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Friday, November 21, 2008

 

infectious

There has been a great deal of outrage at work based on this series in the Seattle Times:

Culture of Resistance

I work at the Big County Hospital prominently featured in the articles. I can tell you that our MRSA infection rate for last month (October) was the lowest that it has been in the last 10 years. This is due to aggressive detection & isolation practices as well as strict hygiene and cleaning measures. The casual statements made in the article about how the hospital doesn't screen or isolate patients is WRONG. All ICU patients are screened at admission and routinely thereafter. MRSA patients are very rarely roomed with non-MRSA patients - and when this happens, it's because the county hospital cannot just close its doors because it's too full. We have to continue to provide care. In these rare instances, the MRSA patient is paired with a low-risk roommate, someone who doesn't have open wounds or a compromised immune system, to try to avoid communicating the infection.

I am appalled at some of the "facts" people are spouting - both in this series and in the comments. For example:

  • Hospitals don't thoroughly clean rooms between patients.
    That would be wrong. Not only do rooms get cleaned in between patients, when the patient has been isolated due to infection, a "terminal clean" is done, which takes about an hour and is very thorough. Every bed is disinfected between occupants.


  • MRSA, C. diff, and other superbugs are viruses.
    No no no. They are bacteria. This means, unlike viruses, they can be treated with antibiotics. This distinction is really important!


  • Patients with MRSA acquired it in the hospital.
    There was a time when this was likely to be true - but these days LOTS of people are carrying MRSA out in the community. So they bring it in to the hospital in their noses or on their skin, then it may flare up into a full-blown infection after trauma, surgery, or some other insult to the immune system. Yes, these carriers need to be isolated, but it's certainly not a given that the hospital made them sick.


  • What it boils down to is that everyone needs to participate in preventing infections. This means hospital employees, patients, visitors, everyone. So patients, quit refusing your baths. Visitors, wash your damn hands, and don't let your kids sit on the floor. Doctors, take off your white coats and put on the gowns when you go in an isolation room. Everyone, clean your stethescopes between patients.

    Now, I would be interested in getting a nasal swab for MRSA because I'm sure it would come back positive!

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    Comments:
    I'd be curious to see what my swab will tell as well. I think it would be a pretty cool nursing research exercise to swab nurses and see what the rates for colonization are. It would surprise a lot of folks I think!
     
    Yikes! It's scary the power that media has, where they can just spout whatever they want and people could take it as gospel truth. The last thing we need is for sick people to stay home because they are afraid the hospital will make them worse. I hope your administration is intending to correct the misinformation!
     
    I had a MRSA infection over a year ago, and I hadn't even set foot inside a hospital in nine months. I guess the evil nurses snuck into my apartment and infected me while I was asleep? Geez, are there really still people over the age of 6 who can't tell viruses from bacteria?
     
    I work at a hospital that screens everyone for MRSA. Every single person. Supposedly our MRSA rates dropped big time after that. We do the same clean too, but people believe what they are gonna believe no matter how you explain it.

    I think at this point I'm not only positive for MRSA but probably a whole other host of bacteria I don't want to think about ;-).
     
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