the HSE has done nothing to improve the situation and in fact has made it worse.

    Regarding air filtration. I have to agree that it would be beneficial in general but most research has found the benefits of air filtration on HCAI’s to be limited and to have little effect on environmental contamination which is a key factor in the spread of HCAI’s.

    As you said yourself these infections are spread with skin cells and fecal contamination. Both these mediums are heave and tend not to remain airborne for long. I agree with you regarding C.diff and spores having the ability to survive for literally decades in the environment (MRSA is vegetative but has been proven to survive for over 300 days in the environment.)

    The problem is that manual cleaning with detergents (and even with 1ppm hypochlorite) is not effective a removing this contamination. This has been proven time and time again.

    Indeed in one study it was found that it took an average of 2.8 cleanings with 1ppm hypochlorite to remove VRE from the environment. Detergent was found to be worse, in many cases not only failing to remove the contamination but to actually spread it around to previously uncontaminated surfaces.

    Hydrogen Peroxide Vapour (HPV) is one of a number of techniques proven to remove this contamination but has of yet to be accepted by the HSE and Irish Hospitals let alone implemented.

    This combined with the lack of effective infection control and failure to use aseptic techniques is what has caused the level of HCAI’s we see in Ireland today.

    I would be delighted to discuss this further with you and to talk about infection control techniques in NZ. If you wish to contact me off line feel free knipex(at)p h y rr ic(remove spaces)(dot)com

  15. curiouserANDcuriouser says:

    Manual cleaning in Ireland is also not very good! I came onto the ward a few days ago and nearly tripped and fell over-there was a cleaner in my path on their knees scrubbing the skirting boards like a madwoman with something that smelled like teatree oil but foamed a LOT more. I actually remembered it and commented on it to my partner as I hadn’t seen similar um, enthusiastic cleaning in Ireland going on. We actually have carpeting here instead of lino in a lot of the hospital but we can have it as it’s so well cleaned all the time.
    Can I ask you, not intending to be nosy but you seem highly knowledgeable in this area, do you work in or have influence over the area of infection control back home? If you do, it would be so worthwhile to implement some of the measures implemented in NZ. It is so much better here for both docs and patients, and it is so sad to see the Irish healthcare system so utterly destroyed by hostility,inefficiency and misplaced funding.

  16. curiouserANDcuriouser says:

    I would personally have to disagree with accepting blame for all communication problems with patients though. I once had to explain to a patient’s relative about treatment they had received through the ED-basically a known epileptic on treatment, (followed by neurology services and reviewed by neuro in the ED) had had a seizure, and the relatives in question were hugely distraught that they hadn’t been admitted. Well, after a precipitating cause is excluded, drug levels are checked and are found to be therapeutic, and the person is stable and alert, there is no reason to admit to hospital! Defensive medicine like that is not aiding our bed crisis! I spent two and a half hours, if you can believe that, talking to these people, and all to no avail, all for nothing. I am quite articulate, and usually very good at explaining things, and English is my first language is case anyone was wondering, but the abuse I got and the repeated lack of any willingness on their part to try to understand the facts was unreal, really. And that brings me to something else in NZ.

    There is no such thing as medical litigation. You cannot sue your doctor. You as a doctor, cannot be sued. There is something called the ACC (Accident Compensation Claim) that assesses every incident, and pays out a “no-fault compensation” sum to the injured party regardless of who was at fault. This is good for two reasons:

    1) No defensive medicine and consequently, no iatrogenic illness/injury. If your clinical judgement tells you that a person does not need an investigation and there are risks to it, you do not do one to cover your ass. You mention in the discharge letter that if the problem recurs/continues/worsens that this should be considered in the future.

    Following on from 1:
    2) Waiting lists for radiology/gastroscopy/colonoscopy/OPD etc are not overcrowded and long because of defensive medicine. Hence if your patient turns out to need that investigation after all in the future, it can be accessed usually within a day or two. The same day, if urgent.

    3) The patient gets compo EVERY time. No legal fees for them to cover, no stressful time in court etc, and GUARANTEED payout more than sufficient to cover any expenses and time off work/ loss of income/transport costs etc that were incurred.

    Now, it’s true, no-one makes their fortune over here with frivolous or spiteful claims against medical staff or hospitals. It has happened at home, and it is unfortunate, and no, I’m not suggesting that all claims are unjustified, but it happens a lot at home. We are a litigious nation of late. But there is no way in NZ if someone has been injured, whether anyone is at fault or not, that that injured party will not be entitled to a sensible amount of compensation. There is no way that the patient can lose, be left with expensive legal bills and no compo, if harm has occurred. And no way that the doctor can be subjected to incredible amounts of stress, face the loss of their home and savings and be dragged through the media whether they are guilty or not. But can anyone really see this being implemented at home??? Yeah right and please, pull the other one.
    It is a case of attitude. NZ has much less revenue and less money from taxes and yet it looks after its citizens so much better. In Ireland they would never consider bringing this in, as they would have to lay aside a substantial amount of money every year for their ACC, and as you know, sometimes our finance ministers do not even have bank accounts, so bad are they with money! In addition, I cannot see the adversarial system being abolished. People want to punish doctors for being doctors at home. We used to lie about our occupation if the taxi driver asked us at home, as we were so disliked and misunderstood that we were afraid of the reaction if we said we were junior doctors. The other day I got my hair done here, was asked what I did, and unhesitatingly said “I’m a doctor”. And it felt good not to be ashamed of it. Medical and nursing staff are seen as a valuable resource here, to be retained and kept happy in NZ at all costs. Nothing is more important than your health and that of your family, and people here seem to have cottoned on to that. But it will never happen at home.

    I’m just glad to have experienced it over here. Working on the inside in Ireland, and finding out that nothing worked and everything was falling apart, and being constantly treated like crap, well, it felt like finding out that when you dial 999, the fire brigade don’t come. You begin to have no faith in all the things that you thought were always there for everyone’s safety. And now I know that that isn’t, as I thought, just the way the world is. It’s just the way Ireland is.

    If I go home I’m going to become a primary teacher. Now THERE’S a profession that is valued.

  17. Knipex says:

    Personally I don’t think things are so bad in Ireland.

    I needed to go to A&E last night with an 11 week old baby and found the doctor to be more than pleasant. He was not an Irish National but his English was excellent and he spent time explaining that everything was fine, what to keep and eye out for just in case and sent us home much happier.

    I actually asked him how he got on in Ireland and how he found the profession here. He had the usual complaints about hours and the HSE but never mentioned patients until I asked him. He did say that he had some bad patients but in general if you took the time to talk to them they were fine. He showed me where he kept all his thank you cards and little gifts he had received. (not allot I have to say but he was very proud of them). We shook hands and I thanked him before we left. (And I didn’t ask him if he had washed his hands as I saw him do it ;-).)

    I am not a microbiologist nor do I work in Infection control or for the HSE but I do have a professional interest in the area. I try to read all the papers, keep up to date and meet with infection control teams and microbiologists all over Ireland and to an extent the UK. I also keep an eye on what goes on in other countries so I have some familiarity with infection control procedures in NZ.

    My main area of interest is the environmental contamination I discussed above and this is very intertwined with hand hygiene. I have look at and examined a number of technologies aimed at infection control and keep an eye on the findings of the Rapid Review Panel in the UK. ( you should have a look makes for interesting reading http://www.hpa.org.uk/infections/topics_az/rapid_review/default.htm )

    It is amazing to me that 10 years ago the environment was considered a non factor in the spread of HCAI’s where as now it is recognised as a key factor. Research in the area is fascinating and certain microbiologists (Balla, Boyce, Hardy, Dancer and French in particular) have done allot to move our thinking forward.

    Unfortunately I have zero influence in the HSE. (I only wish)

    Of all the technologies I have looked at one sticks out head and shoulders above the rest (And it looks like the Rapid Review Panel agree with me as they gave them category 1 approval) is Hydrogen Peroxide Vapour (HPV) as a decontamination agent.

    (If you are interested look at http://www.rbds,ie and http://www.bioquell.com)

  18. steph says:

    Knipex

    My heart goes out to you hearing that you have an unwell 11-week old baby. I’m amazed that you even have the energy to think about infection control, let alone write about it at the moment.

    Our youngest child spent a lot of time in and out of The Children’s Hospital with chronic kidney disease and I remember those days well. The staff were always fantastic even though the conditions endured had to be seen to be believed. Knowing what I know now, it really makes me wonder how our daughter escaped MRSA as she had a lot of IV antibiotics and several operations. The cramped and overcrowded conditions had to be seen to be believed and I don’t expect that much has changed although the A&E dept was upgraded during our final years there. The political/medical dispute that has held up the building of a new Children’s Hospital for so many years, typifies the present difficulties that exist in our health service.

    Anyway, I hope your little one continues to do well and won’t have further need of any hospital treatment.

  19. Knipex says:

    Steph

    The consultant microbiologist in Temple St is Robert Cunney. The same Robert Cunney who was involved in writing the SARI guidelines on infection controll and along with Hillary Humphries and is also involved in the ongoing study at Beaumount. In toehr words he is one of the top guys in infection controll in the country and his team in Temple St. although small are very committed.

    On top of that he is a really nice guy.

    My little fellow is fine. His Dad got a a bigger fright than he did and to be honest the visit was more for piece of mind than anything else. I wouldnt have been abel to live with myself if something happened and I had not taken him in.

  20. curiouserANDcuriouser says:

    well, I used to smile and say I liked my job and things were fine when asked by a patient in Ireland. You don’t want to alarm them when they’re sick and possibly scared that things ain’t all what they should be. Only online do I say what it’s really like.

    Hope your babby gets well soon!

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