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So the unit is subject to a "deep clean". Why not stop nursing staff wearing their uniforms, shoes, etc outside of the hospital? Surely their (sometimes) scruffy trainers must carry in some form of infections? And why not have disinfectant troughs at the doors as they did at farms during foot & mouth epidemic? Let us hope that Dr McCallum's claim that all steps that should have been taken have been.
My son was in the Sick Kids in February and the wards there were just filthy. If you looked under the bed there was about an inch of stoor - acceptable in your own home, just about, but not in a supposed state of the art hospital.
I think what is needed is to get some of the nurses of yesteryear in charge of this, not some greenhorn "management consultant" from a Hospital Trust who wouldn't have the first idea how to put these ideas into practice. And if it means that severe measures have to be taken regarding access to hospitals, as Ken says above, then so be it. Access to hospital these days is far too much of a free-for-all - all sorts of people coming and going at all times of the day and night.
I fully agree with Ken.
ALL staff - nurses, consultants, medical practitioners and clerical should automatically change out of their uniforms/suits/white coats, when leaving the hospital and reserve this clothing for wearing only in the hospital. Before the Health Service even began, no nursing staff were allowed to go outside the hospital wearing their uniforms, let alone travel on public transport wearing them.
Other matters which need to be addressed are: -
1) No sitting on patients' beds either by staff or visitors.
2) Consultants going back to wearing specially- designed white coats (or another colour if they want differentiation from other staff) which will then eliminate the need to wear ties, which have also been proved to carry MRSA infection.
3) In addition to hand washing or the use of anti-biotic gel between patients, each bed space and patient folder should have its own pen - it is no good washing or gelling hannds and then using the same pen for each bed visit!
4) More use of this new material containing silver in ward fittings and furnishings. This material is know to combat MRSA which cannot survive for longer than an hour when brought into contact with it. Silver is a well-know form of anti-biotic material, it was used by the Ancient Egyptians several thousand years ago along with active Manuka Honey, used by the Maoris for infected wounds. We have much to learn from the ancients!
5) Better and more thorough cleansing and sterilisation of surgical instruments.
I could go on - what I say is, 'Bring back the old-fashioned ways which were used in the 1920s'. In those days it was considered to be a matter of shame if an infection was even lurking in a ward.
I have been a victim of MRSA which I contracted in 1999 but it was not diagnosed until 2001. I am fortunate in having survived - most people don't! I have been left in a wheelchair as a result which has affected the quality of my life - no co
Excellent comments from the ill-informed.At no point does the article state that MRSA was brought in to the hospital by staff, yet this is the general assumption. Nursing staff aren't allowed to wear uniforms outside the hospital, and I've yet to see a member of staff in nursing uniform travelling to or from the hospital on public transport!
The recommendation for the use of substances with "anti-biotics", such as hand gels. MRSA is resistant to antibiotics, hence the name.
I wonder if maybe the infection found its way into the hospital on one of the many thousands of visitors that pass through the doors each year?
I agree - more outspoken comments from those with little knowledge of the subject.
Rebekah: from time to time NHS staff are screened for MRSA. In certain centres, up to 40% have been noted to be carriers. Most who 'contract' MRSA do not die, thankfully. Of course MRSA has been known about for some time - it just takes time and effort for the press to sensationalise it as well as they have done. Wait till they get hold of VRE!!The NHS cut costs on such tiny levels that many businesses would consider it over-management - I don't think they'll be able to afford silver-lined wards. Nice thought though. Would make the place look nice.Oh, and most surgical instruments are not the cause of MRSA spread.
The "SA" part of MRSA is a common or garden bacterium which we all have in or on our own bodies all the time. It is this bug that is usually responsible for an infected cut or a pus filled pluke. Usually our own defences deal with it, but sometimes we need a course of anti-biotics. Unfortunately, some "SA" has become resistant to those anti-biotics - the resistant strain is called MRSA. There are many reasons why MRSA has appeared, but it is not because of dirty hospitals. It is mainly because of mis-use of anti-biotics, for example people who miss doses or do not complete the course when they see that their symptoms have subsided.
Consequently, a proportion of the population is now walking around with MRSA instead of simple SA. Normally this is not a problem, until you get an infected wound. With the resistance to anti-biotics, such a wound can be hard to treat and may suppurate for months - longer if the patient is immunocompromised (ie their immune system is weak).
Thats why this is such an issue in hospitals - the danger of infection during an invasive procedure is ever present. Of course measures are taken to reduce the risk of infection but normally there is always a course of anti-biotics to fall back on, not so easy with MRSA.
There will always be some patients and some visitors carrying MRSA, the emphasis is on trying to prevent that being transferred between patients and from visitor to patient.
As for the story above, it should be borne in mind that the babies were found to be carrying MRSA, but there is no mention as to whether or not this (rather than ordinary SA) could simply have been passed to them by their mums at birth.
in response to anon..no..4.. so you say that no nurses travels to and from work in there uniform..
well i for one use the no 33 bus on a very regualar bases and i see nurses in uniform,,,,also the said nurses go outside for there little nicotine fix...
so where does all this take place..yes the new..E.R.I..Aand now that i think about it..where does all the smoking nurses come from....because when you apply for any nursing job you have to say whether you smoke or not on the application form....no doubt to get the job you all LIE,,so why dont the bosses take note of who is smoking outside and check it against there application forms if they said they did.nt smoke SACK THEM..i for one dont want any doctor or nurse treating me with nicotine stained hands..
Doctors who wear ties...shouldn't...unless they intend to clean them every day. Parents and visitors should be screened as well as the staff. Anyone who comes off the streets, into any ward, brings bacteria with them. I agree with John. Hospitals are not cleaned as well as they use to be in years gone by. Bring back the older nurses to train this generation. Most hospitals are under staffed, nurses are over-worked and under-paid.
So, if it is "not because of dirty hospitals and is mainly because of mis-use of anti-biotics, for example people who miss doses or do not complete the course when they see that their symptoms have subsided" as John stated then how do premature infants get it in their system or on their skin???
I don't know a lot about MRSA so I won't make any "ill-informed" comments but what I do know about is what I witnessed when my dying father in law was in hospital, sharing a ward with 5 other men. The nurse dispensing medications came in with her tin medication trolly, lifted the lid, walked to the first bed, read the chart, walked back to the trolly, found the proper bottle of tablets, poured 2 into the palm of her hand, walked back to the patient, picked up the tablets with her fingers, placed the tablets into the patients mouth then went to the next bed, picked up the chart and proceeded to dispense the meds exactly as with the first patient. She proceeded to feed each of the 7 patients their medications in the same manner and ALL WITH NO GLOVES or WASHING HANDS IN BETWEEN!!!!! You want to know how things spread in hospitals... I can tell you! APPALLING. I couldn't believe my eyes!!! There's NO excuse for that kind of behaviour except LAZINESS! I'm sure a lot of people will argue that those cases are few and far between but if I were the patient that contracted something because of that behaviour it wouldn't feel so few and far between to me.
Hospital staff and administrators simply need to take other peoples lives more seriously when it comes to the little things like wearing clean uniforms, using new gloves for each patient, washing hands, having hair tied back, and for goodness sake making sure the facilities themselves are clean clean clean.
It would be nearly impossible to screen visitors and in hospitals where the wards are so big with so many patients some things are surely going to get passed on if people from off th
My good lady is a nurse and she is absolutely scrupulous about hygene in the hospital as is all her colleagues.
Her own thoughts are that A) hospital cleaning should have never been contracted out and left in the hands of the staff and grade nurses B) sisters and in particular matron brought back to make sure everything is as clean as possible and C) visitors coming to an infected hospital should be provided with gowns, masks and made to wash hands before entering a ward.
Of course, the latter suggestion would be a breach of somebody's human rights, wouldn't it?
Think you might be seeing things, as the ward staff have to change their clothes on site and their uniforms are laundered at an NHS laundry at St. John's.
Anon, that still doesn't answer the question raised by colin about the smoking. I've been to the new ERI many times when nurses have been smoking outside in the designated areas. I hadn't even thought of that until Colin's comments reminded me of it. SO whether or not they travel on buses they are outside in their uniforms and what's worse they're in areas of highly concentrated cigarette smoke. YUCK!
Anon
Open YOUR eyes for a change. Nurses are not forced to change in the hospital at all and it's not policed either. How do I know? See comment 9, I have some knowledge of the NHS.
Big thing YOU have forgotten here is agency nurses. They are NOT issued with uniforms from whatever hospital they happen to work in, they are given a generic uniform that they have to look after. Considering that agency nurses can work in up to 4 different hospitals in a week, they cannot and do not get changed in whatever hospital they happen to work in.
Comments from the ill informed you write? Yes indeed Anon, yes indeed.
patti..no..13......thank you patti..you see im speaking from the horses mouth..my wife is a district nurse..which i may add they have no choice but to wear their uniforms outside as they do up to ten visits a day..so i think having to change their uniforms ten times is out of the question....but they do wash their hands with the lotion provided between visits and use throw away aprons....
but back to the main question...how many nurses have falseified application forms......so if the answer is none then all the smoking nurses and doctors must have started at a very late age..dont think so..or as i said before you are all lying..OR DO THE NHS TURN A BLIND EYE AS THEY CANT GET NURSES ANYMORE..?????????
I have some knowledge of the NHS too.I work at the hospital in question.
Must have good eyes to see what's going on in Edinburgh from the Western Isles. But then, we both know NHS policies are consistent, don't we?
My son was born in Simpsons in Oct 2004 and I was appalled at how filthy the wards were
My partner was in for a week and beneath the beds' were never cleaned. The high temp they keep in the wards is fertile ground for bacteria.
The answer is simple ... its called effective cleaning !
So much for PFI Gordon !!
It is a pleasure to read the contributions from Anon [4], Derek [5] and John [6]. Far from being a 'super bug', SA is present in the nostrils of around one in three of the population. And as others have said, it is commonly found on the skin. The MR bit simply points out that getting rid of SA cannot be done with penicillin-based drugs - it does NOT mean MSRA is untreatable - there are suitable drugs. How do I know ? I've just finished a course of treatment. However, for what it's worth - based on experience while an in-patient at ERI - it was a bad day for people when cleaning was contracted out.
ONCE AGAIN...COMMENT TAKEN OUT.....
TO ANON AS I SAID WHEN PROSPECTIVE NURSES FILL IN APPLICATION FORMS IT SIMPLY ASKS IF YOU ARE A SMOKER OR NON SMOKER..SO TO GET THE JOB I WOULD GUESS 9/10 WOULD SAY NON SMOKER...SO WHERE DO ALL THE NURSES THAT STAND OUT IN THE DESIGNATED AREAS FOR SMOKERS COME FROM..
THEY ARE EITHER FALSIFYING THEIR APPLICATION FORMS OR THEY ARE LYING...SO WHY DONT THE BOSSES GO OUTSIDE AND TAKE THEIR NAMES THEN GO AND CHECK THEIR APPLICATION RECORDS...IF IT SAYS NON SMOKER...SACK THEMIF THEY CAN LIE ABOUT BEING NON SMOKERS WHAT ELSE ARE THEY LYING ABOUT..
OH AND FOR THE RECORD ANON MY WIFE IS A DISTRICT NURSE..SO YOU SEE I DO NO WHAT IM TALKING ABOUT...I CANT STAND LIERS....
OH AND FOR THE RECORD ANON MY WIFE IS A DISTRICT NURSE..SO YOU SEE I DO NO WHAT IM TALKING ABOUT...
Some nurses DO keep their uniforms on outside the hospital. I work in a nursery in Edinburgh and we have at least 2 mums who collect their children while still wearing their uniform. Imagine the germs they are picking up in a room full of young children who are just learning about good hygiene themselves and have their hands and fingers in and on everything! My husband was also in the hospital recently for a week and I visited him everday. Not once did I see a nurse clean her hands before or after leaving the room or between attending to the other 3 men in the room. This was at the ERI, also. Something has to change!
HiAfter a short stay in the ERI I was appalled by the thilth in some parts of the hospital. I was in as a day patient and down the side of the chair which I was told to sit on after my opp was full of dirty fluff which I believe MRSA loves to thrive on I don't blame the nurses as most of them try and keep the place clean it is the management to blame for cutting corners with the cleaning contracts you will never eradicate this bug until we have better and more responsible cleaning companies who will pay their staff a decent wage and give them decent conditions so they feel that they are worthwhile.Regarding the nurses travelling outside the hospital in their uniforms this is not uncommon as the same thing happens at almost every hospital in the country.
THE OBJECT IS NOT TO POST BLAME BUT TO IMMEDIATELY ENFORCE GOOD CLINICAL PRACTICES SUCH AS FREQUENT HAND WASHING , KEEPING THE ENVIRONMENT CLEAN AND CAREFULL MONITORING POLICIES THAT WILL CHANGE THE CULTURAL BEHAVIORS IN THE HOSPITALS
Re: Patti's comment (#8), asking how the infants had contracted the MRSA, I believe John answered it in comment (#6) with "As for the story above, it should be borne in mind that the babies were found to be carrying MRSA, but there is no mention as to whether or not this (rather than ordinary SA) could simply have been passed to them by their mums at birth."
As for the nurses who should (or should not, depending on your opinion) refrain from wearing their uniforms outside the hospital, well, you wouldn't believe what you see here in the States. I've never seen the numbers like this that wear their uniforms out and about across the Pond. It's like they feel they need to parade their profession or something. And the smoking problem is the same, if not worse here.Then again, either of us has some aspects of hospital management at which we are better and some in which the other bests us. I think that, while the issue of cleaner hospitals is very serious and needs to be addressed immediately, mostly the moral of this story is: Wash your hands often, but don't abuse antibiotics or antibiotic cleaning products!
MRSA (multi resistant staphylococcus aureus) is everywhere and normally nothing to worry about. It can be carried into hospitals by anyone. Only if you are seriously ill it may be very dangerous. These babies are of course ill and weak.Still, I am sure the hospital is doing all it can do to contain the infections.
MRSA (multi resistant staphylococcus aureus) is everywhere and normally nothing to worry about. It can be carried into hospitals by anyone. Only if you are seriously ill it may be very dangerous. These babies are of course ill and weak.Still, I am sure the hospital is doing all it can do to contain the infections.I don't know about the UK but here the patients are isolated, get special treatment to get rid of the MRSA (washing down with antiseptic twice a day etc) and everyone, including visitors, who goes into the room has to put on a fresh gown, gloves and mouthprotection. This goes on until 3 swabs in a row are clear.
I think the N.H.S. should go back to the good old carbolic soap and water.
I am the custodianal tech(janitor) at a health clinic, right you are Bill @ 20. When the money managers begin to take the sanitation issue seriously, then and only then will you see a change in health care facilitiy cleanliness. There are procucts healthcare providers use, and most do, that help. However, overal sanitation require trained cleaning staff, and that cost money.....etc., etc. round the mulberry bush we go! As an after thought, not all staff are subject to the same degree of extra cleanliness, however, there are critical areas that should require staff showers, and facility furnished and inhouse or contractor laundried fresh uniforms, Money spent wisely for the sake of the patient, ought to come in admin's thinking somewhere, eh?
when we have a health minister that knows something about the subject of health we might get improvments.kerr is a stasitican nothing more.
As a health professional; I fully agree with Ken. I presume what follows is being done but somewhre along the line there is a breakdown. Staff need to engage in thorough handwashing and particular attention should be paid to linens and formites. Food should not be eaten by staff in the neonatal area and hands thoroughly washed between changing soiled diapers and each infants or staff using the toilet. Staff who are sick need to stay at home until they are well or non-infectious.
If staff are wearing their uniforms outside the hospital they are possibly spreading things around as well as between other areas of the hospital and bringing into the hospital bacteria that would not normally be found there. They are also taking the bacteria home with them. Paper throwaway coats/aprons need to be worn over uniforms and latex gloves worn when infants are being dealt with . Hands scrubbed after handling each infant.
Most infections of hospital origins are spread by poor laundry techniques as well as poor handwashing techniques. Handsoap should be banned and instead a liguid soap (or Betadine scrub) squirted into the hands from a floor pump pedal and the hands scrubbed as if one was going into surgery. Even better is to wear sterile latex gloves throwing them away after each patient. Lysol spray also might be helpful.
Linens should be properly removed not yanked off bedding and thrown into the floor but rolled up while wearing a paper front and placed directly in to dirty laundry bag hamper without causing air to rush about or coming in contact with uniforms. Fresh linens put on but not fluffed around either but unfolded on the bare mattress and then the bed made up. Housekeeping staff need to scrub and mop floors with anti-bacterial waters such as a mild bleach solution.
Laundry water should be at least 170F degrees and preferably higher in washing machines and bleach added as they are washed. If management is trying to save on h
Firstly I would say to 'Anon' at comments 4 & 15 -
'Why can you not give your name? The rest of us have'
Anon & Derek at comment 5 -
To both of you I would say that I am very well-informed thank you! I have lived with it for long enough and have suffered kidney and liver failure because of it, so I do know what I am talking about. As for 'Most who 'contract' MRSA do not die, thankfully' - 2000 died in Scotland last year and the number has risen year by year. Having lived with this since 1999 I have made a considerable study of it and am certainly not ignorant about its causes and effects. 'Silver-lined wards' - I think you missed the point here - that is not what I was advocating. A new material has been developed which contains silver and which is being used in some hospitals for coating ward furniture and curtains, screens etc. It reduces the survival risk of the MRSA bacterium. Methicillin Resistant Staphylococcus Aureus is becoming more and more resistant to every anti-biotic thrown at it, surely any measures which can eradicate it are worth trying? What cost is a life (or no life) depending on whether you are affected or not? Surgical instruments can be a source of infection - did you not see the Panorama programme some years ago on ineffective scrubbing of instruments prior to autoclaving? Horrendous! Tissue still adhering to the instruments after the sterilisation procedure - they were barcoded, sterilised packets and could be tracked!
No -one is saying that MRSA is necessarily brought in by staff and no-one is laying blame on them particularly - I merely mentioned some of the steps which could be taken to minimise the risks. In many cases it is brought into hospitals by patients who already have it. In my case I contracted it by being shoved into a ward where patients had been transferred from a hospital known to have MRSA, during the winter, because they were 'bed-blocking'.
Please do not say that I am 'ill-informed
Rebekah:I am sure you are well informed. But the sensationalist build-up of the press iritates all health care professionals.
You mention the cost of a life:the government figures vary, but around 10 years ago were taken to be around £800,000. Sounds appaulling, but they have to have a figure to use to work out the viability of policy decisions, be they lining wards with bactericidal argentified materials or rebuilding a 'danger area' of road to make it safer -there has to be a number. To prove the viability of using the new materials, it would be necessary to prove that the MRSA reservoir would be combated by using such a material and that it would reduce infection rates. The reservoir is more likely to be human. The question is where you draw the barrier around the patient: the hospital? the ward? the patient? The latter is far easier to implement.
Another point no-one has brought up is the fact that very few antibiotics are being developed by the pharmaceutical companies. R+D costs for new drugs are in the 10s of millions of pounds and may prohibit private companies creating new ones - a frightening prospect. Once MRSA is fully resistant to vancomycin, teicoplanin and linezolid, we will struggle to treat it. Why doesn't the government research new antibiotics to combat a national problem? Money.
2000 MRSA related deaths last year - although a disaster and unacceptable - still represents a tiny proportion of those carrying MRSA. It is a resistant bacterium, but not an especially virulent one.
Many health care professionals are now switching careers and leaving health care altogether (myself included). The 'doctor and nurse bashing' behaviour of the press makes good reading, but is contributing to the inevitable downfall of the NHS.
Correction: R+D costs are in the tens of billions of pounds.
I have read the comments with interest. I have worked in NICU since 1988. Thankfully I've never seen an infant develop MRSA. Over the years I've seen our hygiene practices change. It used to be we all wore hospital provided scrubs, visitors wore gowns and masks, and no one visited except the parents. I have however, always worked in a NICU that requires a 3 min scrub by hospital personnel before starting the shift. Some NICUs now use a foot pump antibacterial that is only rubbed into the hands and upper arms-no scrubbing or rinsing required. I don't know how I feel about that. Now--all visitors to the infants are required to do a 3 min scrub. We don't allow children in the unit except siblings over the age of 3, with immunizations current.We no longer have large rooms with 8-10 infants in them, we have double and single rooms with ~120 cu.ft. per infant. We have handwashing signs posted at all the sinks in the rooms and we are diligent about making ancillary staff wash before touching an infant. All the rooms' floors are cleaned daily with all trash and linen receptacles emptied once/day. After each patient leaves the hospital, the room is thoroughly cleaned. I empathize with those who have contracted MRSA, and am not naive enough to think our unit is never going to see it. I know we've had MRSA cases in our hospital. I wish your hospitals knowledge and skill in preventing MRSA infections---
Back to basics everybody. Assume everyone is a beginner. Another thought is a perceptual one, everyone working in the hospital should think of themselves as employees at a germ warfare facility and act accordingly.
