Over the past few months hospital infections have become been highlighted in the press. For me these infections are of concern due to my immunity being so depleted from all the treatment I am getting.
Both mrsa and c diff occur in nature and tend to infect people who are ill or old. It is worth noting that the alcohol spray/gel that you get on the doors of hospitals does not kill c diff. The only way to get rid off it is to wash your hands with soap and water and ensure that clothing is clean.
I have a number of possible ideas to why these infections are increasing in number. The first is that the hospitals and public health are detecting the infections and classifying them this obviosuly increases them.
The second is that the pressure to reduce waiting times means that hospitals are running at capacity and bed turn around times are high - these reduces time for cleaning and airing of wards. It also means that more people are passing through the wards.
The third I believe comes down to staffing changes. The different grades of nurses and cleaners is, in my opinion, causing an interesting problem. Within the nursing grading there is a hierarchy that has been there since nursing started. This hierarchy is now being put in an inbalance. Here is my postulation, the cleaning staff are often low paid, low skilled workers who are doing a very important job but are not allowed the time to do the job. They come in are supervised to get the job done and signed off and then they go to another part of the hospital.
Many of the Health Care Assistants who are also low paid and low skilled tend to have more contact with the patients. They basically are supposed to do the job of ensuring the patient is fed, clean, bathed and toilet duties.
The nursing staff are responsible for the patient day to day welfare on the ward. Many of the staff nurses have moved from abroad and in my experience do an excellent job. Interestingly many of the hca, in my opinion, have been born and educated in this country. I believe that the hca (untrained nursing staff) are part of the weak link in the control of infection.
I also believe that they needs to better training and audits of senior nursing staff (sisters and senior staff nurses). In my experience the majority are truly excellent but you get a few who are useless and a hinderence to both there staff and the patiens. This is a big problem when you are dealing with peoples lives.
Gordon Browns "Deep clean every hospital" will not help in my opinion. You need to go deeper than that you need to give the control of hospitals back to the doctors and consultants who have a far better understanding and medical training of what is truly going on and can also see who and where the weak links are. You then need to empower these doctors to be able to make decisions.
Perhaps the biggest problem faced is that the population is ageing (80% of c diff infections occur in people over 65). When you are young and have to share wards with people who are over 70 you feel at risk. I cant see a way round this unless you start dividing wards into age groups. Perhaps that is an idea??
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I feel your comment on HCAs being the weak link in infection control is very misguided. Staff Nurses are responsible for prodominantly the giving of medication to patients,and HCAs tend to do the majority of cleaning,bathing and tolieting of patients and have increased general contact as a result. Hence its inevitable the HCA's will be at a higher risk of transmission of the likes of c.diff and MRSA to other patients due to their increased contact with the patient and exposure to infected stool. So in conclusion i feel that HCA's don't pose as a weak link in infection control in any sense, just their role places them at higher risk of transmitting infection; but due to a vast majority of HCAs i have worked with having effective hand hygiene and cleaning patients following infection control's regulations, i feel its very misguided to label HCAs as weak links in infection control.
I am reading this now - a year plus after the transplant and things continue to go well. Thank you for your comment. I feel that you have not taken the blog in context. I stand by my experiences in hospitals, but can understand your thoughts. I could quote some very worrying things I experienced that directly related to HCAs but I will not as this is pointless. Most HCAs do a very good job and I keep in contact with many of the HCAs but some HCAs, I feel, often want to do jobs they are not trained for and this to me is where the risk can occur. I still feel it is extraordinary that someone who deals with bathroom duties will then go on to serve the whole ward food??
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