McCleary MRSA Prevention

Handwashing is very important in the prevention of hospital acquired infections, to include MRSA. But, it is not the silver bullet for prevention. Even if it was, only about 40% of health care givers are compliant. I see two problems with this. The first one is noncompliance should not ever be a problem or an issue. It is time, with the current rising numbers of HA infections to mandate compliance or dish out some sort of punishment. It is one of the simplest, most basic methods of infection control there is. My parents taught me the basics of handwashing when I was just a toddler. It simply should not be tolerated if nurses, doctors, techs, and other Health care workers do not wash their hands between patient contacts. It is just plain ignorant. Fine them, reprimand them and if that doesn’t work FIRE THEM! Remember, I am a nurse and I am saying this. Dirty hands are now like a loaded gun. The germs dirty hands can carry are lethal and deadly and we cannot tolerate dirty hands.
Next, although handwashing is paramount in infection control, it is not enough. CDC and most hospitals have been hanging their infection control hats on handwashing alone for too many years. MRSA spreads to patients on contaminated hands (number one method of transfer), on contaminated clothing, on environmental objects, in the air if a patient who has respiratory MRSA coughs within 4 feet of you, and on medical instruments. An unclean stethescope can bring MRSA to you. As can a nurses hair dangling over you while he/she changes your “sterile” dressing, or puts in an IV or catheter.
I saw a sneezing ,coughing nurse (with no mask) caring for Dad while he suffered from MRSA pneumonia. If he hadn’t already been sick with MRSA, maybe she could have given it to him. I saw a nurse pick somthing sticky off the bottom of her shoe and then without washing her hands, attend to my mother after her recent surgery. I saw a nurse drop a blanket to the floor and then pick it up and turn it over for my mother to sit on. I saw a bed moved from the ICU in Dad’s hospital and put in the place of Dad’s after he was moved into ICU. They did this without first cleaning the space Dad had been in. No wonder they have a problem with MRSA in that hospital.
So, handwashing is good and necessary. But, Isolating infected patients, using handwashing AND the appropriate precations with gloves, gowns and masks, and decontamination of the patients surroundings and equipment is what is necessary each and every time to prevent spreading germs such as MRSA.
Other important things are…HCWs should not be wearing hair that hangs over her shoulders and around her face when she is caring for patients. The old nuns at my nursing school were very strict about that and they were right. “Hair off the collar girls”……I can hear the nuns now. We caught the wrath of those nuns if we had dirty shoe laces!
Sterile fields for dressing changes, IV insertions, and urinary catheters are a must. Caregivers should not be allowed to have fake or long painted nails, numerous clunky rings, dangling jewelry , or exposed bellies and upper derrieres with exposed ‘crackage’(belly shirts and hip huggers anyone?). Sick nurses with coughing and sneezing should not be caring for vulnerable patients. If it is absolutly necessary, they should wear a mask during each patient contact along with the other necessary barriers and strict hand washing.
So, yes, wash your hands before touching me or my vulnerable family members. And encourage and remind me to wash my hands too. If I am a patient and I wash my hands regularly, there is less contamination of my immediate environment and any contamination that might be brought to me can be washed away.
I am a tolerant and pretty understanding person. But I will never understand why so many educated nurses, doctors, and othe HCWs find it so difficult to grasp the importance of precautions, asepsis and cleanliness. Please if any of you ever take care of me, at least wash your hands and wear clean clothes every day. Skip the ties and fake nails and keep me safe.

On Tuesday, April 7, my family, friends, nurses, senators and representatives, Union officials, and others testified before the Maine Health and Human SErvices committee. My testimony was allowed in full even though it was very long. Generally there is a 3 minute limit. I took 20 minutes. I needed to be heard. My 13 year old nephew made us all incredibly proud when he stood before the daunting group of committee members at a podium with a microphone and read his testimony. It was against the rules of decorum (no reactions to testimony) but everybody applauded and/or cried when he spoke of his Grampy.
But of course there was opposition. Some of it was reasonable and some of it was just plain stupid, but everybody gets their say. So, we left feeling very confident that our bill would pass.
On April 9, we went back for work sessions. Vanessa Sylvester of Maine State Nurses Association handled the communications between the Maine Hospital association, and the Maine Health Quality forum and me. The communication was fast and quick and we lost out on most of the bill, but we did get Mandated High Risk screening in the State of Maine passed with a unanimous vote from the committee. This is not criticism of Vanessa. She was in a tough spot and worked very hard. Other very valuable pieces of my legislation got lost or transferred over to the other bill that originally was just for reporting of MRSA and C Diff.
My bill was comprehensive and all inclusive. It addressed the most effective approach to MRSA prevention which is Active detection and Isolation. The componants of a good plan are Mandatory screening, Isolation or cohorting, Precautions and decolonization. I got the screening. MSNA and a “consumer” (that’s me) got seats on the MQF committee. We were given until Oct 1 to come up with a solid effective plan for MRSA prevention. This is fine. I will collaborate. I will go to the meetings with an open mind and a lot of knowlege and ideas. But, if we hit a rock wall with ADI, active detection and Isolation and decolonization, I will be back in the Maine legislature next January before the confetti falls to the ground New Years Eve. This is a promise to my father, my family and everybody who advised me and supported my bill. I will not settle for an inadequate plan for MRSA prevention in the State of Maine. In fact I told the director of the MQF, who coincidentally graduated high school with my husband, that together we can come up with the absolute best MRSA prevention program in the country. Then when the Federal CDC wakes up to ever increasing numbers of MRSA victims in our country, they can use our policy as an example for a national policy. That is a lofty goal but a good one.
So the work has just begun. Stay tuned.

My family, Maine State Nurses Association, representaves and friends have all prepared testimony for the Health and Human Services Committee hearing on April 7. I have written the entire story of Dad’s unnecessary hospital acquired MRSA pneumonia. I have had this story in my head for 3 months. When I knew we had to present testimony to the HHS about Dad I asked my family members to write something. My mother, who is very humble and unassuming, didn’t really feel that she could say much about it. Then she read what both of my brothers, my nephew, my son and I had written. She laid awake all night thinking about what she might say. She then asked me if I thought it would help if she said something. I told her of course it would. She said “if it kept me awake, it must mean I should write something”. So she did. It is short and to the point and very poigniant. The testimonies of my other family members revealed to me the pain and hurt they went through during Dad’s illness. His death has effected each of us profoundly but differently, but it was just as hurtful to all of us.
I respect my family and especially my mother for writing from their hearts to help LD 1038 pass. All of them will help, with their testimony to save lives. We couldn’t do that for Dad. We tried for all we were worth to help him, but the disease won.
My testimony is brutally honest and a bit long. But, his story needs to be told in detail to have the intended impact. He suffered terribly and he was confused and frustrated with his terminal infection. About 2 weeks before he died, I had finally convinced the nursing home doctor to do some diagnostics to see where we stood with Dad’s health. When I explained the tests to Dad, he said “What I have is really serious isn’t it?”. He had no idea. And, neither did I at first. The preventable scourge that Dad was given in his hospital blindsided me and my family. By the time we had the results from Dad’s diagnostic tests, he had died.
Dad would be so proud of his family now. He always was anyway. But if he could see all of us standing up and giving our testimony to pass a bill that will save lives, he would absolutely burst with pride. He would cry if he could see his 13 year old nephew Cyle read his testimony about his Grampy. I know I will.

Please, call or write your senators and representatives to support LD 1038. We need to stop MRSA and other Hospital acquired infections. If you have a story and would like it presented to the Health and Human Services committee, please contact me at kathydayrn@aol.com and I will help you with that. The hearing is in Augusta on April 7 after 2pm.