Shorts All Round

  Riojaa 22:40 17 Sep 2007
Locked

It took those highly professional doctors and consultants long enough to work out that their grubby jackets,white coats and ties were a major cause in the spreading of hospital MRSA.

Should they now be forced to wear shorts and plastic bag shoes?
And let's not forget those highly infected and chewed-up pens in their top pockets.
And the constant touching of their infected designer specs.

So, are more hospital staff doing more harm than good?

  Brumas 22:53 17 Sep 2007

I think the problem is more likely that the clothes are not worn exclusively in the hospital and consequently are not clean enough.
Gone are the days when you went to your specialised work in your 'civvies' and changed into a clean set of clothes designed specifically for the purpose and, after work changed back and went home.

  DrScott 23:01 17 Sep 2007

doctors wear white coats nowadays, so this is the government recycling old information. Apparently they've been out of paediatric practice for almost 20 years.

MRSA is transmitted from one patient to another via a suitable vector, be it a nurse, doctor, visitor etc. Ideally we should change all our clothes per patient, but that would be a little more than ridiculous.

Isolation wards are one technique that is known to be effective, but expensive, and also difficult given the shortage of beds.

  DrScott 23:24 17 Sep 2007

might also like to read this report taken from the DoH website:

click here


Which suggests there is virtually no evidence for any of these measures. Rather they are being put in place to inspire 'confidence'.

  mrwoowoo 23:26 17 Sep 2007

Wondering if ,when in hospital,is it really necessary for a surgeon/doctor to push and prod a healing wound.
I would have thought that just looking would be sufficient to see if all was healing ok,and help cut the spread of mrsa.
Obviously,if healed enough,it would not be a problem anyway.
Any thoughts.

  DrScott 23:31 17 Sep 2007

but the pushing and prodding is mainly to assess whether further surgery is required to drain the wound if it's failing to heal. Failure to heal is often caused by infection, and prodding is a way of establishing how deep seated, or how significant, that infection is.

If a wound looks and smells clean, then it probably doesn't need to much prodding, though some surgeons like to ensure the sutures are holding correctly.

  Brumas 23:53 17 Sep 2007

Picture the scenario - a Slaughter man or a farm worker who has just been muck-spreading, fresh from his work hops on the bus and sits in his seat for, say half an hour. He gets off and a nurse/doctor/paramedic then sits in the same spot and then goes to work in the hospital where they, during the course of their duty, brush past or come into contact with patients recently wounded or fresh from surgery.

Are you saying this does not present a terrible risk of infection?

  DrScott 00:03 18 Sep 2007

I'm saying there is no evidence for it.

I'm also not aware of any hospital patients getting exotic infections due to farmyard contamination.

The point is that to transmit infection you need a decent amount of that material, or a prolonged exposure to lowish levels of the pathogen. If I sneeze on you, you do not instantly become infected with every pathogen that came out of my nose. If you briefly touch an MRSA patient with one finger and then shake hands with a friend, that friend will not instantly become infected or even colonised with MRSA.

Now there are some extremely contagious pathogens which can spread easily, but this is usually due to relatively high concentrations of that pathogen - impetigo for example.

Furthermore, many pathogens do not survive outside of the human body for long. C. diff doesn't, but its spores do which is why it needs more than alcohol gel to destroy it.

  DrScott 21:08 18 Sep 2007

is probably a good idea, since it does make washing that much easier. Hand washing is one area that is known to make a difference, but there is a lack of evidence on whether wearing a watch or not on its own contributes to infection rates.

Not running hospitals at over 100% occupancy and avoiding hot-bedding would probably be considerably more effective.

Much of this is spin. Treat it as such.

  Sapins 22:12 18 Sep 2007

The fact that there are so many people being infected with MRSA whilst in hospital is an unbelievable disgrace and the fact that no one seems to have any idea how to stop it just leaves me speechless.

  DrScott 22:56 18 Sep 2007

as I've already said. Isolation wards and proper and it's far easier and cheaper to attack medical staff.

MRSA has been around since the 80s, and was already epidemic in Australian hospitals by the 90s. It's not new. Furthermore, not that many people are infected with it (compare infected with colonised).

C. difficile is a far more pressing problem. Unfortunately, I believe it's only just being realised by the politicians (despite microbiologists telling them for months, if not years), yet infects and kills far more than MRSA.

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