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The quest for the silver bullet

Monty Python’s The Quest for the Holy Grail was the first
Monty Python movie I watched, but from that point on I was hooked!  If you’ve not had the pleasure of watching,
one of my favorite scenes is when
  King Arthur   and his squire, Patsy, who travel throughout   England  in
search
of men to join the Knights of the Round Table, encounter the Black Knight.
 The Black Knight, however, will not
let them pass without a fight.
A sword fight ensues with Arthur gaining the upper hand, but
the Black Knight continues fighting despite having his arms and legs severed.  The Black Knight assures King Arthur that the
injuries are nothing but a scratch and after losing both his legs explains that
he’ll bite King Arthur’s legs off.   Somehow, in the end the battle is declared a
draw…..  The movie continues with Arthur
and his Knights of the Round Table going in search of the Holy Grail.

What does Monty Python have in common with infection
prevention?  Well, until I read an
article on a
new invention that claims
to kill MRSA on surfaces in 5 minutes
I did not realize how far we have gone
in the quest for the elusive silver bullet in our fight against germs.   If we look back in history, routine
disinfection of frequently touched environmental surfaces and floors has been a
controversial issue due to the fact that the exact extent of the impact of
contaminated surfaces on the rate of infections is difficult to establish.  As the prevalence of antimicrobial resistant
organisms continues to rise, more attention has been paid to environmental
disinfection and its importance in an effective infection prevention program. We
would now agree that there is sufficient evidence for the possibility of
cross-contamination from surfaces to patients and staff, and vice-versa, to
make surface disinfection essential.   However, effective disinfection is dependent
on the choice of products, on suitable application methods, on staff training
and lastly, on evaluation and monitoring of processes to
ensure that disinfection is in fact occurring.  Effective cleaning and disinfection is also
dependent on having the appropriate amount of time to ensure that ALL surfaces
are addressed.

Back to King Arthur and the Black Knight
- in our quest to stop the spread of diseases are we King Arthur who is willing
to travel wherever he must to find the grail – even if it means fighting a
killer rabbit?  In our quest to kill
germs are we willing to try anything and everything in the hopes that something
will safeguard us against
our apathy of following methods we know work?  Cleaning and disinfection
works

We know this. But because of the human factor, we cannot trust people to
do their jobs correctly.  Have we
inadvertently made cleaning staff out to be the Black Knight in a futile fight
due to the fact that staffing has been cut and we expect more with less?  Cutting staff and not allowing for an
appropriate time to clean a room leads to cutting corners.  Have we effectively cut their arms and legs
off?

Don’t get me wrong, I am all for
innovation.  I am all for looking at ways
we can improve patient safety.  I am all
for looking at the use of
newer products that are
safer
for the environment and those who have
to use them.  What I am against, is the
use of Silver Bullets like doorknobs, handrails or what have you made out of
salt when we have not addressed the fact that hand hygiene rates continue to be
dismal and are linked to transmission of pathogens.  What I am against is the amount of money we
are willing to invest in the search of the Silver Bullet when if we added staff
to our housekeeping and nursing departments that we would not have people
struggling with too many rooms to clean or too many patients to care,
encouraging the mindset that we need to cut corners and skip cleaning of all surfaces
in a patient’s room or all shared patient equipment in order to get to them all.

Bugging Off!

Nicole

PS – Salt dissolves in a liquid does it
not?  How the heck are these surfaces
going to be cleaned?