The UNMC ID Division was pleased to host Dr Gonzalo Bearman, MD, MPH as a visiting professor 10/19/17-10/20/17. Dr Bearman, who is a Professor of Medicine, ID Division Chief and Medical Director of Hospital Epidemiology at Virginia Commonwealth University, gave an insightful and thought provoking grand rounds presentation on 10/20/17 entitled: “Hospital Infection Prevention: Processes, Pragmatisim, and Controversies”.
Dr. Bearman’s research focus is on the epidemiology of hospital-acquired infections with multiple articles in peer-reviewed publications. He is also passionate about education and dissemination of medical information and in addition to lectures in the College of Medicine and School of Public Health, launched an online magazine called the Medical Literacy Messenger and a blog discussing issues in Infection Prevention and Control and Hospital Epidemiology.
In his presentation, Dr Bearman expanded the concept of “Satisfice” a combination of satisfy and suffice, initially coined by Nobel prize winner Herbert Simon, to the field of Infection Prevention. To satisfice we need to find satisfactory solutions in a pragmatic manner for complex problems – not perfect solutions that are not practical. Dr Bearman is a proponent for Horizontal Infection Prevention solutions – interventions that cut across the board and impact all of our patients – examples include hand hygiene, standard infection control measures, antiseptic bathing, standardized methods to insert and care for indwelling lines and catheters.
During the session he described various approaches that his institution has implemented to decrease the rates of hospital-acquired infections. The most intriguing was the concept of healthcare provider attire and their bare below the elbows (BBE) approach. This non-mandated approach suggests that healthcare providers put away the white coat, wear short sleeved clothing such as team scrubs, team vests, and avoid wearing watches, bracelets or rings. In a survey to assess healthcare worker perception of this practice, Dr. Bearman’s team found that many providers laundered their white coats infrequently and most viewed the white coat as a potential source of bacterial transmission. Despite the BBE approach being non-mandatory, 2/3 of healthcare workers were compliant to this attire suggestion, and as part of a multi-faceted approach that included the BBE attire recommendations, Dr. Bearman’s team noted a significant decrease in hospital-acquired infections. This approach is very promising (and cheap), but requires a substantial paradigm shift and culture change as of course, the white coat has been a long-standing symbol of tradition in medical education.
After Grand Rounds, Dr. Bearman had some time to sit with members of our Infection Prevention and Control and Antimicrobial Stewardship teams for some small group discussion. He gave some advice to one of our PhD students working in Infection Prevention and Control, and discussed strategies for reducing hospital-acquired infections with our Infection Prevention nurses.
Dr. Bearman’s top 3 infection prevention pearls from our small group discussion:
- The science is better: while we cannot prevent ALL infections, we know more now what to do to prevent infections in the hospital
- Look for practical solutions to real life implementations
- Learn to be nimble –if it doesn’t work, be open to making a change! Human beings don’t always function in linear function in systems that are chaotic.
To learn more about Dr. Bearman’s research click here. Thank you Dr. Bearman for visiting us, we enjoyed your talks and hope you can visit again!
At Nebraska Medicine, we strongly adhere to the concept of Horizontal Infection Prevention interventions. Click here to learn more about Nebraska Medicine horizontal infection prevention efforts.
Content courtesy of Drs. Rupp and Marcelin.
BBE photo courtesy Dr. Bearman