Infection Control Today - 08/2003: Are We Winning or Losing the War Against Bacteria?

Are We Winning or Losing the War Against Bacteria?

Thats the question we posed to Infection Control Todayreaders this summer. Heres their take on the battle against the superbugs.

We are winning, in the sense that we continue to develop more specific technologies to identify, contain and confine, and prevent the preventable invaders. Innovative advances in every aspect of the health industry involve practices, protocols, processes, and products. We are losing, in respect to compliance due to fiscal constraints, regulatory mandates, practice restrictions and critical shortages of competent healthcare professionals.

Nancy Bjerke, RN, MPH, CIC Independent infection control consultant San Antonio, Texas As long as practitioners continue to believe that healthcare-acquired infections dont happen in their facility and depend totally on infection control rates, the bacterial war will continue to be waged with bacteria having the edge. We do not seem to have learned lessons from the past; as soon as we think we have controlled one type of microorganism, we get back to our old habits and then, wham! When least expecting it, we get dealt another wake-up call (e.g., SARS). The only way to effectively deal with infectious agents is to make sure all practitioners, in all healthcare settings, follow all recommended practices each and every time, with no exceptions.

Nancy Chobin, RN, CSPDM CS/SPD educator Saint Barnabas Health Care System Livingston, N.J.

We are losing more than winning. I live in a U.S. Mexico border city and I still see several cases of people self-medicating themselves and their children. With prescription medicines available over the counter in Mexico, many people prefer medicating themselves and their kids to save the cost of a doctors visit. Many times the pharmacist acts as the doctor, recommending or prescribing medications to these people. The majority of the people who practice this self-medication routine every time they get sick do not follow the instructions given to them as far as finishing all their medication because they feel better after a day or two. The increase of drugresistant diseases is the direct result of this widespread practice along border cities, and with Third-World conditions being the norm along the U.S.- Mexico border, we are fighting a losing battle.

David Reyes, CEH Superintendent of custodial operations Texas Tech University Health Sciences Center El Paso, Texas For more than 20 years I have been reporting to infection control committees (about) the community-acquired and nosocomial organisms in acute-care hospitals and we have not won the battle thus far. I believe this is due to a number of challenges including the over-usage of antibiotics and the under-usage of aseptic practices. I shudder to think how Dr. Semmelweiss would feel about our lack of handwashing. When are we, as a professional group, whether clinical or non-clinical, going to accept the fact that handwashing has saved lives? And what in the world has happened to the aseptic practices we know are right but for some unknown reason refuse to use? And yes, how about keeping our sterile products sterile to the point of use? Why do we question that artificial nails are not appropriate in direct patient care? And how about the issue of home laundering scrubs for SPD and OR? Holy buckets, if we truly believe this, then why not just wear our blue jeans into the OR suite? After all, we will have a sterile gown put over them. We will never win the battle over microorganisms until we learn that aseptic practice, handwashing and good old common sense are where it all begins!

Nyla Skee Japp, RN, PhD, ACSP Nurse manager, Banner Desert Medical Center Mesa, Ariz.

At this time I believe we are still ahead of the microorganisms, although they do seem to be gaining. Part of the issue is the ability to recognize and publicize the illnesses more rapidly than in the past. And as weve seen, the ease of international travel brings more people into contact with (infectious) agents their immune systems have never seen. A good sign is that in our area, physicians are more reluctant to order antibiotics for patients who want them called in to their pharmacy without being seen by the doctor. But in the long haul, and I mean the really long haul, I think the bugs will win.

Linda Scherer, RN, BSN, CIC Infection Control/Employee Health Nurse Hospice and Palliative Care of Louisville Louisville, Ky.

I have to admit Im not convinced we are winning the war against superbugs. I think the bugs are doing what they are meant to do. They are learning and evolving. We develop new ways of fighting them, they invent new ways of defending themselves. This is life. I dont think well change that. But when it comes down to protecting our patients, we can still do a lot with appropriate hand hygiene and coming up with new innovative ways to encourage proper hand washing among all health care providers, no matter what their titles, physician, nurse or technician. It is, as they say, in our hands and we are the only ones who can take it from there.

Carol Shenold, RN, CIC Infection control Deaconess Hospital One only has to have a cold to know we are losing the war against superbugs. The first words out of most peoples mouths are usually, you ought to be on antibiotics. This is especially true if they happen to be medical professionals. There is still the perception that taking antibiotics will help keep it from getting any worse. Rest, fluids and symptomatic treatment with over-the-counter drugs is still thought of as not good enough. One would think that education would prevent this kind of thinking but I havent seen it happening. At the rate we are going, I fear that more super bugs will be created and antibiotics will become less effective in managing disease.

This is an important issue, and since I see patients with MRSA, and VRE coming to the operating room more often than I would like to, I think there should be some ongoing active dialog among nursing and other healthcare workers to help resolve these problems if at all possible.

Karol K. Santovin, RN CNOR Charge nurse, operating room North Florida/South Georgia Veterans Health System Gainesville, Fla.

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