Skip to comments.(California)State's Hospitals Must Come Clean on Germs (MRSA)
Posted on 01/01/2009 10:11:16 PM PST by blueplum
"The strain of a once-innocuous staph infection that has become invulnerable to first-line antibiotics kills more people each year than the AIDS virus and in most cases is contracted in hospitals.
...SB 1058 will require hospitals to report infections such as MRSA to the Department of Health Services, effective Jan. 1."
(Excerpt) Read more at sacbee.com ...
Maybe medical professionals shouldn’t be shopping and everything else in their scrubs! Try going to the supermarket with out seeing 10 people dressed in scrubs.
and btw.....please point to one case where anybody contracted MRSA from someone's uniform....
for MRSA there is strict isolation with gowns, masks, gloves and possible eye shields....they are discarded each and every time you leave an isolation room...
we have a case where I work..the family member refuses to wear any protective gear..no gloves, no gown, nothing...this person comes and goes into the active MRSA room, uses the elevator, the bathrooms, goes to the cafeteria and refuses to take protective measures to protect we the staff and you the public, let alone the other sick patients....
and there is absolutely nothing we can do about it....legally, there is no way to force people to obey isolation techniques...
A more virulent version of MRSA is in the community already. AIDS is fairly well controlled by the newer drugs.
nick: I’ve seen the same thing and find it an extremely dangerous practice. But, you have to admit that it does make them look important.
cherry: >>”...we wear our uniforms to work and we wear them home...”<<
Why are you spreading germs from your contaminated ‘uniforms’ throughout the community? FYI, we are not impressed and view such behavior as reckless, to say the least. Take the five minutes and change into your street clothes for the sake of us common folks.
Before you start a flame war I must tell you that both my son and his wife are doctors AND that my wife nearly died from MRSP she contracted while in the hospital. So, save your breath if you plan to educate me us that it is safe to parade around town in your germ-ridden uniforms. Even a mechanic changes his clothes before going home.
I don’t see anything wrong with changing into sweats and stuffing the scrubs in a gym-bag. Maybe one benefit of the increased oversight is, nurses and aides could demand and get approval for a scrub-down trailer. I’d be for that, why not? Cheap enough.
now for contracting MRSA from cloth, people who share the same sheets can contract MRSA from each other. And MRSA can be spread by washing a patient’s clothing with other family members. If there was no chance of MRSA being carried on clothing, there would be no need for a gown, or washing patients’ clothing separately followed by a bleach rinse of the washing machine, right?
The family member that you speak of is most likely a walking MRSA carrier. He/she may have built a slight immunity if they’ve cared for the patient, or, more than likely, they are silent victims, not yet your patient, but most likely will be at some time in the future. Maybe if you look at it that way, your viewpoint of he/she will soften. (There IS a solution and that would be to offer them free MRSA screening and treatment, but maybe that’s just a pipe-dream.)
Point is, hospitals were the original source of MRSA and it’s time they cleaned their act up not only for patients, but for the safety of the hospital workers themselves. It’s going to take everyone cooperating and maybe changing routines and procedures. The alternative would be to immediately prohibit all MRSA carriers from performing health care; it would decimate our medical staffing. I’m hoping this new legislation will be helpful to nurses and aides in their role in preventing spread of MRSA, especially to themselves, and which I’m sure none of them would ever want to do intentionally to others.
best regards, blu
I highly doubt uniforms are the main vector, it would be hands splashed in sanitizers. Wash your hands with soap and water.
MRSA can live for up to 7 months on dust
MRSA can live for up to 8 weeks on a mop head
MRSA can live for up to 9 weeks on cotton (towel)
MRSA can live for up to 203 days (over 6 months) on a blanket
MRSA can live on the skin of otherwise healthy individuals, with no symptoms
Door handles and toilet paper rolls I suspect would be equally contaminated, as would be hair and skin.
Because she doesn’t care and is one of the problems. She takes germs all throught the community and to her home.
DOCTORS HAVE lounges AND THEY WALK IN AND LEAVE WITH THE SAME STREET CLOTHES THEY HAD ON WHEN THEY CAME IN.
If you go to visit someone in the hospital, you are carrying all kinds of things on your person when you leave, no matter what. No one should ever do anything but go straight home and shower after visiting or working in a hospital...period.
That said, some of those you see in public in their scrubs are not healthcare professionals...anyone can buy scrubs at Sam's Club. But I do know that some people who work in Nursing Homes especially, who have a careless attitude.
MDR Acinetobacter calcoaceticus-baumanni complex was an issue for the wounded in Iraq.
All hospitals need more extensive containment training for scrub and OR techs. Patient visitation, as cruel as it sounds, needs to be restricted. Spider bites, as odd as it sounds is also suspect in some cases I have researched.
Hospitals with good infection control programs know about all (95+%) of their infections. Hospitals with poor infection control programs either don't know about them, or don't count them properly.
Hence, excellent programs will always report more infections to the state than poor ones.
This is already well-documented in Pennsylvania, which has been on thos idiotic crusade for 3 years.
In PA, there is NO CORRELATION between infections reported to the state and infections billed to Medicare. Some hospitals report every infection they have billed to Medicare, some report no infections that they have billed to Medicare, and many hospitals bill for many infections which they have not reported to the state.
WIthout enforcement, which would be amazingly expensive and has no possibility of happening, this is just another boondoggle.
When this is explained to the people who write these laws, they say, "Well, we have to do something. We'll just get the information (the corrupted, meaningless data) out there, and let the public decide".
Anyone entering or leaving should really go through a decontamination procedure. The facilities improvements and employee training costs a lot of money. If it were up to me, I would virtually end public access to certain hospital areas. It is not a pretty picture, but what you cannot see will kill you.
It is bad enough so many people were too lazy or too stupid to finish their antibiotic prescriptions which lead to a lot of the multidrug-resistent organisms, now many will be too lazy or too cheap to assist in the effort to contain them.
My father died in February 2007, not from the stroke he had, but from hospital acquired infections, including MRSA. He got every one of those infections from a local hospital. The doctors kept giving him stronger and stronger antibiotics, and my dad just got to the point that he couldn’t fight them off anymore. He died from a hospital-type of pneumonia, fighting for every breath.
Unlike the family you mentioned, we followed all the hospital isolation procedures when my dad was put on isolation, including gowns, masks, gloves. But we did have a problem with the hospital staff following the isolation procedures. My mother and I both have worked in the health care field as nursing assistants, in both hospitals and nursing homes. We know about isolation procedures. We observed many instances where staff entered my dad’s room to provide care for him without even gloves on, when plenty of gloves, etc. were right outside of his room. We had to remind some of the staff to following the isolation protocol. We even had to report them sometimes, although nothing to my knowledge was ever done. If I seem like I am criticizing all health care professionals, please don’t take it that way. I’m just saying that not all nurses, doctors, etc. follow their own procedures.
I’m all for ANY additional precautions to prevent hospital acquired infections, if there’s a chance that it may save a life. I had no idea that hospital acquired infections were so prevalent in hospitals until the nightmare with my dad. It is a lot worse now than 10 years ago, when I worked in a hospital; it’s become an epidemic. In the future, if I ever have to go to a hospital, nobody is even going to touch me until I see them wash their hands at the sink and put on a pair of gloves. That is, if I’m conscious. Am I going to be a difficult patient because of that? Maybe so. But I want to be able to walk out of that hospital better than when I came in, not worse like my poor dad.
I know exactly how you feel, I know exactly what you went through.
Bedsores are also an infection risk. I know a man that died from osteomyelitis he got as the result of the most egregious neglect. The bedsore exposed his lumbar spine. He had money and good insurance.
This happens to a greater extent in places like Florida where elderly patients have little or no family nearby to keep the heat on the staff to care for them attentively.
MRSA is more prevalent in the outside world than it is in Hospitals....usually it is brought into the hospital by the patienr.
Yes, my dad got a couple of bedsores too. He spent almost a year in the hospital. When the hospital would release him to the nursing home for therapy, he would only be at the nursing home a few days, his fever would spike up (due to the infections), and he’d have to be sent back to the hospital, where he would pick up other infections. It was a vicious cycle. He never was able to get any kind of physical therapy hardly. He was rendered too sick and weak from dealing with all those hospital acquired infections. And my dad was only 69 years old when he died. He worked all his life, was always strong, but he was no match for those terrible infections.
MSRP = MSRA
err.....make that MRSA. Too little sleep for two days.
I am a hospitalist physician.
I wear street clothes to work and back home
I would wager if you swab every hospital workers nasal mucose that over 1/2 of us are carriers of MRSA
What would you practically do? Put every hospital worker on broad spectrum antibiotics that would only increase resistance?
MRSA is around and has been for years. It does not scare me nearly as much as most resistant bacterial infections (pseudomonas, vre, etc)
We see nearly as many cases of MRSA acquired in the community now as we do in the hospital. The bacteria is in the community at large and I do not see a practical way of stopping it. But we can run up huge tabs in attempting to control a horse that is long out of the barn.
containment is not possible. We see nearly as many MRSA infections acquired in the community as in the hospital. The bug has been around for years. It is not one of the things that keeps me awake at night as a hospital worker. I suspect I have been colonized for years, and probably the rest of my immediate family as well
This is not a bug that causes a lot of problems for people with normal immune systems. Now talk about pseudomonas, VRE, or acinetobacter and I might agree with you. THese are much rarer, more virulent, and MAY have some utility in trying to contain.
Clothing, linens, gowns, dishes, environmental surfaces, etc....have NOT been implicated as vectors for MRSA.
Hand washing, folks....it's simple and effective.
There are likely many more sources than we have suspected and not all of them naturally occurring either as there is some justifiable speculation about weaponizations. The CDC is really looking at this and there is also a special division within the USDA working to detect other sources.
Mom MD: What is a “hospitalist physician”? Are you an Infectious Disease MD? Just asking.
democratsaremyenemy: Better check your sources.
cherry: >>”.....please point to one case where anybody contracted MRSA from someone’s uniform....”<<
From the link below:
“The study found about 85 percent of all invasive MRSA infections were associated with health care settings, of which two-thirds surfaced in the community among people who were hospitalized, underwent a medical procedure or resided in a long-term care facility within the previous year. In contrast, about 15 percent of reported infections were considered to be community-associated, which means that the infection occurred in people without documented health care risk factors.”
“About 1 out every 12 deaths during hospitalization with a serious MRSA disease occurs in persons admitted for community-associated MRSA infection, the remaining 11 of every 12 deaths are associated with MRSA related to healthcare exposures;..”
“Do not share personal items. Avoid sharing personal items such as towels, washcloths, razors, CLOTHING, or UNIFORMS that may have had contact with the infected wound or bandage. Wash sheets, towels, and clothes that become soiled with water and laundry detergent. Drying clothes in a hot dryer, rather than air-drying, also helps kill bacteria in CLOTHES.”
From your link...Universal precaution's are standard.
But, that being said....plain ol' simple hand washing...remains the NUMBER ONE preventive procedure to stop the spread of MRSA.
And I will repeat that clothing, linens, gowns, equipment...are not generally implicated as a vector in the spread of MRSA.
While the role of clothing in the spread of infection hasn’t been well studied, some hospitals in Denmark and Europe have adopted wide-ranging infection-control practices that include provisions for the clothing that health care workers wear both in and out of the hospital. Workers of both sexes must change into hospital-provided scrubs when they arrive at work and even wear sanitized plastic shoes, also provided by the hospital. At the end of the day, they change back into their street clothes to go home.
I think we know that with the environment as a potential source, if you bring scrubs home from your emergency department visit, this does run the risk of bringing this organism into your home. I would strongly encourage physicians not to wear their work clothes home if theyre concerned about community-associated MRSA. It would be ideal for them to change into scrubs, wear the scrubs, and then have the scrubs laundered.
The Committee to Reduce Infection Deaths (RID) announces it is calling on all hospitals in the U.S. to provide clean uniforms or scrubs for their personnel and to bar medical workers from wearing uniforms outside of hospital buildings.
You see them everywhere: nurses, doctors and medical technicians in scrubs or white coats, says Betsy McCaughey, PhD, chairman of RID. They shop in them, take buses and trains in them, go to restaurants in them, and wear them home. What you cant see on these garments are the bacteria that could kill you.
When we spot someone in scrubs we are on them before they can touch a thing. We ask them where they are coming from in scrubs. If they came from working on a “dirty floor,” we make them gown and glove, and tell them that they should not visit after work without showering and changing clothes, or they should come before work. Most of the time, people are cooperative and understand why we are making them do all that.
Sixty-five percent of nurses caring for patients with methicillin-resistant Staphylococcus aureus (MRSA) had contaminated uniforms.
How can someone (in particular, a licensed health-care professional) change out of their street clothes, put on clean scrubs to enter the OR (or clean room, or lab etc) and then wear the same scrubs out of the OR? Don’t they get it? Is it somehow okay to wear scrubs with microscopic OR goo tagging along throughout the day (”Hey, thanks for wearing those OR clothes to the lunch room - sit here next to me”). Worse still what about when these same licensed health-care professionals leave the cafeteria, go to the locker room, take off their lab coats and then go back into the OR. What are they thinking? Don’t even try to tell me that’s okay! I’ve seen it hundreds of times and I’ll bet many of you have, too. Sometimes it’s a surgeon, sometimes an audiologist, maybe a nurse, maybe a tech. I’ve seen them all do it, really. And truth be told, I did it, too, many years ago. But we’re smarter now.
Nursing staff will wear a clean pair of tunic and trouser style scrubs at the start of each shift, with used sets washed daily at very high temperatures using an industrial process in the Trust’s on-site laundry. Staff will not be able to wear scrubs outside the hospital.
Stamford Hospital in Connecticut recently banned wearing of scrubs outside the hospital, given the surge in C. diff. cases, a new superbug threat. MonroeHospital opened its doors two years ago and has had no hospital-acquired infections. The extraordinary success of this Indiana hospital is due in part to hospital laundering of scrubs and prohibiting personnel from wearing scrubs beyond the building.
Like nearly anything...I can find and post many articles, studies, and whatnot...that supports my position.
I will stand with many Physicians, and other health care professionals that I know..and say once again..that THE best preventative to spreading infectious DZ's is "hand washing"