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Infection prevention and management in a virtual medical environment

Immediately after welcoming the arrival of his second child, Josh, Kelly Evans’s “* blissful” postnatal foam burst much earlier than she had imagined.

Within 24 hours of returning home from the hospital with her newborn baby, a Sydney-based mother noticed white spots on her two-year-old daughter Mira’s tongue.

Her eldest son was forced to quarantine at her grandmother’s house for the next 10 days because doctors suspected hand-foot-and-mouth disease (a dangerous condition for newborns).

“It wasn’t the homecoming experience we planned, but thankfully the children weren’t in physical contact and there were no signs of the disease spreading.

“Like the other two years, Mira can be pretty noisy. We were careful not to let her treat her brother right away, because more serious consequences could occur. Thank you for what we didn’t do, “she recalls.

Evans is generally happy with the post-hospital care he receives, but more to educate patients about infection prevention and management (IPC), especially when managing health care at home without professional supervision. I think it is necessary to make efforts.

“I received a lot of help when I was discharged, but I feel like I was a little lacking in infection prevention tips. The facts I received are also inconsistent with what I read online,” she says. I did.

Stop spreading

IPC best practices exist, but Australian Commission on Healthcare Safety and Quality Keep in mind that there is often a “gap between what is known as a best practice and the care provided.”

“Despite best practice guidelines and strong evidence, hand hygiene compliance is not optimal, preventable infections occur, and antimicrobial resistance is becoming an increasingly problematic issue,” a recent report said. Stated.1

In fact, 180,000 patients in Australia suffer from health-related infections (HAIs) each year.1 As a result, antibiotic use is prolonged, patient morbidity is increased, and quality of life is reduced.

HAI is also costly, and in one state we found that the excess costs associated with only 126 surgical site infections totaled more than $ 5 million.1

There is an increasing need for epidemiological rigor in virtual health care. This is demonstrated by the COVID-19 pandemic, where thousands of COVID-19 patients are being treated from home throughout New South Wales.

Cathy Dempsey, NSW Chief Infection Prevention and Control and Healthcare-related Infection Advisor of the Clinical Excellence Committee (CEC), said the rise of home care is generally a positive development for patients and the IPC, but there is always an opportunity to improve. believe. Patient safety throughout the virtual care ecosystem.

“At home, it’s easy to reduce the risk of infection because there are no other patients nearby, and there isn’t much physical interaction with the workers. That said, we should be happy. Not, “she said. Hospital + health care..

“Homes can pose new risks that are less common in hospitals, such as pets, shared laundry and dining facilities, and reduced medical surveillance. These risks are tightly controlled by the clinic. However, you can still get an error. “

A large amount of information is usually distributed when a patient is discharged or treated at home, but care must be taken to ensure that the facts provided are properly adjusted.

“There is a lot of conflicting information online that can confuse patients,” said Dempsey. “For example, many infectious disease doctors will tell you that polluting a child is part of boosting immunity. Yes, but in some situations people say that lack of sterilization is not appropriate. For example, you certainly don’t want to expose your vaccinated newborn to chickenpox. You’re not an adult vulnerable to the common veterinary infection virus. “

In fact, Ms. Evans said she was unaware that another approach was needed when it came to protecting against viral infections. Like most Australian parents, she agrees with the “hygiene hypothesis” and avoids over-sterilizing her home. This theory is based on an increasing number of studies showing that childhood microbial exposure can prevent conditions such as asthma and allergies.2

“Usually I’m very comfortable feeding my kids what they just dropped on the floor and eating non-sterile toys. Naturally. But newborns in the house I didn’t realize I needed to stop this with her, “she said.

Multimodal approach

To achieve sustained behavioral changes in connection with IPC intervention, the World Health Organization says the multimodal strategy is the best way to move forward. Among the strategies it suggests are active surveillance and continuous evidence-based education.3

Dempsey agrees that this approach is the best way to cover all locations.

“Knowledge and monitoring will be the sharpest tool in a virtual IPC program,” she concludes.

* The name has been changed to protect privacy.

References

  1. https://www.safetyandquality.gov.au/sites/default/files/migrated/1.2-Healthcare-Associated-Infection.pdf
  2. https://www.nature.com/news/early-exposure-to-germs-has-lasting-benefits-1.10294
  3. https://www.who.int/infection-prevention/tools/core-components/facility-manual.pdf

Image credit: © stock.adobe.com / au / alfa27

Infection prevention and management in a virtual medical environment

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