Infection Control Today: the last word

Humanizing HAIs and Infection Control

By Allen Soden

“Infection control will really only make sense to people when it becomes about humans and not about incomprehensible statistics and invisible bugs.” This insight originated with a dinner companion during the 2005 Association for Professionals in Infection Control and Epidemiology (APIC) conference in Baltimore (whose name has been unfortunately lost in the midst of multiple introductions and old age). It caught my attention and imagination then, and I’ve been pondering the implications of it ever since. It was this opinion that became front-of-mind again in the middle of December when I read an obituary contained in a relatively obscure newspaper.

David Milne entered the hospital for heart surgery in September 2005. Although initially successful, his recovery was complicated by a surgical site infection. Two other localized infections would take hold before further failures of infection control protocol would contribute to a systemic Clostridium difficile infection. On Oct. 30, 2005, Milne died, the C.diff toxins that had ravaged his body having finally taken the ultimate toll. This death, caused by hospital-acquired infection (HAI), would have gone largely unnoticed, as do several thousand others every year, if not for the simple and elegant wording of a single obituary. Somebody put a human face on his infection.

In the days and weeks following its publication, the obituary and the story behind it garnered a great deal of very high-profile attention. The newspaper in which it was printed wrote a front-page story on Milne and on the human cost of HAIs. Requests for clippings of the obituary came in so quickly and so heavily that the paper, for the first time in its 100- year history, ran a second printing of the section of the newspaper in which the obituary was printed.

The front-page story was picked up by other newspapers, many of which also ran it as a front-page headline. Radio and television channels interviewed family members as well as infection control professionals, highlighting the human cost of HAIs. Media outlets in places as far away as New Zealand pulled details from wire services and ran a version of the story with comments from local infection control practitioners.

The lasting impact of this “humanizing” of infection control has yet to be realized. The hospital in which Milne contracted the infections and eventually died came under a great deal of pressure to improve practices. At least one medical school has started to use the obituary to teach medical residents of the consequences of their actions. It has been posted in the nursing stations of hospitals across the United States and in several other countries in the English-speaking world.

Eventually, the hype around this story will fade, and the story itself will be forgotten. What then? We need to keep telling the stories of people who die prematurely from HAIs. A beautiful 15-year-old girl died last year. She had gone into the hospital for minor surgery, just an overnight stay. Four weeks later, killed by an HAI, her parents buried her. A young mother was pulled from an automobile accident with several bone and soft tissue injuries. She survived the crash and was on the road to complete recovery, but was assaulted by an HAI and left a 3-year-old son to wonder why his mother wasn’t ever coming home again.

We also need to tell the stories of people whose lives are negatively impacted by chronic, drug-resistant infections, and who are compelled to receive lifelong treatment with no hope of cure on the horizon. Or tell the stories of those people whose lifestyles and savings have been devastated by the continuing care required to treat HAIs. We need to hear the stories and understand that these people are victims of improperly washed hands, or unsanitary environmental surfaces, or poorly designed or policed practices and procedures. We need to understand that it isn’t the infections that add billions of dollars of unnecessary expense to the healthcare system; it is people who, by commission or omission, create the circumstances by which infections can flourish. In the end, it’s all about people, and if we can increase the human element in infection control by telling the stories, well that would make all the difference in the world.

If you would like an electronic copy of the David Milne obituary to use in your facility, please send an e-mail request to asoden@debsbs.com. 

Allen Soden is president of DebSBS, a manufacturer of hand hygiene products. Soden is known for his advocacy of infection control practices and infection control professionals, and is a popular speaker at infection control meetings. His particular field of interest is teaching infection control professionals how to better get their message across to healthcare workers and to the general public.