Hospital infections...

[paramedic paul]

I have to agree, during the "Good ol' Days" when Matron ruled with a rod of iron and the wards had to be spotless there possibly was less cross infection, however we no longer live in a time where the government will subsidise excess staffing levels to allow the nurses to get out the dusters and mops and so we have to accept that we all have a role to play in keeping infection down. In fact the opposite is true, the people employed to clean don't have enough time to do that!

Central heating wasn't around back then, i think it's widely accepted that increased heat has increased the spread of infections, not only at hospital but also in the home. How many times do you visit a hospital ward and complain that it's too hot, yet you try and get the heating turned down, see how many patients complain because it's colder than their own home!

What i'm trying to say (admittedly in a Jennings Sneck Lifter semi drunken haze!) is that whilst I accept that the situation is far from perfect we should also accept that we all have a part to play in keeping these dreadful infections at bay, all it takes is a squirt of alco gel when entering and leaving a ward to dramatically reduce the cross infection! The quantity of patients we see who present with D + V who have recently visited a spouse or friend in hospital is increasing, it's obvious they haven't had a couple of squirts!

It's easy to blame the government, and yes they do have to shoulder a lot of the responsibility, but come on, lets all help out!

Sorry if this reply is a bit muddled, i've had a couple of beers but, this is a subject close to my heart! I'm also going to try and dig out some stats i recall reading a few months ago about the cross comtamination of TB patients in the 50s and 60s, i'm possibly wrong but i wonder if it's simply that cross contamination has always been there, just different diseases. As soon as the NHS get on top of one type of cross contamination another one rears its ugly head?

FWIW I don't consider myself informed enough to comment on the Fat Cat allegations and comments!

[cazyoung]

Hot bedding (ie having someone waiting to get in the bed before the most recent resident has left) is an on going infection risk. This will not change while the current NHS ethos pervades. Not palatable reading but true!!!!!!!!

[Odin]

Funny - during my Nurse training I don't recall being taught to mop floors wash windows etc....

We had people employed to do the cleaning whilst we attended to the clinical needs of our patients.

Nowadays... the cleaning staff also dispense the meals, the number of nurses on wards and other areas has been reduced, throughput of patients increased, clinical needs have developed and require more expertise.

Theatres used to be cleaned by a dedicated team. Now most hospitals expect the theatre staff to do the majority of the cleaning. Support workers do scrub the floors though. With the demands on theatre time, and the national shortage of trained personnel (we need to recruit 48 trained staff to match our requirements), the last thing the theatre team want to do at the end of the session (over running list + late off duty being the norm...) is start to wash walls and surfaces.
But they do!

The number of people having access to a hospital in a day runs into the thousands. MRSA and C Diff are out there in the community. We screen for infections and treat everyone as a potential source of infection until proven otherwise.

So DO NOT BLAME THE NURSES
WITHOUT THE NECESSARY RESOURCES THEY ARE DOING ALL THEY CAN!

18 weeks waiting lists? If we do not treat within this time scale we are financially punished. Emergency admissions can reduce the number of availble beds, theatres. Instead of allowing the hospitals to organise themselves and their resources the Govt states a policy. So when we cannot meet the 18 week target, we are "fined" which takes money out of the system, reducing the amount available to carry out the care we want to give.

DO NOT BLAME THE NURSES - LOOK AT THE LARGER PICTURE.

Paul (rant over)
p.s. and do not get me started on the £4k pay drop thanks to Agenda For Change!

[DecoWarrior]

Originally Posted by Odin

So DO NOT BLAME THE NURSES
WITHOUT THE NECESSARY RESOURCES THEY ARE DOING ALL THEY CAN!

DO NOT BLAME THE NURSES - LOOK AT THE LARGER PICTURE.

sorry but my experiences are contary to this, over the past 18 months i have spent a lot of time at the hotel nhs, and i must admit that i did not like what i saw, i suffered at the hands of mrsa and cdiff, about 6 months apart, i was lucky, these incidents nearly finished me off and were making me feel worse than the reason i was there, the cdiff incident vcery nearly finished me off, i was lucky i was in pieces, and this was entirely the fault of the nursing staff, the ward i was on was entirly down to nursing staff not doing their jobs, c diff was rife on the ward unyet they made no atempt to maintain hygene wash and gel between patient, handled contaminated beding without glovces and aprons, refused to move contaminated patients left dirty beding on the ward it was a recipe for disaster, my observations were that the basic fundamentals were overlooked and it is the staff at ground level who are to blame for this, most of my observations were pure laziness

when i had mrsa they blamed me for bringing it in with me despite there being an outbreak on the ward, and basic principles being neglected, so sorry as a patient i have observed these things many times and its easy to say that people are carrying it, if people were doing the basics it would be a lot hearder to spread, i am due in hospital again soon and one of the major concerns i have is not making out due to infections its had me twice and third time lucky as they say...

oh and the recent media coverage made me aware that the infection rates that were published were only for an over 65 age group and didnt cover younger patients..

[Odin]

So, were there any support staff on the ward?
How many TRAINED Nurses on duty?
Did you complain at the time to the person in charge?
We have even banned white coats for Dr's et al in order to reduce the risk of cross infection.
Maybe I'm fortunate to have a very good hospital in my area.

[DecoWarrior]

course we complained!

unfortunalty it wasnt just one hospital, it was the QE in brum and the north staffs in stoke on trent, no one would listen to our complaints, one ward with the mrsa was an oncology ward with lots of very sick patients, complained to the relevant people total impact nil, you get accused of being a trouble maker.....

in brum, ward staff, didnt want to know, i felt REALLy bad as there were lots of old people on the ward i wass virtually begging for some privacy and isolation, they moved me to a bed in the corner of the ward!, next to the phone so lots of people were up and down, staff didnt want to know, when the issues were raised its seen as you are a trouble maker, the nurses were going from contaminated patients with no aprons, the doctors were using stethoscopes with out wiping basic stuff,

oh and by the way, myslef and my family do have experience of how the nhs works because my mum has been an a and e nurse for 30 years and is well aware of the relevant and apropriate procedures, believe me its not just this that has been a frustrating experience, there are lots of problems i have experienced along the way that make this look trivial

[e14724]

Its complicated, most clinical staff do what they can under enormous pressures ans constantly reduced resources, there are however a number who fail to do the basics. Ive witnessed junior Drs going to the loo and not washing their hands!!
MRSA and C.Diff are on a number of the public as already mentioned and screening would have a huge impact. However there are products out there that are proven to reduce infections and they aren't interested, it all down to £££££ and they aint got none!
Initial studies into using virus' to eliminate the resistant strains of bacterium have been possitive, which I think is the best long term solution.

As for the alcohol gel, in some of the hospitals that I work in they have been romoved because the local alcoholics have been drinking it!!

[captainnemo]

As I understand it, alcohol wipes are not effective against C. Diff but luckily good old soap and water works just fine against that one so there isn't any need for high tech magic there.
It is probably true that there is plenty of MRSA and the like out in the community but we aren't addressing the possibility of people keeling over in the wide world, we're looking at people in hospital, where you normally go to get less unwell....

Whatever explanations are offered to explain the problems experienced in the NHS (and there are plenty of reasons given....other than poor routine hygiene practice...cos that would sound a bit dodgy) it is difficult to avoid comparison with the incidence of similar infections in European hospitals and the standard practices exercised there. Logic would suggest that European countries should have a rate of hospital-acquired infections on a per capita level similar to the UK and this is not the case.

The concept of the NHS is superb, free medical treatment for all. There are literally thousands of individuals in the NHS who perform more than they might reasonably be expected to do and should be recognised for that. Unfortunately the latter factor tends to conceal problems in the central theory. The 'free' NHS actually costs rather a lot of billions and we are getting short-changed across the board...including the poor sods who work their nuts off to keep overworked and under-resourced departments functioning while a bloated bureaucracy churns out endless 'targets'....many of which are counterproductive.

The original belief of the great and good who devised the NHS back in the 1940s was that over time the provision of free health care would promote a healthier general population which would consequently diminish demand on the need for subsequent health provision.....and their optimism was not borne out by circumstance. That doesn't mean they were wrong to set up the NHS but some sacred cows need to be slaughtered. It remains to be seen where the bolt gun should be wielded but it seems odd that so many of the paper clip counters get paid so much more than trained medical professionals....when I go to hospital I'd rather see more nurses looking after more widely spaced beds and if that means that there need to be some empty spaces in the offices at the local health authority I could probably live with that.

[susanmac]

OK, I had decided not to get involved but here we go .

I'm a staff nurse on a 20 bedded ward and infection control is high on our priority list. Within the last month 2 patients have been admitted at separate times and later found to have MRSA, one was nursed in a 9 bedded room and one in a 5 bedded room. As soon as these patients were identified as MRSA positive they were isolated and all the other patients given full screens. That's 12 patients at risk of infection because no barrier precautions were in place. I'm delighted to say that all 12 patients screened negative due to the standard hygiene precautions we practice, I'm very proud of my colleagues and myself for achieving this! We are doing something right.

This is also evidence that patients are entering hospital carrying MRSA as no-one else on the ward could have infected them as no-one else had the infection.

While everyone is getting wound up about hospital infections please remember that is where it is identified, not exclusively where it is caught. Can you be certain that the person who rejected that apple you bought, gave you the change at the till, sat in the airline seat before you, or served you food in a restaurant is free from infection? I'm not suggesting we turn into a nation of hypochondriacs (actually I think we already are). I'm simply saying "don't shoot the messenger!"

Healthy days to all,
Susan.

[stevechesh]

Just as a matter of interest, do items like computer keyboards, phones (including the wheelabout patient phones), door handles and so on, get regularly checked for MRSA etc? I thought we all had certain levels of MRSA living up our noses anyway, so stop picking them!