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Dear Michael,
Interesting aspects. I have been arguing for many years that what is missing are (a) the theoretical and conceptual underpinnings, and (b) actually putting a value on proper, intact scientific and/or logical reasoning.
Take medical school teaching, for example. Many people argue that it is enough to put medical students and junior doctor in practice situation (e.g. on clinical rotations), tell them to “adhere to proper practices” and watch them absorb infection control in a passive, osmosis-like process. While I agree that learning through practising is probably the most important component, I have also long argued that this is simply not enough. What is needed is teaching of the theoretical and conceptual underpinnings, e.g. disease pathogenesis, transmission of infectious diseases and how transmission can be effectively prevented.
I have called the first approach the “parrot” approach to infection control. Parrots can be taught to speak but don’t understand it. (I can probably still find my earlier e-mails to OzBug/AICAlist calling this the “parrot” approach). If you look critically at the e-mail below and the report in the weblink, it looks like that’s exactly what’s happening here. I quote: “People were wearing them to protect themselves and not around actually anything to do with patient safety”.
For these reasons, I also vigorously disagree with the statement that it has to do with a “lack of clear guidelines”. How many guidelines for how many different clinical situations can healthcare workers be expected to memorise? It is a lack of understanding, not a lack of guidelines. If someone knows WHY something is necessary and/or makes sense, this is an important step towards doing it.
Best regards, Matthias.
—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387
—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Friday, 22 March, 2013 5:43 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Masks, gloves a ‘waste of time’: study
This article may be worth debating or at least commenting on here
‘Doctors and nurses are confused about when and how to wear face masks and respirators, with some doing it just for show, an Australian study finds.
In-depth interviews at a major Sydney hospital found several staff held negative attitudes towards infection control measures, with one even complaining respirators made them sound like the Cookie Monster.
Speaking Tuesday at the Australasian Society for Infectious Diseases annual conference in Canberra, researcher Dr Holly Seale highlighted a quote from a senior ward director suggesting masks, handwashing, gloves and gowns were a waste of time.
They actually said its all a show and there may not be any value in using those products, she said.
Meanwhile, face mask and respirator use among health workers was inconsistent, with staff unsure about when, how and why to wear them, Dr Searle said. Some complained they interfered with communication and rapport.
People were wearing them to protect themselves and not around actually anything to do with patient safety, said Dr Searle, blaming the lack of clear guidelines.
One participant even went on to call the respirator a Cookie Monster muffler quite out-there language in terms of a product that should be commonly used in these settings.
The interviews were conducted last year with 18 staff. The hospital has not been named.
Dr Seale, from the University of NSWs school of public health and community medicine, called for a review of current recommendations on infection control measures, citing studies showing low levels of compliance among hospitals worldwide.
My concern is that hospital staff dont know how to properly don and doff, nor are there any clear guidelines as to how long a mask can be worn for and whether masks can be used between patients, she said.’
Link: http://www.6minutes.com.au/news/latest-news/masks-gloves-a-waste-of-time-study (free registration by AHPRA registration number required).
Cheers
Michael Wishart
ACIPC Infexion Connexion Administrator
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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