Infection prevention and control course was held between 24th to 27th July, 2019. The course began on the morning of the 24th with the heads of the departments and administration. Audit and surveillance of central line associated blood stream infections (CLABSI) was presented and there was healthy discussion with senior clinicians and administration. It has been shown internationally that with the strict observance of sterile techniques in the insertion and maintenance of central lines, the incidence of CLABSI can be reduced to zero, thus reducing morbidity and mortality.
The session on environmental cleaning was attended by nurses, infectious diseases fellows, consultants, technicians, and technologist, students and housekeeping supervisors, followed by practical demonstration which was attended by the housekeeping staff as well. It was emphasized that bacteria and viruses survive in the environment for a long time, since in Pakistan we have ideal conditions of humidity. Dr. Nizam Damani said that 1 drop of hepatitis B infected blood, left on the surface, can infect 100 persons since the virus remains viable for weeks. Housekeeping staff must also know how to protect themselves from exposure to blood and body fluids during their routine course work. The importance of hepatitis B vaccination for all healthcare workers was stressed by the presenters.
A seminar on Surveillance of Health Care Associated Infections was conducted by Dr. Nizam Damani and Dr. Sartaj Mohammad with case studies and exercises detailing the methodology of performing accurate surveillance. Surveillance is important because it gives us a snapshot of the situation, thus leading to interventions, and improvement. There were over 50 participants which included doctors and nurses from outside institutions.
A dedicated session to safe injection practices was held, in view of the recent outbreaks of HIV in children in Larkana, where reuse of syringes and sharing of saline and medications for multiple children, resulted in the transmission of HIV. This is a tragedy of indescribable proportions, in children who are already struggling with malnutrition, community acquired infections and dire poverty. A lecture on the importance of the proper technique of drawing blood cultures aseptically was delivered by Dr. Ali Nadeem, head of Microbiology, and it was attended by around 100 health care professionals including from the field of nursing. It was mentioned that contamination during blood culture draw leads to increased use of time and resources of the Microbiology laboratory, and, very often, unnecessary treatment of the patient with prolongation of hospital stay and cost. Contamination must be avoided.
On the final day of the visit of Dr. Nizam damani, a debriefing meeting was held with administration and it was concluded that we must focus on CLABSI, environmental cleaning and injection safety and blood culture techniques. Sub-committees were formed. The goal is for a clean and safe environment for healthcare workers, patients and visitors.