We want our patients to be safe in our hospital
An interview with Susana Maria Filipe Gonçalves
Ambassador for infection control
“Working on infection control came quite naturally to me when I was working as a nurse in the Department of Oncology. I became a member of the infection control committee of our hospital and, after some time, the committee became a full-time job. This assignment changed my daily working life a lot: at this time I am mainly working with my colleagues – fellow nurses, doctors and microbiologists – on implementing good-practice guidelines on infection control. This is how I have decided to dedicate my work as a nurse to infection control.”
“I feel that my role may be similar to an ambassador for infection control: each day, I go to most units of the hospital, talk to my colleagues and share with them the guidelines developed by the infection control committee. Together, we find strategies on how to implement these guidelines.”
Infection control should have close bonds to every department of the hospital
“At the same time, I also monitor how the implementation process of our infection control guidelines is developing. It is important to cross-check with my colleagues whether they face any barriers in implementing effective infection control measures. Are there any troubles with interpreting the guidelines? Why are there troubles? And how can we support their understanding and implementation? Naturally, I also give advice and help to improve infection control practices in the respective units.”
Susana’s daily mission: to ensure that the guidelines are not only on paper but implemented in practice
“Our team has developed good-practice guidelines on infection control, based on national and international infection control plans (for example, guidelines from WHO and the United States Centers for Disease Control and Prevention). We adapted these guidelines to the needs of our institution. The development of these tailor-made guidelines was really important so that our recommendations are not only written on paper but are implemented in practice.”
“Good practice starts with extensive compliance with hand-hygiene practices, the responsible use of protective equipment, waste management and additional precautions, among others. It is very important to me that my colleagues know why they should wear protective equipment. It should not be just because it is a habit or because it is written somewhere. It should be a conscious procedure to improve the safety of health care workers and patients. The guidelines on waste management should solve the question of how to dispose of contaminated material. We therefore use different bags for different kinds of waste. We also developed guidelines on isolation precautions that allow several units to take additional precautions when a multidrug-resistant organism has been detected, to prevent infection transmission.”
Effective surveillance as the basis for everyday work
“Another important field of my work is epidemiological surveillance. The laboratory provides feedback to me when they identify a multidrug-resistant organism. In those cases, I study the information and develop recommendations for the unit concerned. In collaboration with my colleagues, I identify additional measures to prevent the multidrug-resistant bacteria from spreading. I also have to try to identify whether the multidrug-resistant microorganism was acquired in the hospital or not.”
We are still taking baby steps
“We are a very young committee. This means that our position among other colleagues is not so strong. We have to become established in all units step by step, and people still need to understand why our work is so important. At the same time, we know that the infection control committee is crucial to patient safety and good hospital care: for the first time in our hospital, we have developed and launched a tool (pocket chart format) that allows the physicians to analyse the resistance patterns of our microorganisms. It is very helpful and increases the accuracy of antibiotic prescriptions.”
“I can simply take the charts, go to our divisions and make them aware of the prevalence of resistant pathogens in our hospital. These charts can help them to prescribe the right antibiotics.”
“This project, however, is still in its infancy. Sometimes it is really difficult to convince colleagues of the seriousness of the situation. Too often, I receive answers like ‘it is not so bad, let’s not panic’. The new tool, on the other hand, is a good basis to argue that patients with high antibiotic resistance levels need special treatment such as isolation. We want our patients to be safe in our hospital.”
“Antibiotic resistance is without any doubt a very important issue in health care and, I would dare to say, in patient safety culture. If we do not use antibiotics in the best way we can, resistance patterns will be so high that we want to treat our patients but we will not be able to do it. We can only treat infections with the right and responsible use of antibiotics. That is why I believe that health care workers should be aware of epidemiologic surveillance reports, because they are tools for ensuring best practices.”
About Susana Maria Filipe Gonçalves
Susana Maria Filipe Gonçalves has been a nurse in Portugal for 11 years. She has worked in general surgery, haemodialysis and oncology. She has been an infection control nurse for almost two years. Currently, Susana is taking a degree in medical-surgical nursing with a specialization in infection control at the Nursing School of Coimbra, Portugal. After finishing her two-year degree, she plans to take a master degree in infection control.
