A Super Superbug??

[lettie]

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]

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]

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]

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]

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]

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]

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]

The Accountant bit sounds more like it Park.

 

[lettie]

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]

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.

 

[Neil]

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.

That does sound too much for 1 person.

Believe it or not the worst culprits for not washing their hands are doctors.

I believe and I have seen it several times. Doctors on rounds floating from one bed to the next never washing hands.

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.

I hope that is the result, it is what is needed. I bet there are plenty of chief execs to get sweaty.