The covid-19 pandemic denoted how decisive is the investment of hospitals in the prevention of infections associated with health care (IAHC). For Luz Saúde – that to date only registered about a hundred of professionals in the group infected with covid-19 –, this was always a priority area, being the motto for this Hospital da Luz podcast, with doctor Carlos Palos and nurse Ana Soraia Bispo. The interveners in this podcast are precisely two specialists that work daily in the definition and adoption of politics in this area: Carlos Palos , specialist in Internal Medicine and Intensive Medicine, is the responsible for the infection control committee of Luz Saúde, and nurse Ana Soraia Bispo belongs to the group of infection control at Hospital Beatriz Ângelo, in Loures. The inevitability of epidemics and pandemics, the “super bacteria” resistant to antibiotics, the reason why money spent in the anticipated preparation of health structures to prevent infections is an investment that saves lives and spares future expenses, and how the Luz Saúde units were organized to prevent IAHC and covid-19 – are some of the questions approached in this discussion. Hospital da Luz Podcast is the title of a series of podcasts, where the professionals in this group discuss the most recent topics in their areas. The podcasts are available on streaming and audio platforms (Spotify, iTunes, Google Podcast, etc.), and also on YouTube. Carlos Palos: ‘The mortality caused by IAHC is higher than thar of COVID-19’ “In terms of health systems management, globally, sustainability is at stake. The IAHC represent a burden as for hospital capacity.” “A considerable number of IAHC are caused by bacteria multi-resistant to antibiotics. For each new antibiotic, bacteria will always be able to develop resistance. According to international projections, until 2050, if we do nothing – namely, in the optimization of antibiotic prescription by physicians –, 10 million people will die due to IAHC.” “Presently, we are very worried about covid-19, but the truth is that the number of deaths caused by IAHC, and in particular caused by multi-resistant bacteria, is much higher than this pandemic mortality.” “The investment that needs to be done includes the training of professionals and the establishment of conditions that will ensure in each unit the human, technical and financial resources necessary for the prevention of IAHC. This is a high return investment and the subject should be approached in an objective and straightforward manner by the national decision makers.” “We are the worst country (together with Greece), with infection rates around 8% - meaning that out of 100 patients in Portuguese hospitals, 8 develop an IAHC –, while the European average is about half, some countries with rates of 2%.” “Over the past few years, we provided training to our professionals and placed at the front line, in emergency services, information for patients. We have created contingency rooms and the whole emergency structure was prepared to ensure safety conditions, from screening to medical assistance.” “Face to covid-19, there was a Herculean effort to convey information to patients that could give them confidence, otherwise diseases would evolve irreversibly. As for collaborators, we created mechanisms to let them know that we could help them, besides conditions to minimize whenever possible the lack of work, but always guaranteeing their safety.” “Presently, we have less than 100 persons infected with covid-19 in the group, that comprises 15 thousand collaborators. And most of them were infected outside the hospital.” Ana Soraia Bispo: ‘You need to measure the impact of prevention’ “We do a great investment in the assessment of the impact of prevention – and we deliver those numbers periodically to the professionals and direction boards. For instance, at Hospital Beatriz Ângelo, the rate of infection associated to urinary catheterization was reduced by half.” “In the Netherlands, infection control teams have long integrated specialists in statistics, that for each investment measure proposed to the board, quantify the respective return, meaning, how much will be recovered in one, two or three years, and so on.” “We may have the best surgeon in the world performing a complex operation along 24 hours, and a nursing team of equal excellence. But if we do not invest in auxiliary staff with adequate training, and if the patient is not laid down in a clean bed and does not have a completely disinfected bathroom, the investment made in the other two groups of professionals goes down the drain, if the patient catches a multi-resistant bacteria.” “I often say and explain that if the cleaning is not properly done after a patient is discharged, it is as if we put the former patient embracing the next patient. Nobody wants that, right?” “The most developed countries should keep this in mind: with globalization, any hospital in any part of the world, could be confronted tomorrow with an infection of extremely high degree of contagiousness.” Listen to Hospital da Luz Podcast on the topic: “As infeções associadas aos cuidados de saúde e a COVID-19” Google | iTunes | Spotify
