bactitech
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http://tinyurl.com/hdeud
YOU could be a future carrier of MRSA to your post surgical (or other) patient. This is worth the time to read. Most hospitals are reporting that nearly 60% of their Staph. aureus isolates are now methicillin resistant, and most are carried by dirty hands.
This is an excerpt from the above article about handwashing in hospitals, and why docs are notoriously noncompliant. Further on in the article, it was only by culturing doctor's hands, taking pictures of the nasty cultures, and posting them on screen savers all over the hospital that convinced everyone that this needed to be done.
"...It may seem a mystery why doctors, of all people, practice poor hand hygiene. But as Bender huddled with the hospital's leadership, they identified a number of reasons. For starters, doctors are very busy. And a sink isn't always handy — often it is situated far out of a doctor's work flow or is barricaded by equipment. Many hospitals, including Cedars-Sinai, had already introduced alcohol-based disinfectants like Purell as an alternative to regular hand-washing. But even with Purell dispensers mounted on a wall, the Cedars-Sinai doctors didn't always use them.
There also seem to be psychological reasons for noncompliance. The first is what might be called a perception deficit. In one Australian medical study, doctors self-reported their hand-washing rate at 73 percent, whereas when these same doctors were observed, their actual rate was a paltry 9 percent. The second psychological reason, according to one Cedars-Sinai doctor, is arrogance. "The ego can kick in after you have been in practice a while," explains Paul Silka, an emergency-department physician who is also the hospital's chief of staff. "You say: 'Hey, I couldn't be carrying the bad bugs. It's the other hospital personnel."' Furthermore, most of the doctors at Cedars-Sinai are free agents who work for themselves, not for the hospital, and many of them saw the looming Joint Commission review as a nuisance. Their incentives, in other words, were not quite aligned with the hospital's.
So the hospital needed to devise some kind of incentive scheme that would increase compliance without alienating its doctors. In the beginning, the administrators gently cajoled the doctors with e-mail, faxes and posters. But none of that seemed to work. (The hospital had enlisted a crew of nurses to surreptitiously report on the staff's hand-washing.) "Then we started a campaign that really took the word to the physicians where they live, which is on the wards," Silka recalls. "And, most importantly, in the physicians' parking lot, which in L.A. is a big deal....[they dispensed Purell in the parking lots, but this didn't work either. Then they tried hand cultures....]
They pressed their palms into the plates, and Murthy sent them to the lab to be cultured and photographed. The resulting images, Silka says, "were disgusting and striking, with gobs of colonies of bacteria."
The administration then decided to harness the power of such a disgusting image. One photograph was made into a screen saver that haunted every computer in Cedars-Sinai. Whatever reasons the doctors may have had for not complying in the past, they vanished in the face of such vivid evidence. "With people who have been in practice 25 or 30 or 40 years, it's hard to change their behavior," Leon Bender says. "But when you present them with good data, they change their behavior very rapidly." Some forms of data, of course, are more compelling than others, and in this case an image was worth 1,000 statistical tables. Hand-hygiene compliance shot up to nearly 100 percent and, according to the hospital, it has pretty much remained there ever since."
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Clinical Microbiology since 1974
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| goodyear
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Great bactitech!!!
to all future doctors.. this should be an eye opener! This is absolutely important to health care givers... A Must thing to do!!
Do this to all pts., Most esp. to oncology patients who are immunocompromised. I know a "Mom" who
makes sure all her kid's doctors & nurses washes their hands before checking her son when he was hospitalized as a leukemia pt.
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| bactitech
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http://freakonomics.com/pdf/CedarsSinaiScreenSave...
This is the screen saver. Please note that these hands appear to be covered with what looks like Staphylococcus aureus, and it's probably MRSA!
Good for "mom." If I had someone in the hospital with open wounds, I would buy one of those humongous dispensers of Purell gel, sit there in the room and INSIST on everyone that comes in the room to do a procedure to use it.
Hospitals are crawling with MRSA and other nasty bugs. The other one that's bad is Acinetobacter baumanii. Many of the strains we see are resistant to almost every antibiotic we set up. There are some other bad ones around also.
Many patients are immunocompromised: cancer patients, renal patients, leukemia patients, HIV - the list goes on. Docs go from one patient to another, probing at this and looking at that. Your ties and stethoscopes, besides your hands, have been implicated in the spread of infection. Clean off that nasty stethoscope with some alcohol wipes. Yuck! Think of where it's been. Don't put that on ME!
ALWAYS wash you hands before you eat - ESPECIALLY in a hospital. Those desk tops on the floor had specimens sitting on them at one point in time.....ewwww....
Edited by bactitech on 09/25/06 - 10:58 PM
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Clinical Microbiology since 1974
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| klimt
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Thanx bactitech - your story is really educational for all doctors and future doctors....
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