(c) MRSA Action UK June 2010
Derek Butler, Maria Cann and John Galvin had the privilege of attending Sherborne over-fifties club following an invitation from our member Sue Spratt. It was a pleasure to meet Sue and her friends and colleagues and to share experiences. Staff from the local NHS Trust were also in attendance so the presentations offered the opportunity for questions and advice.
MRSA and other healthcare associated infections do not discriminate by age, and Derek related the stories of some young people who you would not think of as being vulnerable, showing how important it is to always think about preventing infections in any healthcare environment. The untimely loss of seven people in Derek's presentation demonstrates the legacy for everyone involved in their care. Antimicrobial resistance and the importance of preserving our important reserves of antibiotics also featured in the presentation, and showed the increasing prevalence of resistant infections outside of the hospital setting.
Rosemary Wareham Director of Infection Prevention and Control from Dorset County Hospital NHS Foundation Trust spoke of the measures that were being taken in hospitals in Dorset and the wider community to combat bacteria like MRSA and Clostridium difficile. Encouraging everyone to wash hands, not to sit on beds and being aware that it's OK to ask if busy staff forget to wash their hands before attending to patients was something that everyone should be aware of. This provoked some interesting questions and challenges from those in attendance.
Rosemary was asked how do you get everyone to use the alcohol gel, is it possible monitor them? Rosemary outlined they have tried monitoring compliance including using volunteers, if visitors were challenged they sometimes became abusive, so it was a question of continuing to highlight the importance of using the alcohol gel.
Derek said nothing mattered until it was personal. Education and communication was key, we needed to encourage children they will put pressure on their parents. The Department of Health had been working on an information campaign and we would need to move this on and ensure it was implemented.
Derek said it was difficult for patients and their families to challenge staff - we have reservations as we leave our loved ones in there. How does the person who is unconscious challenge, what about those who have dementia or are non-compos mentis, staff should do it, the patient shouldn't have to challenge. We were asked about "it's OK to ask" but don't like the idea, but if you feel strong enough and it encourages staff to do it then that's OK, but staff should depend on being reminded they should wash their hands between patients without question.
Valerie Maret voiced her concern as a patient, she was very concerned to see staff not using hand gel and washing hands at every opportunity. How does a patient challenge when they feel vulnerable in their bed, they shouldn't have to. What happens when staff don't comply, what actions do you take?
Rosemary advised please do challenge, we know it's difficult when people are feeling sick. There are hand hygiene audits and the Director of Infection Prevention and Control challenges staff, and re-audits where compliance is poor. If there are difficulties speak to a different member of staff, ward sister or matron.
The audience were asked how many people used the hand gel when they came into the hall, no-one said that they did, it was possible many didn't see it, posters and floor signage can help bring this to their attention.
Dorchester Hospital had combined telephone and TV units with a contract for weekly cleaning. Rosemary was asked if they were cleaned between patients. Rosemary confirmed this was part of the cleaning routine, housekeeping staff have a checklist. The patient line system was on the list and the ear plugs were also changed.
Derek outlined many hospitals have touch screen and flat surface keyboards, some have alarm systems that warn of levels of contamination, the technology is there. This could be applied to TVs, why not have advertising on the TVs about use of gel and infection prevention within the suppliers contract. Patients were living longer, medical science is in the 21st century, but infection prevention and control isn't there yet. Effective hand hygiene should be the first requisite for training doctors.
Dr Valerie Maret MBE PhD, Derek Butler and Sue Spratt
Valerie cited the example of General Electric Healthcare's former chief executive who spent 92 days in hospital last year recovering from a hospital acquired spinal infection that almost cost him his life.
The failure to follow handwashing with compliance levels running at only 35 to 40 per cent prompted General Electric Healthcare into action.
General Electric is developing a high-tech hospital patient 'smart room' which monitors clinicians' every move via video cameras and sensors around the room and alerts them when they have failed to wash their hands or perform other basic procedures. The cameras, which monitor doctors, nurses and patients in the smart rooms, can identify individual clinical staff and patients within the room.
As the average intensive care nurse is required to wash his or her hands an average of 200 times per shift, the opportunities for becoming infected were high with poor levels of compliance. Valerie said these were worrying times.
It was a pleasure to meet everyone at the event and very thought provoking, we hope to visit Sherborne again.
Mervyn Smith, Chair of Sherborne Over 50s with Derek Butler
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 email@example.com