Comment

23.06.17

The now and the future of infection prediction

Source: NHE May/Jun 17

Marco-Felipe King, an infection control postdoctoral researcher at the Institute for Public Health and Environmental Engineering at the University of Leeds, explains why the future of infection prevention is in smart buildings and real-time contamination prediction.

Current practice centres on antimicrobial stewardship and hand hygiene as being the most effective interventions for controlling infection. They have become a central focus for global infection control, with much media attention devoted to their promotion. A disproportionate amount of effort has been put into strategies enticing us to clean our hands, but despite time and money being spent on this, hospital-acquired infections (HCAIs) are still a major problem. The central tenets of Florence Nightingale’s ‘Notes on Nursing’ are still very much present in current infection prevention practices today: most of them are common sense, but what happens when common sense isn’t enough? From an engineering perspective, the future of infection prevention is in smart buildings and real-time contamination prediction. 

‘The Big Five’ is what I call the most prominent routes of infection transmission: direct and indirect contact, common vehicle, droplet and airborne transmission are terms that very rarely exist independently but which are still poorly understood. Some multidrug resistant organisms, such as MRSA and Clostridium difficile, are known to spread through direct contact but many others hitch a ride on airstreams, depositing out onto surfaces metres away from the infectious source. As a result, four or all five of these routes can be involved in pathogen transmission.

The idea that the hospital building, the air and staff behaviour can contribute to propagating infection is not a new one, but often too much effort is invested cheaply into only one aspect at a time. Advancement lies in understanding how these three interact. Hospital airflow patterns are too often slaves to external weather conditions, cold patients and poorly functioning ventilation systems. It’s crucial to remember that the building around us itself is not a static entity, especially in terms of microbial biome, and that the way humans interact with their workspace is surprisingly predictable. Computer simulations at the University of Leeds can now predict the movement of pathogens through the air, how long it will take them to deposit on surfaces and what rate of ventilation would help balance the cost of airborne infection transmission with energy usage. 

Moving forward with connectivity 

We’re at the beginning of an age where every gadget in our homes contains a computer, and this idea of connectivity is now being applied to hospital wards. If you ever wanted to be able to see the movement of microorganisms floating through the air, the technology to make this possible is already here. Infection prevention within five years will see smart systems such as indoor ‘weather’ forecasting, at a fraction of the cost of traditional building management systems. Tiny wireless sensors in clinical areas will relay live air quality data to a central computer which will alert staff when conditions such as low humidity, high temperature or increased bioaerosol counts might increase infection risk. It will combine smart algorithms that can predict staff surface contacts with cleaning rotas to give an up-to-the-minute forecast of which areas might pose a higher risk to patients, particularly those with weakened immune systems or susceptible to airborne pathogens. 

It is time to address the current obsession with the culture of blame and unrealistic hand hygiene targets by balancing out the use of other weapons we have in our infection prevention arsenal. Appropriate antimicrobial stewardship, catheter-care, targeted cleaning, patient screening and good ventilation should go hand-in-hand with future smart technologies. Florence Nightingale is often quoted as saying “hospitals should do the sick no harm”, and this is as current today as it will be in the future.

Tell us what you think – have your say below or email opinion@nationalhealthexecutive.com

Comments

Mitch Hansen   26/06/2017 at 14:48

How do you see Point-of-Use disinfection systems playing into this? I'm thinking specifically of the UV-C LEDs that have been coming up in development.

Bruce White   29/06/2017 at 22:58

Great article Marco and why we've developed Airthinx, a IoT connected device that can be an early detector for airborne issues and/or conditions such at PM10, PM 2.5, and PM1, plus Temp, Rh, CO, CO2 and other optional contaminants. Field tests when used in Healthcare construction as a predictive warning device that auto alerts by text and email, those who need to be aware of a pending issue. You are spot on in that the trend, while mainly focusing on antimicrobial issues, should be the holistic conditions that are ever changing, but can me measured to build predictive models, or as an alert to a pending condition. Keep up the good work!

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Test and trace service to be given £300m additional funding

26/05/2020Test and trace service to be given £300m additional funding

Local authorities are set to be supported by £300m government funding to work alongside local NHS providers and other stakeholders, as part... more >
Five new research centres to improve patient access to clinical research

22/05/2020Five new research centres to improve patient access to clinical research

Five new regional Patient Recruitment Centre sites are set to be hosted by NHS trusts across the country, providing patients with an improved&nbs... more >
New treatment for advanced breast cancer given NICE recommendation

22/05/2020New treatment for advanced breast cancer given NICE recommendation

As part of NICE’s newly released draft guidance, the drug atezolizumab has been recommended for treating patients with a type of breast can... more >

the scalpel's daily blog

Why an online healthcare masters is key to career progression

21/05/2020Why an online healthcare masters is key to career progression

The University of Glasgow offers a whole host of healthcare online degrees designed to promote your skills and progress your career. Join us and make your mark today. Against a backdrop of increasingly aging populations and advancing medical technology, the pressure on health services worldwide is growing. If you’re a healthcare professional willing to learn new skills, this presents a prime opportunity to significantly progress y... more >
read more blog posts from 'the scalpel' >

interviews

Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

health service focus

Diversifying to meet a demand: One business' response to PPE shortages

18/05/2020Diversifying to meet a demand: One business' response to PPE shortages

As Covid-19 demands innovation from all busin... more >
NHS SBS: A 21st Century NHS

02/04/2020NHS SBS: A 21st Century NHS

Sean Hopkins, Head of Programmes and Technolo... more >