MRSA Notes

Proper hygiene is well recognized as the most effective way to avoid MRSA of all types. Many studies are done all of the time on the proper methods and products to use to effectively remove bacteria from your hands and bodies. The World Health Organization (WHO) is in the process of revamping its recommendations for handwashing for healthcare workers, and the final recommendations are due out in 2007, but you can read more about it than you ever thought you wanted to know at Infection Control Today.

Here is the current handwashing guide from the WHO (in PDF) from 2004 that is in the process of being revamped, addressing the reasons that health care workers are not sufficiently adhering to the current guidelines. Some of the reasons they are not currently following the guidelines are:

1. Observed risk factors for poor adherence:

* Working in intensive care
* Working during the week (vs. weekend)
* Wearing gowns/gloves
* Automated sink
* Activities with high risk of cross-transmission
* Understaffing or overcrowding
* High number of opportunities for hand hygiene per hour of patient care
* Nursing assistant status (rather than a nurse)
* Physician status (rather than a nurse)

2. Self-reported factors for poor adherence:

* Handwashing agents cause irritations and dryness
* Sinks are inconveniently located or shortage of sinks
* Lack of soap, paper, towel
* Often too busy or insufficient time
* Patient needs take priority
* Hand hygiene interferes with healthcare worker/patient relationship
* Low risk of acquiring infection from patients
* Wearing of gloves or belief that glove use obviates the need for hand hygiene
* Lack of knowledge of guidelines and protocols
* Not thinking about it, forgetfulness
* No role model from colleagues or superiors
* Skepticism about the value of hand hygiene
* Disagreement with the recommendations
* Lack of scientific information of definitive impact of improved hand hygiene on HAI rates

3. Additional perceived barriers to appropriate hand hygiene:

* Lack of active participation in hand hygiene promotion at individual or institutional level
* Lack of role model for hand hygiene
* Lack of institutional priority for hand hygiene
* Lack of administrative sanction of noncompliers/rewarding of compliers
* Lack of institutional safety climate /

I would have to say this is one of the most important things in health care. If the workers are not willing to do what they can do to keep patients from becoming more sick, then they have to go. To me, this is nothing but a big fat list of excuses that doesn’t fly with me, but that is just my opinion, apparently it differs greatly from that of the hospitals. Something to think about.

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Education, Handwashing, hygiene, MRSA, WHO

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