Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, January 24, 2008

Infection Control – An International Problem!

I thought it was interesting that the need for improved infection control in hospitals is getting a serious run both here and in the US.

From Australia we had:

Dirty name tags add to risk of superbug deaths

Kate Benson Medical Reporter

January 7, 2008

FIRST it was ties, then it was stethoscopes and keyboards. Now, a study has found that deadly superbug bacteria are crawling all over identity badges and lanyards worn by doctors and nurses.

The study, published in The Medical Journal of Australia, found that the superbug methicillin-resistant Staphylococcus aureus, or MRSA, which kills more than 700 patients a year, lives on about 10 per cent of name tags and lanyards, sparking concerns hygiene procedures in hospitals are inadequate.

An analysis of 71 clinical and infection-control staff at Monash Medical Centre in Melbourne showed that 27 lanyards and 18 badges carried pathogenic bacteria, including seven with MRSA and 29 with methicillin-sensitive Staphylococcus aureus, a more common but equally dangerous bug. Lanyards carried about 10 times the bacterial load of badges.

The author of the study, Rhonda Stuart, an infectious diseases physician, said yesterday the results had come as no surprise.

"Lanyards and identity badges are worn by both male and female clinical staff for long periods of time without cleaning … and their position at waist level and their pendulous nature increase the risk that they will become contaminated," Dr Stuart said.

"We believe hand hygiene is the most important defence against these bugs so we did this study to remind people to not only disinfect their badges regularly, and replace the lanyards, but wash their hands after touching them."

She said bacteria could survive on fabrics and plastic surfaces for up to 90 days and that doctors' badges were four times more likely to carry bugs than those belonging to nurses, consistent with previous studies indicating doctors were less likely than nurses to continually wash their hands.

Continue reading here:

http://www.smh.com.au/news/national/dirty-name-tags-add-to-risk-of-superbug-deaths/2008/01/06/1199554485373.html

And more relevantly to this blog from the US we had:

Dangerous Devices

By Steven J. Davidson, M.D., and Gregg Malkary

Mobile computers can bring both information and infection to the point of care.

Mobile computing devices represent a patient safety conundrum. While they bring decision support, bar-code and RFID-assisted medication administration, and the latest patient data to the point of care, they also can serve as vehicles for germs and increase the potential for hospital-acquired infections.

A recent market research study of the current state of physician computer adoption in the United States found that 65 percent of physicians interviewed believe mobile computing devices pose infection control risks at the point of care due to poor physician hand-washing habits, multi-tasking at the bedside (simultaneously using a device while examining patients’ ears and eyes or listening to their heart and lungs) and ignorance of the potential risk. This represents a 160 percent increase from a January 2005 study in which only 25 percent of physicians interviewed believed mobile devices posed any form of risk.

Spotlight on Nosocomial Infections

Hospitals are under increasing pressure to prevent hospital-acquired infections, and anything that could be a carrier—a physician’s necktie, white coat and stethoscope, or a device used at the point of care—is under scrutiny. Stethoscopes often are contaminated with Staphylococcus aureus and other dangerous bacteria because caregivers seldom take the time to clean them in between seeing patients. The Committee to Reduce Infection Deaths, a not-for-profit education campaign that suggests lower-cost interventions, recommends that patients ask their physicians to wipe the stethoscope’s diaphragm with alcohol before use.

Similarly, a new dress code banning neckties, long sleeves and jewelry for physicians takes effect in British hospitals this month. The dress code, which also bans the traditional white coat, is being implemented to stop the spread of deadly hospital-borne infections, including Methicillin-resistant Staphylococcus aureus (MRSA).

Continue reading here

http://www.hhnmostwired.com/hhnmostwired_app/jsp/articledisplay.jsp?dcrpath=HHNMOSTWIRED/Article/data/Fall2007/080109MW_Online_Davidson&domain=HHNMOSTWIRED

The lessons from all this seem to be very clear.

Those germs are clever and will travel on whatever they can.

The obligation clinicians have is to alert to the cleverness and use the basics of handwashing and alcohol hand rinses religiously to make it tough for the bugs!

Device designers also need to make sure their stuff is easily and properly cleanable and that it is easy to do!

More can also be learnt on the topic here:

Basic Microbiologic and Infection Control Information to Reduce the Potential Transmission of Pathogens to Patients via Computer Hardware

What a can of worms and germs (figuratively)!

David.

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