A recent series of articles at The Conversation on antibiotic resistance in bacteria1 provide a disturbing reminder of modern medicine’s reliance upon the use of antibiotics and how dangerous the world was without them. For example, procedures currently viewed as routine such as hip and knee replacements would in many cases be too risky to justify in the absence of effective antibiotic cover.
Unfortunately however, the options for antibiotic treatment continue to diminish as resistant strains of bacteria evolve. Concern regarding the effectiveness of the antibiotic options has been accompanied by an increasing or renewed focus upon physical infection control through hand cleaning. Driven by research showing increasing compliance with hand hygiene can significantly reduce rates of bacterial infection and the Commonwealth Government funded Hand Hygiene Program, hospitals are now littered with alcohol-based hand-wash dispensers.
Hand hygiene compliance by health care professionals is said to have increased from less than 50% to almost 76% in just three years as a result. Drilling down the compliance rate is less for doctors at 62%2.
The implications of antibiotic resistance and the changes it is driving in medical practice have so far been more medical than legal. While some patients have pursued claims for infections suffered in hospital, infection generally is accepted to be one of the risks involved in a hospital admission. It would be difficult for a patient who cannot point to some particular act or omission to prove that a general lack of infection control procedures caused their infection.
However, infection control efforts may still impact the medico-legal landscape more generally. A patient who suffers an infection resulting in an extended hospital stay and a poorer outcome will look harder at the treatment they have received, and a claim for damages may result. Such complaints may also cause organisations such as the Health Quality and Complaints Commission and health practitioner regulation boards to look at systems more generally.
Assuming infection control grows in importance as part of modern medical practice as expected, the hand washing habits of health practitioners are therefore likely to come under increasing scrutiny.