(c) MRSA Action UK June 2008
MRSA Action UK attended an Infection Control Study Day at Southport & Ormskirk NHS Trust, organised by Martin Kiernan, Nurse Consultant, Infection Prevention & Control, and newly elected President of the Infection Prevention Society.
Martin invited Derek Butler to present "A Healthcare Infection - A Lifetime Legacy". The delegates in attendance took the opportunity to share experiences and to update their knowledge, skills and attitudes for the effective management of various infection control issues across the whole healthcare setting, which included the wider community and Care Homes.
Speakers gave presentations on Tuberculosis, Necrotizing Fasciitis, Clostridium difficile, Five Moments for Hand Hygiene, Health Economy Working and PVL.
The information covered facts on diseases such as Tuberculosis, giving the delegates data on the two types and a history of its development. What is little known with Tuberculosis is that it is the second highest killer as a bacteria to HIV. Some 8 million people worldwide contract Tuberculosis, 95% of whom are from developing countries. In the
The presentation on Necrotizing Fasciitis caught everyone's attention. Dominic Williams works at Southport & Ormskirk NHS Trust and his presentation focused on the fact that this infection can cause death within 36 to 48 hours of contraction. He explained to the delegates that it is not a single bacteria that causes such a rapid onset, but is usually a number of bacteria that work in conjunction with each other. Necrotizing Fasciitis is a rare infection with a contraction rate of 0.4 per 100,000 worldwide, but what is well known is that the mortality rate for this particular infection stands at 73% in
The bacteria produces toxins that spread very rapidly and Dominic gave a graphic account of one surgeon's comments when he tried to treat a patient with this disease. The surgeon said that he could actually see the disease spreading on the patient he was treating while they were on the operating table, which made this virtually impossible to treat. What makes this particular disease so devastating is that while antibiotics would kill the bacteria there is little alternative in treating the toxins except for radical surgery.
Dominic explained that various groups were at a higher risk with this disease, such as diabetics, alcoholics, those with liver disease and infection could be brought on just by simple insect bites. Even those with a recent trauma have had infections begin as little as five days after trauma. One of the symptoms with Necrotizing Fasciitis is that the patient suffers severe pain out of all proportion of what can be seen and that the skin goes black and purple with severe discolouration. Slides of patients with this disease were shown which were very graphic in detail. The only antibiotic that has any real effect is Clyndamicin in that it kills the bacteria and has the ability to switch off the toxins.
The presentation given by Sarah Maxwell, Consultant Microbiologist from
B is to be bug aware, and to be observant with your patients
A is that antibiotics are dangerous and can bring on C.diff without warning
N is not to have C.diff patients on the main wards
I is to isolate positive C.diff patients immediately
S is for soap and water
H is for hand-hygiene compliance at all times
Sarah gave some facts and figures. The human body is made up of 100,000,000,000,000 cells, 10% of which are yourself, the rest are something else. She said that we have between 1 and 2 kilograms of gastric bugs in our system and without them we cannot survive. There has to be the perfect balance for a healthy patient and antibiotics disrupt this natural balance.
These facts and figures and the devastating effects that bacteria can have made the Five Moments for Hand Hygiene poignant and highlighted just how important hand hygiene is. Martin began his presentation on the Five Moments for Hand Hygiene with a slide with the words "We get things right most of the time" but Martin said that this was not good enough. He said we have to take a zero tolerance to infections and that although infection prevention and control may be a hidden cost, the cost of not getting it right is far steeper. He gave the example of how an infected hip joint can cost 72,000 pounds to treat, when the cost of a non-infected joint would be much lower.
Martin talked about the environment around the patient, and how just the bed that the patient is on can be contaminated and give the patient a 41% chance of contracting an infection. He gave an example of how a test was performed in a hospital using the cauliflower mosaic virus, which is totally harmless to humans, and how 75% of the virus was still in place after 8 hours, 25% after 7 days and how it had spread to five other wards in the hospital, just by simply not complying to the Five Moments for Hand Hygiene.
Martin explained that MRSA itself can survive for as long as 300 days in the environment. This demonstrated that although the Five Moments for Hand Hygiene give an invisible return on savings, just the prevention of an infection can save Hospital Trusts enormous amounts of money. This has to be seen as an integral task for healthcare professionals and we have to get away from the thought of many healthcare professionals that the higher the status, the less the need to comply with the Five Moments for Hand Hygiene.
Martin finished his presentation with two simple quotes:
"The hand of the carer frequently used to comfort and care often becomes a lethal weapon in transferring pathogens"
The second quote was from Timothy Spall the actor who Martin said summed up his presentation perfectly:
"Nothing matters until its personal"
To learn more the the Five Moments for Hand Hygiene visit the National Patient Safety Agency website. You will know if your hospital complies and if they don't, tell them it can save many lives, remember it's OK to ask
If you or someone you care about has been affected by a healthcare infection and you wish to discuss this with us, please contact us at firstname.lastname@example.org