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	<title>Comments on: A Modest Proposal To Reduce Hospital Infections</title>
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	<description>Bad Science And Scary Science</description>
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		<title>By: Ryan</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37819</link>
		<dc:creator>Ryan</dc:creator>
		<pubDate>Sat, 13 Oct 2012 01:33:35 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37819</guid>
		<description>It is clear liability isn&#039;t properly distributed. Doctors are afraid of malpractice... but not because they give their patient a disease.


Also, washing your hands too often isn&#039;t healthy, blisters. Probably best to put on your gloves and then wash those.</description>
		<content:encoded><![CDATA[<p>It is clear liability isn&#8217;t properly distributed. Doctors are afraid of malpractice&#8230; but not because they give their patient a disease.</p>
<p>Also, washing your hands too often isn&#8217;t healthy, blisters. Probably best to put on your gloves and then wash those.</p>
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		<title>By: I'mnotreallyhere</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37785</link>
		<dc:creator>I'mnotreallyhere</dc:creator>
		<pubDate>Wed, 10 Oct 2012 15:11:09 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37785</guid>
		<description>[quote comment=&quot;37706&quot;]I like the idea of making it a financial pressure issue, but not sure how that would work out with NHS hospitals, since the finance is managed centrally and its not like they send the bill up in the way privates do, but it could well work with private hospitals.[/quote]

Actually it&#039;s really really easy under the NHS : you simply make rates of infection a target issue and apply funding penalties to hospitals which don&#039;t hit the target. This has been done, and with some success : http://www.nao.org.uk/whats_new/0809/0809560.aspx

[quote comment=&quot;37764&quot;]This is particularly true of women who still make up the bulk of new uptake into nursing. In the past it was one of the few careers an intelligent independent minded girl could aspire too. Now these women can do just about anything they want. In the past you could make these girls eat dirt because they had no other choice if they wanted a job, now you have to work to keep them.[/quote]

This is a very important point. As little as forty years ago, becoming a doctor was incredibly difficult for women (my own mother quit a medical degree because of the abusive, chauvinistic environment) so smart, driven girls were aiming for nursing. Now it&#039;s becoming something of a weak option - the smart, driven young women I know (with a love of science) have all studied genetics, pharmacology and medicine.

[quote comment=&quot;37777&quot;]Sorry but you are wrong. Lack of patient contact IS the core of the problem.[/quote]

Have to say I&#039;m with DV8 on this : the lack of patient contact is a result of other pressures. Yes it has some tragic effects (that&#039;s by no means the only article which could be cited) but it&#039;s a result of the current healthcare climate in the UK: target setting (= dubious priorities), budget cuts (= staff cuts) and accountability (= excessive paperwork).

Returning vaguely to the original blog topic : would there be any worthwhile gain from having more (all?) staff and visitors wear surgeon-style face masks?</description>
		<content:encoded><![CDATA[<div class="quoter-wrap">
<p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <a href="http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/#comment-37706"><b>Mark said:</b></a></p>
<blockquote cite="http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/#comment-37706"><p>
I like the idea of making it a financial pressure issue, but not sure how that would work out with NHS hospitals, since the finance is managed centrally and its not like they send the bill up in the way privates do, but it could well work with private hospitals.</p>
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<p>Actually it&#8217;s really really easy under the NHS : you simply make rates of infection a target issue and apply funding penalties to hospitals which don&#8217;t hit the target. This has been done, and with some success : <a href="http://www.nao.org.uk/whats_new/0809/0809560.aspx" rel="nofollow">http://www.nao.org.uk/whats_new/0809/0809560.aspx</a></p>
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<p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <a href="http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/#comment-37764"><b>DV82XL said:</b></a></p>
<blockquote cite="http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/#comment-37764"><p>
This is particularly true of women who still make up the bulk of new uptake into nursing. In the past it was one of the few careers an intelligent independent minded girl could aspire too. Now these women can do just about anything they want. In the past you could make these girls eat dirt because they had no other choice if they wanted a job, now you have to work to keep them.</p>
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<p>This is a very important point. As little as forty years ago, becoming a doctor was incredibly difficult for women (my own mother quit a medical degree because of the abusive, chauvinistic environment) so smart, driven girls were aiming for nursing. Now it&#8217;s becoming something of a weak option &#8211; the smart, driven young women I know (with a love of science) have all studied genetics, pharmacology and medicine.</p>
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<p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <a href="http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/#comment-37777"><b>Peebs said:</b></a></p>
<blockquote cite="http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/#comment-37777"><p>
Sorry but you are wrong. Lack of patient contact IS the core of the problem.</p>
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<p>Have to say I&#8217;m with DV8 on this : the lack of patient contact is a result of other pressures. Yes it has some tragic effects (that&#8217;s by no means the only article which could be cited) but it&#8217;s a result of the current healthcare climate in the UK: target setting (= dubious priorities), budget cuts (= staff cuts) and accountability (= excessive paperwork).</p>
<p>Returning vaguely to the original blog topic : would there be any worthwhile gain from having more (all?) staff and visitors wear surgeon-style face masks?</p>
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		<title>By: DV82XL</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37779</link>
		<dc:creator>DV82XL</dc:creator>
		<pubDate>Mon, 08 Oct 2012 16:45:05 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37779</guid>
		<description>If this is the case in the U.K. it is indeed shameful and clearly things are not anywhere near as bad in Canadian hospitals even though we we have socialized health care too. This being so we are then obviously arguing from two very different perspectives and without any common ground between us. As a consequence of this realization I am dropping this discussion.</description>
		<content:encoded><![CDATA[<p>If this is the case in the U.K. it is indeed shameful and clearly things are not anywhere near as bad in Canadian hospitals even though we we have socialized health care too. This being so we are then obviously arguing from two very different perspectives and without any common ground between us. As a consequence of this realization I am dropping this discussion.</p>
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		<title>By: Peebs</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37777</link>
		<dc:creator>Peebs</dc:creator>
		<pubDate>Mon, 08 Oct 2012 08:38:00 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37777</guid>
		<description>Sorry but you are wrong. Lack of patient contact IS the core of the problem.

http://www.telegraph.co.uk/health/9593278/Nursing-care-in-crisis.html

Disgraceful and no excuse. 

Those involved should be charged with manslaughter,</description>
		<content:encoded><![CDATA[<p>Sorry but you are wrong. Lack of patient contact IS the core of the problem.</p>
<p><a href="http://www.telegraph.co.uk/health/9593278/Nursing-care-in-crisis.html" rel="nofollow">http://www.telegraph.co.uk/health/9593278/Nursing-care-in-crisis.html</a></p>
<p>Disgraceful and no excuse. </p>
<p>Those involved should be charged with manslaughter,</p>
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		<title>By: DV82XL</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37776</link>
		<dc:creator>DV82XL</dc:creator>
		<pubDate>Mon, 08 Oct 2012 00:47:57 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37776</guid>
		<description>Lack of patient contact is not the core of the problem, it is the &lt;i&gt;symptom.&lt;/i&gt;  The &lt;i&gt;problem&lt;/i&gt; is a lack of manpower and the fact that the people that we do have are expected to deliver a far greater number of medical services than their predecessors were.  It is all very well to talk about getting out and being with the patients but another thing altogether being able to do it, and modern nurses just don’t have the luxury of doing so. Those that make these sorts of broad statements need to back them up with some practical alternatives, and that is usually lacking.   

Robotics is one potential alternative in that these may one day take on some of the routine work that sucks up human effort and time thus freeing people like nurses to spend more time doing things like direct patient contact.</description>
		<content:encoded><![CDATA[<p>Lack of patient contact is not the core of the problem, it is the <i>symptom.</i>  The <i>problem</i> is a lack of manpower and the fact that the people that we do have are expected to deliver a far greater number of medical services than their predecessors were.  It is all very well to talk about getting out and being with the patients but another thing altogether being able to do it, and modern nurses just don’t have the luxury of doing so. Those that make these sorts of broad statements need to back them up with some practical alternatives, and that is usually lacking.   </p>
<p>Robotics is one potential alternative in that these may one day take on some of the routine work that sucks up human effort and time thus freeing people like nurses to spend more time doing things like direct patient contact.</p>
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		<title>By: Peebs</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37774</link>
		<dc:creator>Peebs</dc:creator>
		<pubDate>Sun, 07 Oct 2012 22:23:38 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37774</guid>
		<description>I agree the argument is becoming somewhat circular but your reference to the Japanese and to robotics leaves me baffled.

Lack of patient contact is at the very core of the problem.

I&#039;m on my mobile (cell) at the moment so C&amp;P is arduous but I&#039;ll post a link referring to this very problem as soon as I can.</description>
		<content:encoded><![CDATA[<p>I agree the argument is becoming somewhat circular but your reference to the Japanese and to robotics leaves me baffled.</p>
<p>Lack of patient contact is at the very core of the problem.</p>
<p>I&#8217;m on my mobile (cell) at the moment so C&amp;P is arduous but I&#8217;ll post a link referring to this very problem as soon as I can.</p>
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		<title>By: DV82XL</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37764</link>
		<dc:creator>DV82XL</dc:creator>
		<pubDate>Sat, 06 Oct 2012 03:33:31 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37764</guid>
		<description>This argument is becoming circular. Yes it would be great if things were done as they were in the past when labor was cheap and plentiful and those that were delivering these services were ether more committed, or more easily dominated, BUT that is not the case now.

You cannot make the sorts of demands on this generation in the workplace that we were burdened with in our day. The bottom line is that there are not enough of them, at the quality now needed to fill the spaces available, and there are others trying to hire from the same pool.  

This is particularly true of women who still make up the bulk of new uptake into nursing. In the past it was one of the few careers an intelligent independent minded girl could aspire too. Now these women can do just about anything they want. In the past you could make these girls eat dirt because they had no other choice if they wanted a job, now you have to work to keep them. 

This is not just women in nursing – its happening all over and businesses and industries of all sorts have to make adjustments to how they manage human resources and explore automation to replace labor to do the jobs that no one wants to do at the price we are willing to pay.  This is just the new reality particularly in the West, and we all better get used to it.  The Japanese saw this coming a long time ago, which is why they have invested so much time an money into robotics.  We would do well to follow their lead in this regard.</description>
		<content:encoded><![CDATA[<p>This argument is becoming circular. Yes it would be great if things were done as they were in the past when labor was cheap and plentiful and those that were delivering these services were ether more committed, or more easily dominated, BUT that is not the case now.</p>
<p>You cannot make the sorts of demands on this generation in the workplace that we were burdened with in our day. The bottom line is that there are not enough of them, at the quality now needed to fill the spaces available, and there are others trying to hire from the same pool.  </p>
<p>This is particularly true of women who still make up the bulk of new uptake into nursing. In the past it was one of the few careers an intelligent independent minded girl could aspire too. Now these women can do just about anything they want. In the past you could make these girls eat dirt because they had no other choice if they wanted a job, now you have to work to keep them. </p>
<p>This is not just women in nursing – its happening all over and businesses and industries of all sorts have to make adjustments to how they manage human resources and explore automation to replace labor to do the jobs that no one wants to do at the price we are willing to pay.  This is just the new reality particularly in the West, and we all better get used to it.  The Japanese saw this coming a long time ago, which is why they have invested so much time an money into robotics.  We would do well to follow their lead in this regard.</p>
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		<title>By: Peebs</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37761</link>
		<dc:creator>Peebs</dc:creator>
		<pubDate>Fri, 05 Oct 2012 21:01:37 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37761</guid>
		<description>I haven&#039;t heard pressure sores called decubitus for a while!

The point is that there is no need for expensive kit like the inflatable mattresses to which you refer except on high dependency units such as ITU or CCU. Get the nurses out of the classroom a bit more and onto the wards.

I&#039;m not alone is this school of thought. A lot of senior nursing and medical staff feel the same way.

DonM expresses my points but with much more brevity!</description>
		<content:encoded><![CDATA[<p>I haven&#8217;t heard pressure sores called decubitus for a while!</p>
<p>The point is that there is no need for expensive kit like the inflatable mattresses to which you refer except on high dependency units such as ITU or CCU. Get the nurses out of the classroom a bit more and onto the wards.</p>
<p>I&#8217;m not alone is this school of thought. A lot of senior nursing and medical staff feel the same way.</p>
<p>DonM expresses my points but with much more brevity!</p>
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		<title>By: DonM</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37754</link>
		<dc:creator>DonM</dc:creator>
		<pubDate>Fri, 05 Oct 2012 06:02:59 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37754</guid>
		<description>...  how to be (at a minimum) the most efficient at what you do.</description>
		<content:encoded><![CDATA[<p>&#8230;  how to be (at a minimum) the most efficient at what you do.</p>
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		<title>By: DonM</title>
		<link>http://depletedcranium.com/a-modest-proposal-to-reduce-hospital-infections/comment-page-1/#comment-37753</link>
		<dc:creator>DonM</dc:creator>
		<pubDate>Fri, 05 Oct 2012 05:57:47 +0000</pubDate>
		<guid isPermaLink="false">http://depletedcranium.com/?p=12560#comment-37753</guid>
		<description>Peebs, all your points are very good.

It is sad that it has beocme the accepted norm that a degree now merits the accepted status as &quot;qualified&quot; for anything.

While at the same time, because of poor regulation, sucess with hands on experience is no longer an accepted indicator of a persons ability.

I haven&#039;t been involved the medical professions, but I would assume that it is the same as other endevors that require a very broad range of knowledge; working from the bottom up would create a better overall understanding of</description>
		<content:encoded><![CDATA[<p>Peebs, all your points are very good.</p>
<p>It is sad that it has beocme the accepted norm that a degree now merits the accepted status as &#8220;qualified&#8221; for anything.</p>
<p>While at the same time, because of poor regulation, sucess with hands on experience is no longer an accepted indicator of a persons ability.</p>
<p>I haven&#8217;t been involved the medical professions, but I would assume that it is the same as other endevors that require a very broad range of knowledge; working from the bottom up would create a better overall understanding of</p>
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