The fear is real. Newspapers headline stories daily – newborn dies of
MRSA in intensive care unit; midlifer’s parent dies after recovering
from a routine operation; midlifers themselves surviving the infection
but permanently disabled.
How does it spread?
The bacteria enter the bloodstream through open wounds, through
injections, through IV sites, through catheters. Bacteria thriving on
the skin are easily transferred from one person to another.
There has been much hype from a campaign called Cleanyourhands. To many
people, a cleaner hospital is also just a question of sweeping floors.
If only it was that simple. Unfortunately, the bacteria thrive in
countless other places: on surgical instruments, on dressings, on
patients and visitors’ clothes, on nurses’ uniforms, in hospital beds.
At a recent meeting by the Patients Association there were a number of
suggestions put forward on how to contain the bacteria. Contain is the
operative word. The medical technology to effectively tackle the
antibiotic-resistant bug does not exist. Dr. Mark Enright, senior
research fellow at the University of Bath’s department of biology and
biochemistry, told more than 1300 infection-control experts that the
only viable way to kill off MRSA was to isolate sufferers. He added that
so many patients now had the bacteria that there were not enough
And he warned that emptying beds to allow them to be cleaned properly
would push up waiting lists – a move that would run contrary to
Obstructions to taming the bacteria
Sterilizing instruments would help tame the bacteria. But recent
research showed that sterilization of Britain’s endoscopes, for example,
The research, among healthcare professionals, also revealed that five
percent of those questioned didn’t clean their instruments between
patients; more than half reuse the sterilizing fluid; many endoscopes
never make it to the Central Sterile Department at the end of the
clinic; and there are no uniform guidelines on who is responsible, or
just what they should do.
Claire Rayner, President of the Patients Association, and a recent
sufferer of MRSA, says: “If this is happening in a number of UK
hospitals, it is inevitable that infections are spreading widely.”
Other examples for infection control were cited. There are
bacteria-proof dressings to prevent complications in both post-operative
and chronic wounds. These are available in some hospitals, but not all.
Nurses’ uniforms should be washed and disinfected daily. Like the
clothes of other staff, plus patients and visitors, fabrics harbour the
bacteria. Studies have revealed that one-third of hospitals have no
facilities for washing uniforms. Staff take the uniforms home to
launder. Home equipment may not be the most effective for
These and many other possible solutions from the NHS staff, industry
representatives, and patients who attended the Patients Association
conference, will be collated in a working document, publicized as the
100-Day Challenge, to be presented to politicians, civil servants, and
Trusts for their response. After 100 days, the Patients Association will
return to these key figures to find how they have acted on the
recommendations to reduce hospital-acquired infections.
Laterlife will report on the outcome of the 100-Day Challenge as soon as
results are revealed. But you can use your patient power now to help in
reducing cross- infection and improving hospital cleanliness.
TEN TOP TIPS
1. Check your hospital’s cleanliness. Log on to
www.cleanhospitals.com and follow the links for the PEAT (Patients Environment Action Team) to
check how clean your hospital is. NB. This website has now been closed by the NHS. (April 2008)
2. Before a planned admission, take a long, hot, soapy bath or shower,
without using heavily scented brands, and have an all-over scrub with a
soft gentle brush or loofah. Clip your toe and finger nails (removing
all nail polish) and wash your hair. Put on freshly-laundered underwear.
All this helps prevent unwanted bacteria coming into hospital with you
and complicating your care.
3. When preparing the items you are taking with you, such as
newly-washed nightwear, dressing gown, slippers and so on, add packs of
antiseptic hand-wipes together with a couple of bulldog clips (from most
stationers) and some plastic bags. Use the wipes every time you go to
the loo, and also before and after meals. Use a bulldog clip to clip an
open bag to the edge of the bottom sheet and use it for your own
rubbish. Give full bags to the ward cleaner for disposal.
4. When you arrive take a note of areas that are messy or dirty and
point them out to staff. A clean and tidy environment not only keeps
infection at bay, it looks better, makes all patients feel better and
can get you out of hospital faster.
5. Arrange a ‘phone tree with family and friends. Ask one of them to be
the person who ‘phones the ward staff for information on how you’re
getting on, and then pass the news on to everyone else (e-mail is good
for this!). It may not be of direct use against MRSA, but it will
obviously save busy staff time which they could put to good use against
6. Ask visitors to coordinate their visits so there are only two people
at the bedside at any time. The more visitors a patient has, the higher
the risk of bringing in an infection from outside. Also, instead of
coming straight from work, try to persuade them to go home and have a
thorough shower or bath before coming to see you – again this reduces
the risk of bringing infection in from outside.
7. Ask them all to use the hand cleaners that should be at the foot of
each bed (as specified by the Government), as they arrive and before
they leave. This can greatly help the fight against the spread of
8. Try not to let any children be brought in as visitors. However much
you want to see them, it’s better not to expose them to possible
hospital infections or to bring their own coughs and colds into the
9. Advise visitors not to sit on your bed. Not only uncomfortable for
you, but another way to prevent infection reaching you. Remember even
healthy people carry bacteria on their skin; indeed we all do! And if
they have even the slightest sniffle or indications of a cough, ask them
nicely not to come and see you.
10. When a nurse or a doctor comes to your bed to touch you - for
example, to examine a wound or check you in some way – be prepared to
ask whether they have washed their hands or used the disinfecting hand
gel. It takes courage, but it’s your health that’s at stake.
Above all, never be afraid to ask questions, especially about your own
condition, or to make valid complaints. It may be easiest to speak to
the ward matron. Do it gently but firmly. Your complaints or comments on
what happens in the ward could be of great value to others too.