Posted by: Witch Doctor | November 21, 2008

Deaths from hospital acquired infection


As you can deduce from the previous post, we witches find The Humankind very trying.

For this reason we always restrict our number of Humankind friends to seven. Seven is the magic number and so we are in a position to call upon a spell or two when we feel relationships are getting too taxing.

We allow ourselves infinite numbers of witch friends. We call them “Our Friends.” We call our seven chosen Humankind Friends “Our Irksome Friends”

At the moment, since The Witch Doctor’s remit is to study the vagaries of the medical profession and try to stop them acting like lemmings, all seven of her chosen Irksome Friends are doctors. They cover a good cross section of age, sex, seniority and specialty.

To date only three of them have been mentioned in this blog. These are Dr Sixties Sideburns, Dr Flower-Power and My Less Irksome Friend (The favourite as he is not so irksome as the rest.)

Last night The Witch Doctor was watching a programme about deaths from Cl difficile in a particular hospital.

It reminded me of My Less Irksome Friend. He is a microbiologist.



In the hospital where My Less Irksome Friend works, it is very unusual to have a death from bacterial infection unless a patient is admitted in the very late fulminant stages.

It is even unusual for patients to die from bacterial infection while receiving the most rigorous immuno-supressive therapy eg during remission induction for acute leukaemia.

No, it is not unusual.

It is rare.


Because the radar My Less Irksome Friend uses, detects when things are not as they should be, and he nips everything in the bud.

He knows patients individually, he knows ward staff individually even though his office is in a laboratory.

He managed to identify an early increase in the number of patients with isolates of Cl difficile in his hospital and took corrective action very quickly. Just by talking to staff and winning them round and working together. True teamwork. True leadership. While others play about with feedback statistics, protocols, committees and working groups, he moves from the lab to ward, from ward to ward, from ward to lab and back again. Everyone, everywhere knows him well. They see him daily. He is trusted and respected. His respect has been earned, not because of the status he holds, the committees and working groups he sits on (or not). He is respected because of his wide and deep knowledge of micro-organisms and the various tricks the different types get up to during their interplay with patients and the environment. He is respected because of his practical dedication to patient care, and the sound support to gives to all staff whatever their role. He is hands on both in the lab and at the bedside.



That is his radar. It enables him to get on to things very, very quickly – usually before they happen.

He gets no thanks from on high, because no one has asked why there is not a hospital acquired infection problem where he works.

Those on high have not even noticed that there is not a problem in his hospital with hospital acquired infection.

They are so busy sweating it out with the media and lawyers in the places where there is a problem.

No-one on high has realised that if they looked down below they would see A Gold Standard glistening far below them.

There are more important things to do.

No doubt the hospital featured on TV last night would have a microbiologist. Was there a microbiology lab on site? If not, was there a microbiologist based there who walked round the wards daily, identifying and teasing out problems and who was in close communication with the lab at all times?

Or was there A Notional Microbiologist situated somewhere between a neighbouring hospital and the moon who could be notionally contacted if there was “a problem.”

Bearing in mind that by the time the ward staff are aware there is a problem, the stable door is often wide open.

If anyone on high is reading this post who has been involved in a hospital with a high death rate from hospital acquired infection, then please ask this question.

Was there at least one microbiologist dedicated to this hospital who was physically present there in the wards and lab every day?

Or was there A Notional Microbiologist very busy somewhere else but as far as the hospital is concerned, might as well have been on the moon waiting for a phone call. A Notional Microbiologist whose main role was to be wheeled in when problems were out of control and to take the blame?

Was The Radar indeed in place?

If not, therein lies the problem.



Does it take a manslaughter charge somewhere before it is realised that deaths from hospital acquired infection can be substantially decreased by one simple measure?

Bearing in mind that the ultimate responsibility for infection control within a hospital is now the responsibility of the chief executive.

Bearing in mind that infection control manuals, protocols and statistical feedback are a help but are not enough.

This country needs more doctors.

This country needs a consultant DELIVERED service.

That includes a consultant DELIVERED clinical microbiology service.

redapple.jpg a red apple ……………………

The Witch Doctor – Link to a random page






  1. WD et al

    Hope you are all ok over there. Not heard a peep out of you for a few weeks.

    Just drop me a note to say you are ok


  2. […] Doubtless, My Less Irksome Friend would like to know…… […]

  3. Infectious Diseases in Clinical Practice: Clostridium difficile-Associated Disease : “The Perfect Storm” Has Arrived and it falsely kills many because it is not talked about enough too.. There should be weekly mandatory reporting of all hospital acquired infections, not just the number of Hospital deaths Have you also not noticed that most hospital patients, many of who are too too sick to get up, they do not wash their hands before they eat Personnel Cleanliness in Hopsitals and even the Hospital food ain’t always that great still too..
    Did they say that the infection was growing somewhere in the ER? Sounds like a late-night movie, but this is very serious. Who has the contract for cleaning, the same people who clean Maple Leaf Foods? Some serious Infections can be airborne transmitted as well as the standard contact transmission, and no serious disease should be taken lightly by anyone.

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