I always welcome the opportunity to visit the National Botanic Garden of Wales so was delighted to be invited to discuss how the Hywel Dda’s paradigm shift in thinking about the management of healthcare associated will support our local care homes.
The conference, “Working together to promote health, wellbeing and quality of life” was opened by Sarah Rochira, Older People’s Commissioner for Wales where she discussed elements of her care home review, “A place to call home?”
I was struck by her messages around the wellbeing agenda for older people in our community and what “good” looked like in those care homes that sought to continue to meet the inner needs of residents, playing into the wellbeing agenda. It is no accident that this website has wellbeing as an important component of health. Clearly, my messaging is primarily around the influence of wellbeing on infections that people face but wellbeing affects all aspects of health and the commissioner made us all reflect on the fact that we are all aging. Indeed this author at 62 (or for the delegates who listended to my confusuion: 63, 64 or 65!) acknowledges that he too has a vested interest in ensuring wellbeing remains at the forefront of care.
My role was in talking about infection and infection management but in advance of my presentation delegates were introduced to the range of services provided to the community by the Acute Response Teams in each of the counties. The clinical microbiologists regularly engage with the ART, providing advice to primary and secondary care over the selection of appropriate intravenous antibioitcs, with the aim of allowing the patient to stay in the community. From an infection management perspective this has advantages:
- Being in your own home immediately plays into the wellbeing agenda and as I have explained before, when an individual has a posiitve mind set, their immune function is improved. Yes, the IV antibiotics will help manage the infection but antibiotics alone are not enough and being in a positive frame of mind, even if subdued by ilness, will be more positive on home territory than in a hospital.
- As Craig Jones highlighted, not being in hospital means an individual is less likely to be exposed to antibiotic resistant bacteria and the risks of acquiring more difficult to treat infections.
My personal wellbeing was served at lunch and I’m not refering to the buffet, delightful though it was. I always bring a camera with me to the National Botanic Garden of Wales, as there is always something to see. The bottle-brushes were out in abundence under the dome, as with many other flowering plants. In other parts of the gardens, much anticipatatory buds, probably out within the next month, as well as a glorious pink camelia, similar to the one in Ty Canol Gardens although that does not get the same level of protection as the camelia in the double walled garden.
My own presentation discussed the lastest work we have been doing relating the link between bacteraemia and urinary tract infection and allowed me to reflect on the need to use the microbiology laboratory appropriately, reminding delegates that microbiology does not diagnose infection, that can only be done clinically: we will grow bacteria present at any site but these may simply be colonising. Nowhere is this so important than with urinary microbiology, where in older people, asymptomatic bacteruria is commonplace and antbiotics are not indicated. I referred to the reference guide for UTI as well as the NICE and SIGN guidenlines
The pilot work undertaken in our Carmarthen Laboratory, will be replicated for all 3 labs to give a 3 county view and I will aim to present those on the site when they become available. In the meantime, the Hywel Dda Infection Control Team was introduced as a resource now available to primary care and we look forward to assisting you in managing infection in the community.