better a surgeon's notes on performance by atul gawande

Instead, their greatest difficulty is getting clinicians like me to do the one thing that consistently halts the spread of infections: wash our hands.There isn't much they haven't tried. The hardest part of the infection-control team's job, Yokoe says, is not coping with the variety of contagions they encounter or the panic that sometimes occurs among patients and staff. Centers for Disease Control, two million Americans acquire an infection while they are in the hospital. Recently at large in the hospital, they told me, have been a rotavirus, a Norwalk virus, several strains of Pseudomonas bacteria, a superresistant Klebsiella, and the ubiquitous scourges of modern hospitals-resistant Staphylococcus aureus and Enterococcus faecalis, which are a frequent cause of pneumonias, wound infections, and bloodstream infections.Each year, according to the U.S. They once instigated a nationwide recall of frozen strawberries, having traced a hepatitis A outbreak to a batch served at an ice cream social.

Yokoe and Marino have seen measles, the plague, and rabbit fever (which is caused by a bacterium that is extraordinarily contagious in hospital laboratories and feared as a bioterrorist weapon).

By the time the results came back, the neurosurgeon's brain-biopsy instruments might have transferred the disease to other patients, but infection-control team members tracked the instruments down in time and had them chemically sterilized. But they have coped with influenza epidemics, Legionnaires' disease, fatal bacterial meningitis, and, just a few months before, a case that, according to the patient's brain-biopsy results, might have been Creutzfeld-Jakob disease-a nightmare, not only because it is incurableand fatal but also because the infectious agent that causes it, known as a prion, cannot be killed by usual heat-sterilization procedures. Marino is in her fifties and reserved by nature. Yokoe is forty-five years old, gentle voiced, and dimpled. This is not flashy work, and they are not flashy people. Their full-time job, and that of three others in the unit, is to stop the spread of infection in the hospital. They work in our hospital's infection-control unit.

PART I Diligence On Washing Hands One ordinary December day, I took a tour of my hospital with Deborah Yokoe, an infectious disease specialist, and Susan Marino, a microbiologist.

Better a surgeon's notes on performance by atul gawande