I P&C POL ICY
Compassion and IPC: time for a hard reset?
Speaking at IP2021, Julie Storr called for a ‘hard reset’ in infection prevention and control, to ensure compassionate care is not overlooked, amidst efforts to eliminate risk from infectious diseases.
Reflecting on the pandemic, Julie Storr, a consultant with the World Health Organization and past Infection Prevention Society president, spoke of the need for a ‘hard reset’, within the field of infection prevention. This, she asserted, must focus on compassion. She challenged delegates to rethink infection prevention and control (IP&C), to learn lessons from the past, and to challenge decisions made in the name of IP&C. She argued that IP&C policy must be used as “a force for good” yet this has not always been the case. “We have had restrictions on our liberty to stop COVID-19, which have ranged from the way we shop, to how we work, to delays to medical appointments; some will have had restrictions on seeing loved ones in hospital or care homes and many will have had to enforce restrictions, as part of their role, and to try and support people to lift some of those restrictions, to change the way they were applied,” she commented.
Before 2020, if you searched in the IP&C guidelines and literature for references to ‘compassion’ in terms of training and policies, you would have had to search quite hard. However, as far back as 2016, Julie Storr wrote in a book (co-authored with Paul Elliott and Annette Jeanes) of the need to apply IP&C from a holistic, rights-based perspective that takes account of dignity, ethics and humanity.1
In one of the book’s chapters, she sought to challenge IP&C practitioners to ask questions about some of the edicts and “things that happen in the name of IP&C”. Historically, some of these have been questionable and even damaging – the way in which patients with AIDs were treated in the name of IP&C is just one example. Storr highlighted the need to consider the unintended consequences of IP&C policies and actions. Jette Holt, for example, discussed the ethical aspects and unintended consequences of isolating
of patients with infectious diseases and questioned whether MRSA was the “infection stigma of our time”.2 “This paper highlighted cases of elderly people with dementia being isolated for long periods, people being denied access to GP services, GP consultations taking place in car parks, new staff being made to strip naked and examined for skin lesions. In that paper they said: ‘what were we doing?’ Maybe we have failed to learn some of the lessons learnt from the HIV/AIDs era...I have always had this fear that IP&C is sometimes seen as too black and white – draconian, punitive, non-negotiable and maybe ignoring the psycho-social,” she commented. “If you search WHO and national infection prevention guidelines [written pre-COVID-19] the word ‘compassion’ doesn’t appear once… The word ‘consequences’ appears once but only in relation to the consequences of healthcare-associated infection and not in terms of the consequences of what we do to prevent that infection.”
Beyond IP&C, she pointed out that there is a growing movement around quality healthcare and the word ‘compassion’ has started to seep into the dialogue. A document from the WHO on ‘Delivering quality health services’3
states: “People
centredness is the doorway to all qualities. Indeed, the common thread of success is putting patients’ needs and values front and centre. This means caring with compassion and respect.” In Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference, physician scientists, Stephen Trzeciak and Anthony Mazzarelli, claim that healthcare is in the midst of a compassion crisis. They give the example of a 34-year- old man fighting for his life in the Intensive Care Unit who has been on an artificial respirator for over a month. Could it be that his chance of getting off the respirator is not how much his nurses know, but rather how much they care?4
They argue that: DECEMBER 2021
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