Risk assessment at Hospital/Day Care/Old Persons home

As far as MRSA prevention is concerned these places are very similar. So I am grouping them together.

There are three separate groups to be considered. There are workers, patients and visitors.

Workers

By workers I mean anyone who works at one of these places where patients are cared for. They could be a doctor, sister, nurse, trainee nurse or a cleaner. Their job could be administrative or hands-on with the patient. Every one of them needs to be reminded regularly and systematically, of the dangers to themselves and to the patients of lowgiene (low levels of hygiene). It may be as simple as a doctor being reminded not to use the same marker on all the patients he is operating on today. It may be as complex as making sure that the records are not ignored or falsified by a cleaner who is in a hurry to get home to a sick child or relative.

Everyone needs to be educated and reminded that MRSA is here and will kill. I have a role in its prevention.

Patients

A new patient arrives. They need to be informed of the procedures and precautions that are in place. What about if the patient is unconscious or drifting in and out of consciousness? The patient needs to be informed as soon as they can receive the information and put it into practice. That must be the responsibility of someone who will make sure the patient can receive the information and act on it.

Most patients need to be informed, but they need to understand what they can and what they cannot do. The lessons need to be reinforced regularly especially when they are in the same place for a period.

Visitors

Not just humans but some places have visits from pets that many of the patients find helps their rehabilitation.

Human visitors need to be educated and segregated. Visitors will have a separate toilet and wash basins. These need to be cleaned even more scrupulously and regularly than the patient’s toilets or the staff toilets. They need to be greeted with eye-catching posters that warn them of the dangers of MRSA to their health and the health of the person they are visiting. These posters need to be changed regularly so that they do not become “part of the decor” of the ward. They will find hand-washing facilities before they can see the person they are visiting.

Animal visitors need to be clean and house trained. Their owners need to be educated to realize that both before, and after being in the hospital they need to have a bath. They must not take MRSA into the hospital and they must not be allowed to affect the home from which they come. Patents who have come into contact with the animal must wash their hands and if necessary their face as well. Anywhere that has come into contact with the visiting animal.

Workers, patients and visitors need to be educated and active to stop the spread of MRSA.