A Super Superbug?? - Page 2

vorlon24 · 25-05-2005, 19:23

Quote:

Originally Posted by Margaret Pilkington

Does what work Vorlon......?

The well developed Control of Infection team

Margaret Pilkington · 25-05-2005, 19:34

Well, it is 2 years since I left the NHS......but they were pretty hot when I was working......and they used to turn up on the ward unannounced and just watch what was going on.

The Ward that I worked on was used for pilot schemes......and we would report every Monday morning on what ops had been done the previous week and what infections there had been...if any.

I would be quite happy to go into the hospital that I worked in.......and we had two superb ward cleaners, who were included in the team.......what I mean by that is that they were involved in the things that were going on in the way of improvements.

We had Kings Fund Approval and just before I finished we were awarded Chartermark.

Margaret Pilkington · 25-05-2005, 19:39

MRSA has always been about.......in my day it was called Multi-Resistant Staph Aureus......and if you worked on a surgical ward you could be sure that if there was rise in the number of infections, you would be required to have nasal swabs done.....if they came back positive you were sent off duty until they were negative.

There is far more openness in the NHS now which is why we hear about rates of MRSA.

lettie · 25-05-2005, 21:01

Infection control are still as hot as ever at Blackburn Margaret. I am attending a day with them in the next couple of weeks in order to become a liaison type person for the delivery suite. This is a new thing where each ward will have somebody responsible for teaching new employees infection control techniques ie, handwashing. This includes visitors as they never wash their hands and they come in with all manner of illnesses. It is not uncommon for visitors with coughs and colds to visit a relative when she has had a new baby. I know of one woman who brought her child to with her to antenatal clinic when the child had German Measles. Her husband came with her, he could have stayed at home and looked after the kiddie. We had to then find all of our patients Rubella statuses for that day and test those who were in early pregnancy and not yet been tested. Some people are just thoughtless.

I think that visiting should be kept to next of kin only, as there is no doubt that hospital visitors are adding to the infection rates.

Neil · 25-05-2005, 21:53

The last time I was in Accy Vic with my wife attending an antenatal visit I was listening to two of the midwifes talking. One was saying how they had been instructed not to wear cardigans because you can't wash your hands properly with long sleeves on, she also mentioned about how they are not supposed to wear wrist watches for the same reason. The other midwife said something like " they should live in the real world ". Needless to say she was wearing a cardigan and wrist watch. What annoyed me most was her attitude about it. I then started looking at other nurses and doctors walking about. Many wore wrist watches and all the doctors wore long sleeve shirts. if someone is making rules nobody is enforcing them at Accy Vic.

As for bathing Margaret, I intend to get in the bath on Monday and get out just before I leave home on tuesday morning

lettie · 26-05-2005, 05:17

I wear a wristwatch for work. It's not frowned upon these days but it is understood that you will remove your watch when washing your hands to perform a procedure. It is acceptable to wear cardigans in community clinics, a midwife is highly unlikely to be performing any kind of sterile procedure in these clinics. It is unacceptable to wear a cardigan on delivery suite and on the wards. Accy Vic is a community clinic, they don't wear cardies on the wards. Shirtsleeves should be rolled up prior to procedures, but you will find that most sterile procedures, dressings, catheters, TPN etc are performed on the wards rather than in a clinic.

The midwives at these clinics work on the community. It's freezing when you're going from clinic to clinic and house to house in the winter. If they weren't allowed cardigans they wouldn't do the job. Some people's houses are freezing when we go in and many of the houses that I used to visit with my case load were also filthy. I remember having to nip home on several occasions to wash my hands and change clothes after being in some of these houses.

pendy · 26-05-2005, 16:32

I can remember the old days, a fob watch was essential, we were never allowed to wear wristwatches. The rule was that the only jewellery you could wear was a wedding ring to which you were entitled!! Also, hair had to be short, or pinned up if long, under the cap. Short sleeves were the rule. I know the aprons were a nuisance sometimes, but at least you could change if it got messy. And handwashing - you could be almost raw by the end of the day. These days everyone wears scrubs on A&E, some of which look very dirty, and hair dangling all over the place - definite potential for infection.

Margaret Pilkington · 26-05-2005, 19:03

I am now suffering with eczema on my hands from all the years of washing down beds with STERICOL and from all the severe handwashes that we used.
Neil, I would endorse what Lettie says about cardies and wristwatches........I wore a fob for many years and then latterly a wristwatch.......but if I was doing anything sterile I would remove my wristwatch........and my uniform had long sleeves.......which again I would roll and pin if I was doing a sterile procedure.

When I worked on orthopaedics it was routine for patients to come in up to 48 hours before surgery so that we could do skin prep........the skin was washed with special soap and then painted with an alcoholic solution........the limb was then wrapped in sterile J cloths.......oh yes, and the shaving was done from the joint above where the surgery was to be performed to the joint below. Bacteria tend to cling to hairy places.

park381 · 26-05-2005, 20:40

Quote:

Originally Posted by Margaret Pilkington

I am now suffering with eczema on my hands from all the years of washing down beds with STERICOL and from all the severe handwashes that we used.
Neil, I would endorse what Lettie says about cardies and wristwatches........I wore a fob for many years and then latterly a wristwatch.......but if I was doing anything sterile I would remove my wristwatch........and my uniform had long sleeves.......which again I would roll and pin if I was doing a sterile procedure.

You are all talking with years of experience, having been there and done it. Why are standards so low now, is it cost related? or has everyone forgotten basic training.

fireman · 26-05-2005, 21:29

Never mind bringing back the matron . Bring back the real domestics who took a real pride in what they did, and were not put under pressure from faceless grey suited accountants who deem it necessary to cut everything to the bone in favour of lower costs.These costs are not measured in money. I am not saying the present domestics don@t take pride in their work, but that they are not given the recources, the time, the proper training of working in a hospital environment, or the proper remuneration for doing the job as well as it needs to be done.

Neil · 26-05-2005, 21:47

Quote:

Originally Posted by park381

Why are standards so low now, is it cost related? or has everyone forgotten basic training.

I think a lack of accountability is part of the problem. This is interesting on that subject.

I suspect that hospitals are the same as any other work place. You have good staff and bad staff. It only takes 1 person to not wash there hands properly and infections can be spread.

park381 · 27-05-2005, 05:32

Quote:

Originally Posted by Neil

I think a lack of accountability is part of the problem. This is interesting on that subject.

I suspect that hospitals are the same as any other work place. You have good staff and bad staff. It only takes 1 person to not wash there hands properly and infections can be spread.

or another work place driven by accountants, where cost is all important

Neil · 27-05-2005, 09:30

The Accountant bit sounds more like it Park.

lettie · 27-05-2005, 15:59

An interesting link there Neil..

It's high time that the money controllers were made accountable. There will always be incidences of these infections without the adequate amount of cleaners available, sufficient cleaning products, inadequate visiting policies, inadequate training for staff and lack of sufficient screening of patients prior to medical procedures. Lets not forget that many cases of MRSA are brought in by patients and visitors. Mass screening of patients prior to surgery would be expensive, but not as expensive as the prolonged hospital stay, treatment, mortality and morbidity that these infections cause.

We need more domestic staff. At present 1 domestic can be expected to clean up to 3 wards during the course of a shift. This is unacceptable, there should be 1 domestic cleaning 1 ward. Handwashing has always been high on the agenda. Believe it or not the worst culprits for not washing their hands are doctors. If I am assessing a student or an NVQ candidate in care and she does not wash her hands or is wearing jewellery (multiple rings, necklaces, bracelets) or has not tied her hair up....... she fails. It's as simple as that. I am a fair person and I do make it my buisness to warn the students of this. If they choose to ignore this warning it's hard luck.

I have a feeling that if this law comes in there will be chief execs sweating all over the place, trying to recruit domestics, enable screening and train staff. They will be frantically trying to pull in money to do this.

As it stands at the moment, every nurse, midwife and health visitor is accountable for their own practice. Through supervision (especially in midwifery) these problems are identified. The NMC will also investigate individual nurses, midwives and health visitors where reports of bad practice are made. When reports of this nature are investigated and found to be justified the nurse may be struck off, put on supervised practice or demoted in some cases. All nurses know this.. If they don't, they should....

Margaret Pilkington · 27-05-2005, 19:49

Lettie....I think you have hit the nail on the head. The policies about visiting definitely need to be looked at.......with maybe visitors only being allowed if they are carrying a visiting card. Visiting times need to be shortened except in circumstances where the patient is critically ill. Pre-operative screening is essential to identify those who are carrying MRSA before anything is done.......or maybe all surgical patients should be given 7 days supply of Aquasept wash to use on the 7 days preceding admission (with full instructions on how to use).

Domestic staff need to be recruited and given permanent work areas so that continuity of cleaning can be maintained.........as you so rightly observed Lettie, these measures are expensive.......but not nearly so expensive as a couple of court cases with patients suing for so called hospital acquired infection.

Oh, and the good news is that the Japanese think they have found something that will cure MRSA.......it is another bacteria that lives on shellfish in the sea.........won't be available for a while yet.