Preventing and treating MRSA using the help of reliable Infection control techniques
As a Health Worker, It Is My Job to Protect the Public
Having worked in a medical establishment for nearly a decade, I frequently look after people with deadly illnesses such as MRSA and other nasties like Clostridium difficile and Norovirus. For a poorly person, a superbug can be truly life threatening. A healthy person on the other hand is likely to have no symptoms whatsoever. This ‘invisible’ illness is then transferred around from pillar to post and before you know it, there’s a full blown epidemic going on!
Sure, healthcare workers are trained to deal with this kind of thing on a daily basis but what about the millions of the general public who haven’t got the necessary experience to help themselves and others?
This Guide Will Help You If You Are:
- Suffering from MRSA yourself and looking for ways to manage the disease at home
- Looking after another person with MRSA
- Planning to visit a sick relative who is at high risk of contracting super bugs
- Hoping to educate yourself about the current infection control techniques practiced in hospitals and nursing homes around the UK today.
Firstly, the purpose of this article is not to diagnose your condition – that is what your doctor is for. Instead, I will explain what each infection control method does and the ways it can contribute to a faster, healthier recovery. The next time you go to a hospital for instance, you will know when to spot poor infection control techniques. By blowing the whistle on poor hygiene, you will be saving a person’s life.
What Is MRSA and What Are the Symptoms?
MRSA (methicillin-resistant Staphylococcus aureus) is a common bacteria present in a lot of healthy people believe it or not - often found in the nose, throat and skin. It only becomes a real problem if the bacteria get inside open wounds and lesions, causing the MRSA to infect the blood and to attack various parts of the body. This is why you go into hospital with one complaint and come out with another; usually after an operation or when visiting sick relatives!
- MRSA bacteria can enter through:
- Surgical wounds
- The eyes
- Catheter and colostomy sites
If you notice swelling, inflammation, tender skin or a foul smell or discharge from an affected area, seek medical advice as soon as possible.
How Is MRSA Tested in Hospital?
These days, hospitals in the UK have to MRSA screen every patient that comes through the doors. The MRSA screening involves two swabs; a swab taken from the nose and one from the perineum (between the genitals and anus).
The swabs are then sent to the pathology lab for examination. If MRSA is present, the medical team will be informed and treatment can commence.
Wash Your Hands
If you only take one piece of information away with you from this how-to guide, this is it right here! Washing your hands frequently is your number one priority since germs can be transferred when handling objects, and when you come into contact with other people. If you think you are washing your hands enough already, did you know that merely touching your hair can contaminate them? Drying your hands on a towel leaves tonnes of bacteria all over them – possibly more than what you had on your hands to start with
Your hands might look visibly clean, but under ultraviolet light you will discover the ugly truth (see figure 1)
When You Should Always Wash Your Hands:
Before, during and after food preparation
Before and after eating or helping to feed someone else
When your hands become visibly soiled
After blowing your nose
Before and after coming into direct contact with an infected person
After visiting the toilet
Before and after washing the laundry
After doing housework or changing bed sheets
After smoking a cigarette
If in doubt, wash them anyway. I know what you are thinking though... “My hands are going to be like leather if I wash them that many times”!! That is why a lot of healthcare workers have eczema or psoriasis on their hands due to repeat washing. I personally blame poor quality hand soap. You will definitely need a moisturising barrier cream between washes to help prevent excess drying.
Although alcoholic hand gel is a good addition to your hand care regime it doesn’t work in removing MRSA microbes! Don’t be tempted to cut corners by using alcohol hand gel after you have been in contact with something contaminated.
Instead, wash your hands with hot soapy water – hospitals in the UK use Hibiscrub Liquid Soap because it kills microbes too. You can buy Hibiscrub in places like Boots or Superdrug but you can probably find it cheaper online (see figure 2). It can be quite expensive though.
If you don’t have access to Hibiscrub, in the very least use a good quality Antimicrobal liquid soap; I believe the US equivalent is called Hibiclens (see figure 2b).
. Just make sure it’s not a solid block of soap since these harbour millions of germs. You will have dirty hands before you have even finished washing them! If you want to learn the proper way to wash your hands, check out the YouTube video below.
You are supposed to wash your hands for a minimum of 30 seconds in order to clean them properly! This is an almighty bummer for those in a hurry. Still, it’s better to take your time than to be dead on time.
If you are looking after another person with MRSA, make sure you wash their hands frequently too. Did I forget to mention to wash your hands? ;)
This Is How You Should Wash Your Hands
Barrier nursing is a precaution traditionally used to contain a contagious disease and to stop it spreading from one place to another. It is often referred to as “bedside isolation” because as the name implies, it is encouraged that contagious people stay in one place (or at least in separate rooms to reduce the risk of cross contamination) until they get better.
If you are coping with MRSA at home, it is not always practical to isolate yourself totally. However, it is important that you keep your house exceptionally clean and that you practice tried and tested infection control techniques to minimise the risk of spreading infection.
Definitely try to avoid public areas as much as possible, especially in places like supermarkets, community centres, hospitals (unless you have been instructed to go there for an appointment) and schools. If you absolutely must go out, make sure that any infected wounds are covered with fresh clean dressings before you go about your daily activities.
If you are looking after a person with MRSA, you will need to protect yourself one step further by taking some additional precautions. Every little step helps – not only to stay clean but to speed up the recovery process. Use your common sense though. I once knew a cleaner that was so paranoid about catching MRSA in our nursing home that she went fully armed with two aprons on front and back, a clean nappy bag on her head, 2 pairs of gloves, foot covers and a mask!! Just imagine how awful that poor infected patient must feel.
Be sensible and protect yourself but do it in a way that is respectful to those around you. By panicking and flapping about, you will probably spread more germs and make more mistakes.
Disposable gloves should always be worn whenever you are offering personal care to someone or if you are dealing with anything possibly contaminated. Although latex gloves protect your hands from visible soiling, bacteria and microbes will still pass through them after a few seconds so don’t think this is an easy way of bypassing your normal hand washing routine. If you are really concerned about this, you can always put 2 pairs of gloves on to reduce the risk of any excess bacteria getting through
Paper hand towels are used in hospitals to dry your hands after hand washing. Kitchen towel will be a good alternative if you are at home.
Disposable aprons offer protection for your clothing by attracting the microbes and spores to the plastic instead of floating about in the atmosphere. Although it is impossible to keep your clothes sterile, it helps drastically reduce the amount of contact you have with the disease
It is important to take the apron off slowly and carefully so that the nasty germs stay contained in the apron – gloves should be removed last so to avoid excess exposure to the MRSA
Masks are used to cover your face to prevent the inhalation of microbes and also to reduce the smell of nasty wounds/infected discharge/faeces etc. Need I say more?
Nappy sacks are super useful for containing dirty sanitary ware and used contaminated dressings. By putting contaminated waste in a nappy bag THEN into a bin liner, you are essentially creating a double barrier against the disease.
Cleansing wipes should be used when offering personal care instead of porous flannels that absorb and harbour bacteria. Wipes can be disposed of easily therefore reducing the risk of further cross contamination
Some handy tips
ALWAYS make sure that contaminated waste is disposed of in the appropriate way in an enclosed bin, specifically for this purpose. Keep contaminated waste well away from other household waste.
Remember to wash your hands with Hibiscrub before leaving an infected room to avoid cross contamination (as you would separate vegetable and meat compartments in your fridge for the purpose of food hygiene)
This topic is a big one because anything involved with personal hygiene is a direct link to cross contamination – so much so that I am merely touching the tip of the iceberg here. It’s a fact of life that we need to keep ourselves clean so we might as well be thorough about it (for the good of us and others)!
Caring for the Body
Choose liquid soap over solid soap any day of the week! The liquid stuff is so much more hygienic than the kind you get in bars. They just sit there, getting crusty and caked with bacteria. Yuck.
I recently discovered a soap in ‘Lush’ (the natural cosmetics company, well known for its unusual soaps and bath bombs) containing the ever so potent Oregano essential oil – famous for killing MRSA microbes. The company has marketed and designed this soap especially for healthcare workers. Really great, except for the fact that it’s only sold in a solid form! Kind of defeats the object in my opinion :) *rant over*
In summary, keep your skin clean and your clothes clean to avoid the increased risk of cross contamination.
Don’t even think about going to public places whilst wearing your contaminated clothes!! Something to bear in mind if ever you see a carer or nurse shopping in your favourite supermarket, fully dressed in their uniforms, ‘groping’ all the fruits and veggies for tonight’s dinner! Just think where their hands have been.
If the NHS catches a member of staff doing this, they could lose their job over it.
Caring for Hands and Nails
Short, clean nails are always preferable since they are easier to keep clean. Never ever wear nail varnish in hospital environments because the polish acts as a sponge and will absorb bacteria. Not only does this cause cross contamination between people; it can cause the disease to spread from one part of the body to another when you scratch somewhere itchy or touch your face etc.
Caring for Your Hair
For girls and boys with long hair, tie it well back off your face and wash frequently with a good shampoo. I dread to think how many gross organisms make a home on our crowning glories! If one is bedbound, there are several dry shampoos on the market (not to mention hair care products containing antibacterial ingredients such as lavender and tea tree essential oil).
Personally, I have an antibacterial hair straightener using Nano Ceramic technology! It’s absolutely amazing if you like to stay as clean as possible whilst looking great at the same time; a real plus for healthcare workers.
Every time you strip a bed or wash contaminated clothes, there are microbes flying about all over the place. This is why dissolvable laundry bags are useful for washing stuff contaminated with MRSA because it reduces your exposure to microbes. Simply add the dirty laundry to the bag then tie it up and add to your washing machine. The bag will split open after it is in contact with water, which you can then dispose of after the wash cycle.
The hotter the wash, the better but don’t ruin your clothes. It would be more sensible to wear cotton clothes because these can cope with higher temperatures. If this is not an option, maybe you could buy some Milton Antibacterial Fabric Solution to kill the bugs at a lower temperature? Alternatively, you could make your own antibacterial fabric softener by adding Tea tree essential oil to ordinary household white vinegar, Bicarbonate of Soda (baking soda) and water.
A Bleach solution works wonders for killing superbugs across the whole spectrum but remember that it lightens fabric! No good for your sexy black undies.
Never wash contaminated laundry wearing thick yellow rubber gloves – the type you wear to do the washing up. This is because the rubber absorbs the nasty bacteria and microbes. Better to invest in a box of latex gloves because they can be disposed of after use.
This is a real problem subject for a lot of ladies who like to wear fancy rings and bracelets full of big elaborate stones and beads. In a healthcare setting, this is just not a good idea. Every time you get dirty hands, your jewellery gets contaminated – that is why you should remove all jewellery from the wrists down.
Ideally, it would be a good idea to wear any sentimental rings on a chain around your neck. If you absolutely have to wear your wedding ring, you can on the exception that it has no gem stones. Big jewels set in place with a claw are the worst kinds for harbouring germs.
If a wound is infected with MRSA, frequent swabs will need to be taken from the affected area then sent off to the path lab for testing. This is usually performed by a registered nurse who then changes the dressings for you on a regular basis.
Continue barrier nursing until the path lab declares you free from MRSA. Just because the symptoms have gone, doesn’t make you safe, just yet. If you want to keep a track of your healing progress, it’s a good idea to take a photo now and again to compare (not something for the family album that’s for sure)!
In the meantime, keep all bandages/dressings dry when showering. Wrap Clingfilm around them if necessary to keep the moisture out.
If you are responsible for changing dressings, make sure you follow the barrier nursing techniques mentioned above. If you don’t have the first clue about wound care, get a professional to do it. It’s not worth the risk of further complications.
Dealing with an Infected Environment
Long gone are the days of nurses scrubbing the floors on their hands and knees to keep hospitals clean. It’s a terrible shame that the hygiene in hospitals have taken a nose dive due to factors such as government cut backs, long waiting times and large volumes of traffic in and out all day, every day.
Although we have little power to clean up the act of hospitals, we can help ourselves by ensuring that our living space is clean.
If you have MRSA and are living with it at home, pay close attention to flooring because you are potentially walking the disease around from one room to another. Carpets should be kept clean with regular maintenance. If you really want to go the whole hog, it is recommended you shampoo and/or steam clean the carpets and furniture from time to time.
Mop heads should be replaced frequently. However, in between uses you should leaving the mop upside down (so the mop head is pointing upwards) to allow for thorough air drying. Moisture harbours germs and causes nasty smells too; really not great to live with.
For general cleaning, stock up on disposable cloths. These are really cheap and versatile and can be used to clean toilets, sinks, tables, furniture, mirrors and windows. Just make sure you keep the cloths separate for each thing you clean and then throw away after each use to avoid cross contamination.
Tip of the day
Nursing homes and hospitals keep all cleaning materials locked up for the interest of safety (and possible lawsuits) but your home is slightly different in that sense; unless of course you have lots of children! Personally, I like to leave plenty of cleaning products dotted around the house to encourage and remind myself to wipe over surfaces etc.
Are we lowering our immunity for being too clean? It’s possible although it more likely down to sloppy hygiene. If you practice the above infection control techniques, you can at least rest in the knowledge that you have done your bit towards banishing superbugs such as MRSA. Remember folks, wash your hands and be responsible for the welfare of yourself and others. Happy healing! :-)
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