Quote from Aeterna
When an outbreak of any kind is declared, what generally happens?
I'm so sick and tired of constantly having the threat of MDROs or C.diff dinned in our (nurses) ears when no one else seems to care. .... Still, if they're so concerned about MDROs, then they should just close the unit!
I want to complain to someone but I'm not sure even where to start...
Mandatory reporting and public comparisons between hospitals, and the new policy of CMS to not pay hospitals for care for infections acquired while in the hospital should increase the pressure somewhat on the administrators to care about this problem.
Well publicized examples of hospitals that have cut their infection rates dramatically put a lie to the legacy apathy that "it's just the way it is, nothing can be done about it." Patient advocacy groups may the ones to add local pressure there.
I don't think infection control departments are very powerful in the scheme of things, compared to other interest groups.
And people in general (patients, families, visitors) are astoundingly uninformed about infection control. More than once I've observed visitors with infants in strollers pick up a dropped pacifier off the main corridor floor and pop it back in their child's mouth.
I hesitate to estimate what fraction of visitors don't wash their hands after visiting the heavily used public restrooms, often more poorly designed for infection control than the local Interstate rest-stop. As a society we've grown sloppy and complacent.
From a public health point of view, in terms of MDRO's, hospitals in general are a nightmare. If all you cared about was infection control, hospitals and ICU's should all simply be shut down because they are the primary incubators and spreaders of MRDO's. But no one wants to admit that antibiotics are failing, or that untreatable TB is on the rise.
But we don't know how to grapple in public yet with situations in which, regardless what policy we select, some people will die as a result of the choices we make. The "medical establishment" doesn't want to cope with an issue that shows the "feet of clay" and the reality that doctors are not gods, and have limits. So don't expect this issue to be dealt with without very real outside pressure and even that is hard to generate.
In fact, society is great at putting this question out of mind. The 1918 "Spanish flu" epidemic killed more people than World War I, and was the single most important event of the day. Yet studies of recent history textbooks show that it merits at most a sentence, or no mention at all. At all levels, people just don't want to think about it.
Public health departments have been aware of and pushing on these issues for over a century, but the response of society and the AMA to the statistics has been largely to do everything possible to squelch that voice and slash the budgets for such departments, and misportray them as "advocates of free care for underserving poor people" who need to be put out of existence.
All that said, nurses ARE the primary line of defense of the patient, and increasing the power and influence of nursing organizations may do more than anything else to help.
It's hard to care when no one else seems to, but that's also when it matters the most.