|
|
|
|
How to break the cycles |
  |
|
 |
Keeping skin and surfaces clean |
Infectious bugs can contaminate and colonise almost any surface and that includes your skin. You are at serious risk when your own skin is contaminated as it is only a short step to infecting your body through open skin such as bedsores, surgical sites, rashes, or entering your nose or mouth. Once inside you bacteria, spores, fungi and viruses have different mechanisms of spreading infection and you will then be dependent on your own immune system or medication to kill off the infection.
It is obviously better to prevent an infection in the first place.
Disinfection of the surfaces around you is the first stage. |
| |
If you are in hospital or a care home
it is the responsibility of the staff to keep your environment clean. But cleaning usually takes place only once a day. As soon as that surface comes into contact with more microbes from someone’s hand or other contaminated surface, it is recontaminated. It is a sensible precaution to have a supply of surface wipes and a spray to use on frequently touched surfaces such as toilets, bedrails, chairs and mobile phones.
You should never clean the toilet or any obvious soiling with antibacterial wipes yourself. This puts you at risk of accidently picking up contamination. Where there is no soiling, it is better, in high risk areas, to use a spray to avoid any contact with surfaces. . You should never risk contamination of your skin, your dressings or medical devices like catheters or cannulas. It is always better to ask a visitor or member of staff to clean the surfaces around your bedside if necessary.
Ideally, if you are worried about cleanliness you should ask for a cleaner but in a busy hospital ward it is not always possible to provide a requested service within a reasonable time scale, especially in the evening or at weekends. |
| |
| |
|
|
| |
“Nearly four out of ten (39%) of nurses said cleaning services are not provided by their organisation 24 hours a day.”
“One in three nurses do not have access to a dedicated room for cleaning hospital equipment, meaning they have to perform this vital task for patients in bathrooms, according to the Royal College of Nursing research.”
Nursing Times Online May 2009 |
|
| |
|
|
|
|
 |
|
| |
Nursing and Care Homes |
| |
|
|
| |
“Approximately 66% of MRSA bacteraemia cases were diagnosed two or more days after admission, indicating that they were probably acquired during that admission. The remaining one third of cases could have been acquired in the community – particularly in nursing homes.”
Pulse September 2008 |
|
| |
|
|
|
| |
At home and in the Community
Your risk of certain infections is reduced but increased for others. We do not recommend using antimicrobials as part of a normal daily routine where there is very little risk factor. This could, in the long term, increase the likelihood of resistant strains developing. But there are times when extra precautions are sensible.
Community Acquired MRSA (CA MRSA) is increasing and the strains seem to be more virulent than Healthcare Acquired strains. This is becoming a real problem in the U.S. where the infection is spreading throughout the community in nurseries, schools, prisons, sport and fitness facilities – anywhere that people gather together in close contact. The U.S. death toll is rising and there is some evidence that CA MRSA is taking a stronger hold in the U.K.
Using an antimicrobial bodywash after contact sports and taking extra care to disinfect cuts and grazes, may become routine practice as it is fast becoming in the States. |
| |
| |
|
|
| |
“More Americans are developing drug-resistant staph infections, known as MRSA, from common, relatively minor foot problems such as cuts, cracks in the skin, athlete’s foot and ingrown toenails”
The American College of Foot and Ankle Surgeons (ACFAS). May 2009 |
|
| |
|
|
|
|
 |
|
| |
Caring for the infected at home
Poses special risks and a need to constantly guard against cross contamination. Although many family members or carers are unlikely to become infected, others, such as the elderly, the very young, those with health issues themselves, those who have been on repeated antibiotics, those with catheters or cannulas need increased protection. A scrupulous cleaning regime should be carried out until the infection is cleared and for some time after. A daily shower with antimicrobial bodywash could prevent colonisation though this may not prevent nasal colonisation. Exposed to infection, healthy people can become colonised and although they may not become ill, can easily spread the infection to others. |
| |
The Spread of Infection |
| |
|
|
| |
Although carriage of MRSA amongst healthy family members is not a risk in itself, there are a number of reasons why it makes sense to minimise dispersal of MRSA in the home environment and reduce opportunities for exposure amongst family members, which could lead to colonisation:
- When carriers of MRSA are admitted from home into hospital for surgery, there is significant risk of self–infection.
- When a family member who is a carrier of MRSA is admitted to hospital they represent a source of infection, which may be transmitted to other patients.
- When a family member who is a healthcare worker becomes colonised with MRSA at home, they may transmit the organism to patients in the healthcare setting where they are employed.
- For family members carrying PVL-producing strains of CA-MRSA, colonisation of cuts and abrasions may result in serious and potentially fatal skin and soft tissue infections.
- Family members who are most likely to be colonised with MRSA include healthcare workers or those who work in healthcare settings where they may have acquired the organism from infected patients or their environment.
The risks from MRSA in the home are exacerbated by the fact that, if it is allowed to become “endemic” in the home environment, it can persist for very long periods of time and can be difficult to eradicate
International Scientific Forum on Home Hygiene IFH January 2007 |
|
| |
|
|
|
| |
Returning home after surgery
Particular care should be taken by those returning home after surgery. Their carers could be colonised or their home environment contaminated so the same routine of cleaning and skin care should be followed at home until the surgical site is fully healed and for some time after. |
| |
The immune compromised and suppressed
are particularly vulnerable to infections. This includes those undergoing HIV or Cancer treatment, transplant recipients, those on dialysis, bone marrow recipients and those with diabetes – in fact anyone whose immune system is weak from their condition or from the treatment which they are receiving. The same high standards of cleanliness and care should be maintained particularly if the person has a wound or any invasive device such as a cannula or catheter. |
| |
| |
|
|
| |
“When patients who are still infected or colonised with MRSA are discharged from hospital, the organism may be transmitted to other family members or contacts, or can be disseminated into the home environment where it can survive for very significant periods. Although the patient may recover from the infection, they can become re-infected if they are again exposed to the organism either by another family member who has become colonised, or from surface contamination persisting in their home environment.”
Home and Immune Compromised International Scientific Forum on Home Hygiene IFH January 2007 |
|
| |
|
|
|
|
 |
|
| |
|
 |
|
| |
|
|
|
|
|
