bactitech
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http://www.medscape.com/viewarticle/564005?src=mp
"Cedars-Sinai Medical Center in Los Angeles, California, identified hand hygiene compliance as an institutional priority in September 2004. It set a goal of achieving 90% compliance by March 2005 and sustaining that for 3 months, said presenter Rekha Murthy, MD. Compliance at baseline was about 65%, with nurses leading the way at nearly 70%, whereas physicians and other healthcare workers hovered just under 50%. This pattern reflected what has been seen in the literature..."
The article goes on to state that some physicians had to have their PRIVILEGES suspended because they refused to wash their hands. They were able to raise compliance of nurses to 90% but docs only to around 69%. Can anyone help me to explain why this is? Are you really in THAT much of a hurry that you can't wash your hands?
I hope that you all on this group, the next generation of physicians, realize that you also are capable of passing on this terrible infection and remember to wash your hands before examining ANY patient, preferably where the patient can see you do this.
I work on abscess and wound cultures routinely. I would say that S. aureus, and specifically MRSA, constitute my most isolated pathogen. There are some days when almost all my S. aureus isolates are MRSA. I would estimate we run over 70% MRSA now. Our lab has a very large workload of these type of specimens, as we do the work of four hospitals in our area, so this is not an isolated incident.
Handwashing is the first step. Soon (2009) Medicare will stop reimbursing hospitals for infections that start after admission. You will be graduating to this new rule so you might want to familiarize yourself with this, as I can guarantee it will be rigorously enforced by the hospitals, who do not want to lose Medicare revenue, as they will have to eat the costs of these infections and will not be able to bill the patient for them as they do now:
http://www.medicalnewstoday.com/articles/80074.ph...
The hospitals will go berserk and start cracking down on everyone, including the docs. The UK has already decided that the long white lab coat is going away. Soon, all physicians over there will have to wear short sleeves (no cuffs) and no ties. I would guess they would probably go to scrubs. These at least can be changed easily if contaminated.
I used to work at a medical school hospital. I know that the short vs. long white coat helps define the pecking order and the doctors to nurses and patients. It will be interesting when these status symbols go away. What will be next? :-)
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| GoodGirl
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Very interesting article,seems like it is never enough to hear it again and again '' wash the hands''.
Thanks Bactitech.
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| silver
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The line that stood out the most for me was that 2 years ago more people died from MRSA infections than AIDS in the US.
Definitely handwashing cannot be over-emphasized. I've seen some doctors who when they become patients demand impeccable hygiene and sterilization...so it should be considered from that point of view--if they can't bear to be touched by someone with dirty hands, then so does every patient who comes in to their office--they're human too; not to mention the risk you're putting these people and your coworkers into.
And I'm extremely against those sterilizing/anti-bacterial gels--what is that??? Nothing beats washing with water.
Edited by silver on 10/22/07 - 04:29 AM
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| bactitech
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Actually the gels work quite well according to most articles I've read. They abrade the hands less. Many phlebotomists use them in between patients because they're drawing about 60 people a day.
http://tinyurl.com/yurupw - this article addresses this issue
These are other articles with various conclusions regarding alcohol hand gels...
http://sciencelinks.jp/j-east/article/200705/0000...
http://gateway.nlm.nih.gov/MeetingAbstracts/10226...
http://intqhc.oxfordjournals.org/cgi/content/abst...
http://tinyurl.com/2bez22
http://www.colostate.edu/orgs/safefood/NEWSLTR/v8...
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| bactitech
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Real-life diary of an MRSA patient - this person was trying to work through their Ph.D. when MRSA hit - VERY eye-opening and highly recommended reading for all of you. I only see MRSA on plates - YOU will see the patient. I know you're pressed for time but it's very interesting.
http://www.nickyee.com/abscess_septra.html
I found this online diary through a link I was reading from this article:
http://well.blogs.nytimes.com/2007/10/23/drug-res...
I have NOT checked out the picture links he has posted - supposedly graphic
testimony to his CA-MRSA infection. It is very eye-opening to read the
patient side of the story. I'm not sure whether I'll look at the pics or
not. I'm sure you presurgical students will be very much interested in the videos. I watched about a minute of the first one and chickened out....
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Clinical Microbiology since 1974
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