Lessons from the frontlines - Control of healthcare associated infections

In 1742, physician Sir John Pringle, was tasked with logging the problems associated with military life. In "Observations on the diseases of the Army" Pringle stated that there were two fundamental issues related to infection: 1) inadvertent contact between medical professionals, the sick, and the instruments and surfaces they touched led to more instances of the same illness, 2) the cause was not some mysterious ethereal phenomenon but rather an unseen one. He was certain that infections were microbial in nature and that he could stop their spread with the use of a combination of chemicals, which he termed "antiseptic". The solution was straightforward: keep hands, clothing and environmental surfaces clean and infections would be prevented. Pringle’s efforts are still the theoretical basis of current infection control measures. Yet the relative simplicity of infection control principles are unfortunately not easy to accomplish.

Today, healthcare facilities are an assemblage of departments each of which is responsible for carrying out certain roles. To prevent HAIs from occurring, there are usually two departments. The first is the infection prevention and control department (IPC), which is staffed with academically-trained professionals. The other is Environmental Services (ES), which is comprised with trade workers who do the actual cleaning the institution. Their job is to work together towards a similar goal. Unfortunately, as history has shown, this is where the problems start. This talk will review the interaction of IPC and ES, as well as discuss historical approaches to HAI control as well as current best practices.