Dr Mike Simmons | Public Health and Wellbeing

Wales the wonderful

April 11, 2019 by Dr Mike Simmons Leave a Comment

This is a blatant plug to encourage you to consider coming, living and working in Wales. I’ve been based in west Wales covering the counties of Carmarthen, Ceredigion and Pembrokeshire since 1990. While I did spend a fascinating 10 years working in Cardiff and gaining a new set of skills, my home has always been just outside Carmarthen.

Today was one of my days when I work from our hospital in Aberystwyth and it was one of those gorgeous spring days where I can enjoy seeing the red kites overhead as I drive along the coast road between Aberaeron and … Read the rest

Demonstrating sepsis detection in Hywel Dda

April 16, 2018 by Dr Mike Simmons 2 Comments

Medicine is a serious business and when you hear harrowing stories of sepsis, how do you respond? Certainly, many of the accounts you will read, or perhaps you have witnessed through personal exposure to family or friends who have had some form of sepsis, can be very disturbing. Survivor accounts can be as equally distressing to all those allied to the caring professions and for all of us beg the question, what more can we do to improve diagnosis? In Wales, as in other parts of the UK early recognition and detection of sepsis is key to early interventions. The … Read the rest

Catheter urine sampling

June 23, 2017 by Dr Mike Simmons 2 Comments

I had a call this morning from one of our very talented staff nurses who wanted to check out carefully her understanding of when it is appropriate to send a sample for urine in a catheterised patient. She explained that she had an elderly patient and the patients daughter had suggested that the catheter urine should be sent to our laboratory on a weekly basis to check for infection.

The patient did not have any symptoms or signs to suggest urinary infection and had therefore advised that sampling was inappropriate but was facing a series of questions and could I … Read the rest

Antibiotic suppression reducing

August 5, 2016 by Dr Mike Simmons Leave a Comment

In a previous article I promised that I would share a measure of the improvement we are seeing in the clinical information on our request forms. As you may know, the Hywel Dda University Health Board is committed to seeing reductions in all aspects of healthcare associated infections and has set themselves the target of reducing E coli bacteraemias by 20% as a global surrogate of all infections across our area.

Why is clinical information important?

Microbiology does not provide explicit answers to the question, “Does this patient have an infection?” Our laboratories will grow bacteria but are bodies are … Read the rest

Little things

August 1, 2016 by Dr Mike Simmons 2 Comments

I have just completed my on-call week. As many will know our working pattern means one consultant is first on service for a seven day period. This ensures a degree of continuity when we receive calls and are dealing with the acute services. In this role, we are the first point of contact for enquiries and I thought therefore I would reflect on a couple of the highlights.

Little Thing #1:

One of my local GP’s rang to ask for a urine sensitivity result. I am always at pains to be as helpful as I possibly can when I … Read the rest

Urine quality improves

July 17, 2016 by Dr Mike Simmons 1 Comment

In a previous post I discussed the two simple rules that I ask colleagues to use to test interventions around the management of infections:

First do no harm
Second, find and take the positive action

All well and good offering this advice to others, but the challenge was also to me as a clinical microbiologist. In discussions with my colleagues, we agreed that a large number of our E coli bacteramias were probably as a result of urinary associated infection and if we were to make a difference, we needed to take a closer interest in how we managed the … Read the rest

HCAI complexity rules

January 27, 2016 by Dr Mike Simmons 3 Comments

When asking anyone to think about Healthcare Associated Infections and what actions they need to take, I ask them to apply 2 rules:

First: do no harm

Second: seek and take the positive action

First do no harm is not easy in dealing with infection because the actions we may need to take will often break this first rule and cause harm. Seriously? Yes, very seriously. Take the apparently simple act of prescribing an antibiotic. Antibiotics are not heat seeking pathogen missiles. While they seek out a specific bacterial target, that target will usually be generic to many bacteria … Read the rest

Urine triggers

January 26, 2016 by Dr Mike Simmons Leave a Comment

One of my lab scientists highlighted how a few years ago, when working in a smaller laboratory at a time when they were severely short staffed, they had to take the urgent decision to stop testing any urine sample that came into the laboratory without any clinical details.

There was a two fold effect: the absolute numbers of urine samples arriving in the laboratory, prior to any being rejected for lack of clinical information reduced and secondly, the clinical information on those samples arriving improved dramatically.

Some time later, the staffing situation improved and the lab felt able to stop … Read the rest

Gamekeeper turned Poacher

December 17, 2015 by Dr Mike Simmons 6 Comments

I had minor surgery today courtesy of the Day Care Unit in Prince Phillip Hospital. Thanks for asking, it was for a small umbilical hernia and all went well. However, the point of writing this is not to play the sympathy card but to take the opportunity to reflect on how I saw the unit work from a couple of perspectives: quality and infection, prevention and control because of course, professionally, these are two areas that engage a lot of my time.

It was interesting to be able to observe first hand our health systems in operation. Systems is key … Read the rest