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Edwina Currie, Patron for MRSA Action discusses the ongoing campaign to reduce infection rates across hospitals and explains the importance of good hygiene

“The Leeds NHS Trust is facing a potential fine of £400,000 because there have been too many instance of MRSA in its hospitals.
Every time the Leeds Teaching Hospitals NHS Trust goes over the agreed monthly target of MRSA cases it faces a fine of £100,000 and it has breached targets four times over the past 10 months. The fine will be reimbursed if the trust meets the annual figure of 19 cases, however with two months to go before the end of the financial year there have already been 19 cases so one more will tip the trust over the edge.
The trust has made dealing with MRSA one of its priorities as in recent years it has consistently missed national targets both on MRSA and Clostridium difficile. It has now begun MRSA screening for all acute patients and each case of the infection is closely analysed to assess how it occurred.Despite this Leeds still had the highest rate of MRSA infection compared to five other similar sized hospital trusts.” Yorkshire Post 16 March 2011


The campaign waged against hospital superbugs demonstrates the power of action by ordinary people affected by a disaster. Leeds NHS Trust faced headlines earlier this year for reaching its maximum target of no more than 19 cases of MRSA in the year ending March 31st, having hit the 19 with two months still to go. With fines of possibly £400,000 or more in the offing, hospital officials did what they should have done years before: ordered MRSA screening for all acute patients, and a case review of every single case to see exactly how it occurred.

They will have found what their patients would regard as the “bleedin’ obvious”: lack of hygiene, lack of attention to detail, lack of commitment by some staff to the rigorous standards needed to care successfully for thousands of sick people at close quarters in a busy hospital.

As Patron of the charity MRSA Action UK, I’ve come across many instances of bad practice which at the least are folly, at worst criminally negligent. Sharps being stuck into mattresses “so we can find them.” Commodes rusting and smelly. Floors with stains, pools of congealed blood by toilets, waste bags left in corridors. Intravenous lines being reused repeatedly with inadequate sterilisation. Doctors “too posh to wash” their hands, or wearing scruffy outdoor apparel with long sleeves. No wonder it’s so hard to eradicate MRSA and other superbugs.

When it comes to C diff, we’re often talking about out-dated medical practice including inappropriate broad-spectrum antiobiotic use, wiping out all the gut flora so that C diff can then proliferate. Poor hygiene then spreads it around. Both C diff and MRSA are becoming endemic in many nursing homes too, where training standards are much lower than in acute hospitals – in Leeds recently almost a quarter of residents of nursing homes tested positive for MRSA.

To be fair to Leeds, the number of cases of MRSA in the Trust used to run at around 200 a year, so getting down to 19 must have taken genuine effort. But reported figures are only a tiny part of the problem, for only bloodstream infections are covered; wound-site infections and other conditions aren’t counted, though they are caused in much the same way, and can result in long debilitating stays in hospital and permanent damage.

I’ve toured hospitals where the official policies are pristine, only to find that at ward level nobody knows about them. In the Royal Free, for example, officials told me everyone used hand gel as they entered a ward, only for me to point out that, standing at the entrance to a ward, I’d just counted seven staff enter without doing so. Their excellent rules stated that cannulas (a known site of infection) should only be inserted if necessary and removed once no longer required; when I asked several patients with cannulas taped to hands or wrists when these were last used, the answer was, “a couple of days ago.”

Part of the problem, in my opinion, is that we forget we are dealing with human beings. If staff thought that patient in the bed was their mother, or their daughter, they might not rush past, and they might hesitate before “forgetting” to wash their hands. When I speak on behalf of the charity, I put human stories to the statistics, and never fail to produce gasps of horror from some of those listening.

And did Leeds have to fork out £400,000? The latest figures (available on the MRSA Action website) suggest that the Trust as a whole ended up with 31 cases in the year ending March 31 2011. Pressure from watchdogs does not appear to have had the desired effect - yet.  Personally I’d prefer that huge sum to be spent on extra staff, not on a fine. Good hygiene is not a matter of money, but of understanding and commitment, and both still seem to be in short supply.

www.mrsaactionuk.net

http://www.telegraph.co.uk/health/healthnews/8538475/Edwina-Currie-says-doctors-are-too-posh-to-wash-hands.html

Written by Edwina Currie
Monday, 04 July 2011 16:04

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