Hand hygiene has been stated as the one main element that can prevent the spread of MRSA (Gould 2002). Washing hands is not kid’s stuff – not in the era of MRSA. Once entrenched MRSA can be extremely difficult to treat. If it gets into the blood stream it can be lethal (Belkum, Verbrugh 2001). Simor and Andrew (2001) also emphasise that hand washing is the most important control practice. It is essential because personal contact is the primary mode of MRSA transmission. Therefore good hand washing technique is vital to ensure that the decontamination is effective, as no soap will be effective if the technique is poor. Rayner (2003) affirms this by stating that appropriate hand washing effectively removes transient organisms, which prevents MRSA transmission.
It is clear that there are many advantages and disadvantages to the process of hand hygiene, and procedures and protocols should be in place to minimise the disadvantages but in practice these are not always implemented or are hindered in some way. Personal experience has shown that there are barriers to hand hygiene, whilst working on a surgical ward within a general hospital. As this ward was surgical the importance of hand hygiene needed emphasis due to the number of recently operated on patients and also the high prevalence of MRSA that was already on the ward. From the moment of starting it was iterated the importance of ensuring that MRSA did not spread, especially to the patients that had recently had surgery. Although it is hard to follow procedure if the materials are not available to carry it out to the best of the staffs’ ability. Also it is very easy to forget especially in such a busy ward about hand hygiene but everyone must be vigilant in ensuring that it is not a regular occurrence.
Another means of prevention is the use of protective clothing. Gloves and aprons are considered protective equipment according to Pellowe et al (2004). Gloves should be worn for any contact with a wound, sore, invasive site or mucous membrane of a patient. It is also important to wear them when there is a risk of contamination from any bodily fluids. This should be done for any patients, regardless of MRSA status. Also, aprons should be worn if extensive soiling is likely or if the patient is colonised or infected with MRSA. This preventative measure should be worn to enhance the effect of hand washing and give added protection and should not be used instead of hand washing. Gloves and aprons are for single use only and require careful disposal when the wearer has been in contact with MRSA.
Although fomites (bed linens, towels, dishes) and environmental surfaces have not been implicated as vectors in the transmission of MRSA it has been shown that the spread of MRSA can be greatly reduced by overall environmental hygiene. It is important to ensure all horizontal surfaces are damp dusted to remove any bacteria from infected skin cells falling as dust (O’Connell, Humphreys 2000). A recent study carried out by the Infection Control Nurses Association (INCA 2003) has shown that improving the wards cleanliness can reduce infections. This was because regular cleaning removes the contaminants and prevents the build up of colonising bacteria on the hospital surfaces, thus reducing the risks of cross – infection.
Another major control factor in the spread of MRSA is caring for someone in isolation. The objective of isolation is to minimise the risk of micro - organisms from the affected person being transferred to others (Wilson 1999). The Centre for Disease Control and Prevention (CDC) reaffirm the above objective by recommending that patients who are colonised or infected with MRSA be physically isolated in a single room – separation can minimise close contact, thus eliminating transmission of MRSA between patients, and nurses tend to wash their hand more when caring for patients who are in private rooms because they have to leave one room before going to...
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