off record
Shaukat Ali Jawaid


Increasing prevalence
of Hospital 
Infections (HAIs)


There are reports of increasing Hospital Acquired Infections (HAIs) which are increasing morbidity and mortality since most of the healthcare facilities both in public and private sector have no Infection Control Committees. While this is increasing the cost of medical care tremendously, the most alarming situation is the emergence of Multi Drug Resistant bacteria. Resistance to the common antimicrobial agents which are economically priced is increasing which leads to the use of latest generation, most expensive antibiotics. Increasing resistance to the presently available antibiotics was also taken up by the WHO recently which has warned that no new molecule of antimicrobial agent is in the pipeline, hence we need to use the available drugs judiciously.

In the absence of any monitoring and mechanism to control hospital acquired infections, most of the so called Intensive Care Units (ICUs) are in fact reservoirs of bacteria and once a patient gets admitted there, their chances of recovery are decreased tremendously. Firstly most of these ICUs are not properly equipped and staffed with qualified trained healthcare professionals including consultants, medical officers, nurses and paramedics and secondly no body feels the need and importance of putting in place effective infection control measures as it calls for some investment.

Professional ethics demands that healthcare professionals must demand setting up of Infection Control Committees in each and every institution. They should have standard Operating Procedures (SOPs) which must be followed and implemented in letter and spirit. Government as well as owners of the private health care facilities must realize their duties and responsibilities to initiate infection control measures, ensuring rational prescribing, neat and clean environment in and around healthcare facilities, proper entry and exit points in all hospitals, strict adherence to Visiting Hours for the attendants of patient while children should not be allowed to visit hospitals even during visiting hours. However, one often sees that patient’s attendants and relatives quite frequently visit even the Intensive Care Units and Coronary Care Units in healthcare facilities by greasing the palms of staff posted at the entrance. Little do they realize that this frequent traffic to hospitals, ICUs and CCUs results in spreading infections which endanger the lives of their near and dear ones admitted there?

Government of Punjab a few years ago had established the Punjab Health Care Commission (PHCC) which has been entrusted with the responsibility of registering healthcare professionals as well as healthcare facilities. It is doing a commendable job despite lot of political and legal hurdles and opposition from the medical profession itself. The doctors believe that when quackery is rampant and quacks are playing with the life of people without any check, it does not justify to harass the qualified healthcare practitioners. They have a point and campaign against quackery needs to be further intensified and accelerated but this does not mean that neither the doctors nor the healthcare facilities should be brought under any monitoring system and held accountable for their professional negligence and mistakes. PHCC is also helping the Governments of Sindh and KPK who have also established Provincial Healthcare Commissions to initiate some measures benefiting from their experience and expertise.

Professional specialty organizations also have a responsibility to educate its members, remind them of their responsibilities to uphold professional ethics, practice infection control measures besides creating awareness among the general public. Instead of resorting to any punitive measures, fines and punishments, those healthcare facilities who identify their lapses, problems and are willing to rectify them within a given time, are willing to make investments needed, should be encouraged, helped and supported. The objective should be ensuring patient safety and making the healthcare cost effective rather than making the death more expensive through un-necessary investigations, interventions most of which are not needed and are dictated by the financial interests of the healthcare professionals and healthcare institutions. Ethics has a lot to do with morality, let us promote moral values and try to shake and wake up those whose conscious is sleeping which may be much more rewarding as compared to any punitive measures.

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