This information has been written to provide a guide for patients, carers and visitors about MRSA and other healthcare associated infections, and some of the questions you may have if you are going into hospital. It is written as a general guide and may not be specific to your needs, it is always best to ask your doctor or the team at the hospital looking after you about what you need to do to prepare for your stay. Contact details for hospitals near you can be found on the NHS Choices website.

Chances are you have come to our website because you are either going into hospital or visiting someone and want to understand more about MRSA and other healthcare associated infections. There are a lot of measures in place now to reduce the risks of acquiring infections and to stop their spread, including screening for MRSA, that is finding out if you have MRSA on your skin. Screening for MRSA may be done routinely done prior to your surgery; your GP will be able to discuss this with you.

Typically, a nurse will take swabs as part of other checks, such as blood pressure and blood tests, leading up to your hospital stay. Nasal swabs and swabs from other parts of the body such as the groin, underarm and perineum are routinely taken to ensure you are not colonised (carrying MRSA on the skin, in the nose or sputum). If you are colonised ointments and antiseptic washes will be given to ensure the colonisation is cleared up prior to any surgery. If you have questions about screening for MRSA click here for more information.

Our downloadable leaflet "Information for patients and carers about MRSA and going into hospital" is available here

The skin carries lots of bacteria, including Staphylococcus aureus, so do not shave the area where you are to have surgery, tiny nicks and cuts in the skin may provide a harbour for the bacteria. Surgeons are now using clippers to avoid surgical site infection; you may want to check this by asking your surgeon.
Do not touch any wound or device that enters your body, such as a drip or catheter. This can help keep the area free from bacteria
Shower as frequently as you can, and change into clean clothes regularly, particularly clothes that are next to your skin
Do not share personal items or equipment with other patients
Tell one of the nurses as soon as possible if you have diarrhoea or vomiting. It is important to let staff know so they can keep you and other patients safe

The number of healthcare associated infections in hospital can be kept down if all hospital staff adhere to good hygiene measures. The most important is to wash hands before and after contact with each patient, and before doing any procedure. This simple measure reduces the chance of passing on bacteria from patient to patient. Most staff remember to do this, but sometimes when they are busy they can forget and don't mind being reminded, so if this does happen politely ask staff to wash their hands before touching you if they have come from another patient or were finishing a task before they came to treat you.

Ask the nursing staff about the five key moments of hand-hygiene, they can explain about why these are important, it's a way of alerting them that you know about the importance of hand-hygiene in preventing infections and that you are helping to remind them

Always wash your hands with soap and water after using the lavatory or commode, keep nails clipped and avoid wearing rings and jewellery, these can harbour bacteria. Apply hand rub after washing with soap and water

Wash your hands with soap and water before eating or preparing food, if you have any food brought in keep it covered, talk to the staff about whether it is appropriate for your visitors to bring in food and ensure it is stored at the correct temperature

If you need help with washing your hands then ask the nursing staff or get your carer to talk to the staff about any assistance you may need

Ask your visitors to wash their hands before they come onto the ward and when they leave, ask them not to sit on the bed and that they follow the guidance on visiting times.

If your visitors are unwell with a fever or tummy upset ask them not to visit until they have been well for at least 48 hours after they have had any symptoms.

It is also best if visitors do not sit on your bed. To minimise the risk of infection, visitors should not use the patient toilets on the ward. Staff can direct family and friends to the visitors' toilets.

Do not tamper with drips or catheters. Some hospitals advise changing the cannula after 3 days, that is the area where the drip enters the body, you may wish to ask staff about this if your cannula has been left in for longer than 3 days without changing. If there are any signs of redness or soreness at drip sites then you should tell the nursing staff immediately.

If you are expected to stay in hospital for longer than 5 days ask your doctor about the benefits of antibiotic-impregnated or silver-Chlorhexidine coated catheters to reduce the risk of infection.

Do not be afraid to ask if equipment is cleaned before any procedure as stethoscopes, blood-pressure cuffs and other items used for daily observations, as these can become contaminated with bacteria.

If you need a "central line" catheter, ask your doctor about the benefits of one that is antibiotic-impregnated or silver-Chlorhexidine coated to reduce infections.

Before your doctor uses a stethoscope, ask that the diaphragm (the flat surface) be wiped with alcohol. Stethoscopes can be contaminated with Staphylococcus aureus and other bacteria, and should be cleaned after each patient use.

Keep all towels, flannels, toothbrushes, razors, combs etc separate for your own use, do not share personal items

Do not walk around in bare feet; ensure you wear something on your feet at all times. Dry between your toes after bathing

If you have laundry it should be bagged and sealed if taking home and washed separately at 60 degrees for at least 10 minutes. If using antibacterial detergent ensure it has been tested and proven to be effective against MRSA and C.diff and follow the manufacturers' instructions

The NHS performs a lot of procedures and operations and not all infections are avoidable. To set the context NHS hospital statistics showed that over 14.5 million procedures and operations were performed in 2010. Every infection is one too many however which is why staff are working to do everything possible to reduce the numbers of people affected. There are a number of websites that give information about the numbers of people affected and we also collate figures on MRSA and Clostridium difficile on a weekly basis. This is in response to the public asking us for information on the numbers of infections in hospitals, weekly and monthly statistics on MRSA bloodstream infections and Clostridium difficile by region and hospital trust are available here

Other Useful Information:

Help The Aged offer advice on going into hospital, which includes information on benefits for patients and carers, click here for this external link

Useful information and resources for parents:

You and Your Child in Hospital by Margaret Carter. (Methuen)

www.childrenfirst.nhs.uk 

www.actionforsickchildren.org

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 info@mrsaactionuk.net