MRSA:"It is endemic in every hospital."

tallaght01

nesf wrote:

As I said earlier, I didn't think it was the cause or anything, I believe that it's contributory and that it would be generally a good thing to improve in any case and it would reduce to some extent the spread of diseases (not just MRSA) within hospitals, which we can all agree is a good thing.



I was just curious really, I appreciate that it's a big issue over there too, I've friends who work in the NHS. But as you said it's a huge multifactorial problem and there are many ways to reduce, if only in small ways, the problem. Attitude shifts in the unions allowing for some realisation that criticism of a minority of their membership is not a criticism of the profession might go some way towards helping matters.


The depressing thing is that MRSA is only the headline grabber and is only the tip of the iceberg regarding the whole issue of cross-infection in hospitals.

I dunno what the story is with all this chat about unions. I don't really know about the situation in Ireland though. IN the UK, the doctors' union is so poor, and is so lacking in power than only about 60% of docs are members (i'm not a member) and the nursing union is only slightly more powerful. Over here, our unions are certainly not reacting to criticism of us.

I keep up to speed, more or less, with Irish health news, and don't remember the INO or the IMO vociferously defending a tiny majority of their members on this issue, but I'm happy to be corrected.

I would imagine it's more likely that they're defending their members because many many many people think that clinical staff are a major cause of MRSA outbreaks, when there are many more, larger issues at play.Whenever you hear about MRSA, somebody mentions handwashing. Like I said before, the national hygiene audit was very favourable towards nurses and doctors, with regard to their handwashing practices.

Dr Galen

just on the Union point, can i just say that its really been a policy issue for us in the INO to get rid of MRSA in what ever way possible.

IN our union magazine we regularly have articles etc on the topic, and on a political and lobbyong front, the INO has been constantly lobbying for reduction in bed occupancy rates in Irish hospitals, which as has been said before, is a big reason for the spread of MRSA and other hospital acquired infections.

I'm not trying to all pro-union on this, just putting the information out there.

I also accept your points that although the majority of medical staff are very good with their hygiene there is a minority who aren't. Though in my 4 years in the hospital I'm in at present I've definitely seen a major improvement. A few people definitely need a kick though!

SOmeone else mentioned that as far as they were aware, MRSA can only live for 3 days on a surface, as if that wasn't really all that long.......well our hospitals are so over stretched, that in a busy week, my ward (and many others) could have as many as 5 patients through a room/bed. this is a major reason for the spread. thats 5 patients, plus visitors, plus staff, plus all the other things that could carry ANY infection in a relatively small space.

nesf

tallaght01 wrote:

I would imagine it's more likely that they're defending their members because many many many people think that clinical staff are a major cause of MRSA outbreaks, when there are many more, larger issues at play.

Essentially that is what it comes down to. People tend to generalise poorly and people tend to have herd instincts when it comes to their profession being criticised. Also people are poorly educated on what actually causes cross-infection in hospitals and outbreaks of MRSA etc, they usually go on whatever their choice of media tells them.

People want some group to blame, confuse correlations with causations and get all confused when it comes to estimating the chances of certain things happening and have a nasty tendency to view x increases the chance of y as x is the cause of y.

The end result is interest groups such as unions and representitive associations, management etc all doing their best to appear as if they have no relationship with MRSA happening for fear of people or media deciding that they are the cause of it. The problem is that if you repeat something often enough you might start believing it and risk ignoring problems that are actually there.

faceman

nurse_baz wrote:

SOmeone else mentioned that as far as they were aware, MRSA can only live for 3 days on a surface, as if that wasn't really all that long.......well our hospitals are so over stretched, that in a busy week, my ward (and many others) could have as many as 5 patients through a room/bed. this is a major reason for the spread. thats 5 patients, plus visitors, plus staff, plus all the other things that could carry ANY infection in a relatively small space.

That doesnt sound right, sure that would mean that doctors and nurses alone are the reason for the spread of MRSA??

Im kidding of course, but its things like this that dont get highlighted as a MAJOR factor in the spread of it.

nesf

nurse_baz wrote:

I also accept your points that although the majority of medical staff are very good with their hygiene there is a minority who aren't. Though in my 4 years in the hospital I'm in at present I've definitely seen a major improvement. A few people definitely need a kick though!

The problem is giving them that kick. It's difficult to police hygiene effectively and how do you exactly deal with them once you've caught them. Should there be a disciplinary procedure or should it be rather draconian and lead to supensions etc? Go too softly and it won't change much, go too harshly and the unions (quite rightly) will probably kick up a fuss since there would be bound to be a few people caught in the net where it was down to fatigue rather than negligence.

Dr Galen

now there's the question!
answers on the back of used twenties

badlyparkedmerc

Did the report referred in the title of the thread tell us anything that we didn't already know, I was assuming the reason the media were picking up on it is that they didn't understand the meaning of the word endemic - but because it sounds like epidemic must be something really bad.

from wikipedia

"In epidemiology, an infection is said to be endemic (from Greek en- in or within + demos people) in a population when that infection is maintained in the population without the need for external inputs."

Incidentally since we're told it's endemic this more or less implies that MRSA isn't in general brought in by visitors or that there's enough MRSA present in the hospitals for visitor brought in MRSA to not matter.

faceman

badlyparkedmerc wrote:

Did the report referred in the title of the thread tell us anything that we didn't already know, I was assuming the reason the media were picking up on it is that they didn't understand the meaning of the word endemic - but because it sounds like epidemic must be something really bad.

Ur probably bang on there. Its the same media afterall who told us 100% of banknotes in circulation contained cocaine.

InFront

badlyparkedmerc wrote:

Incidentally since we're told it's endemic this more or less implies that MRSA isn't in general brought in by visitors or that there's enough MRSA present in the hospitals for visitor brought in MRSA to not matter.

That is a completely silly interpretation of the article and of what endemic means, it does not 'more or less' imply that.
Endemic means that something is characteristic of a region, and in popular parlance, that it is commonly observed therein. For goodness sake, MRSA does not arise out of thin air, it is always 'brought in' to a hospital.
I really doubt that Dr Lynch was attempting to pass secret messages to the readership of the breakingnews.ie website or anywhere else her opinion might be published.

InFront

InFront wrote:

it is always 'brought in' to a hospital.

Now that is simply not the case.Many Patients without MRSA do contract it in hospitals for the first time.
Unfortunately many of them die or endure considerable pain or both unnecessarally as a result.

InFront

'Many' is a conveniently fuzzy term. You cannot put numbers on that.

My question is how do people think MRSA got into every hospital in the first place? You think it only sits on the people with scrubs on? Invariably, MRSA will have been 'brought in' to a hospital by someone from the outside. What is the point in doctors and other staff washing hands every seven or eight minutes of the day when patients and visitors just constantly wander in, walk straight to their relative or friend, and don't do anything on their part to help prevent the spread of MRSA?
That is why I consider badlyparkedmerc's interpretation of the word endemic to mean that visitor MRSA "does not matter" to be completely off the wall.

You simply cannot differentiate between MRSA that came in two hours ago and MRSA that "ultimately" arrived in two years ago. That's why this differentiation between "Hospital Associated MRSA" and "Community Associated MRSA" is such rubbish.

nesf

InFront wrote:

What is the point in doctors and other staff washing hands every seven or eight minutes of the day when patients and visitors just constantly wander in, walk straight to their relative or friend, and don't do anything on their part to help prevent the spread of MRSA?

Just because a disease may be brought in from the outside doesn't mean that steps shouldn't be taken to prevent it spreading inside the hospital. Hospital staff are exposed to a lot more patients than any visitors, if they didn't have a good hygiene system then the situation would be far worse and diseases could spread far more rapidly through hospitals.

InFront

nesf wrote:

Just because a disease may be brought in from the outside doesn't mean that steps shouldn't be taken to prevent it spreading inside the hospital.

Again, that isn't the point. I'm saying this is all important, but that another poster's comments in relation the possibility of visitors bringing in MRSA doe not matter is completely wrong. I don't see how it can be any clearer.

Originally posted by nesf
Hospital staff are exposed to a lot more patients than any visitors

Right, and a lot of patients 'are exposed to' far more visitors than they are to doctors. If you watch visitors when they come in the first thing they do is walk over and shake hands, and sit around the bed. Next time you're ina hospital, ask visitors in the next bed to wash their hands/ use the gel and see what sort of reponse you get.

InFront

InFront wrote:

'Many' is a conveniently fuzzy term. You cannot put numbers on that.

Whereas you were prepared to imply with certainty that there are none..
I'm afraid you had lost some credibility at that point.

My question is how do people think MRSA got into every hospital in the first place? You think it only sits on the people with scrubs on? Invariably, MRSA will have been 'brought in' to a hospital by someone from the outside.

Now that is,whats this you said about someone posting earlier-lets use your words.. thats a completely silly interpretation... on reality.A hospital should be clean,it should not have bugs of its own regardless of their origin,there should be no residuals ready to infect the next innocent MRSA free patient.
There should be an effective barrier.

What is the point in doctors and other staff washing hands every seven or eight minutes of the day when patients and visitors just constantly wander in, walk straight to their relative or friend, and don't do anything on their part to help prevent the spread of MRSA?

Oh lovely.
If their relative has MRSA, they are risking their own health by not taking precautions.The doctors and nurses should be washing their hands at all times and of course wearing gloves and aprons when dealing with MRSA patients given that they will be also treating as yet non MRSA patients.
If med staff or visitors are routinely allowed (or to put it a better way tollerated) to mix and move without recourse to simple barrier routines then that is the hospitals fault.They are being lax with their rules.

That is why I consider badlyparkedmerc's interpretation of the word endemic to mean that visitor MRSA "does not matter" to be completely off the wall.

You simply cannot differentiate between MRSA that came in two hours ago and MRSA that "ultimately" arrived in two years ago. That's why this differentiation between "Hospital Associated MRSA" and "Community Associated MRSA" is such rubbish.

Thats all academic to be honest.
Hospitals should not allow any situation that spreads the disease to occur.It's not rocket science.All it takes is a little divorce from the lazy couldnt be bothered or ah shur it will do approach.

InFront

Tristrame wrote:

Whereas you were prepared to imply with certainty that there are none..

It's a pity you can't even attempt to back that up with a quote. I did not imply that, which if you read my posts, should be pefectly obvious to most people.

A hospital should be clean,it should not have bugs of its own regardless of their origin

No bugs? Get real.
Also, can you comprehend how lingering MRSA has nothing to do with medical staff, but to do with resources available to them and to cleaners?

If their relative has MRSA, they are risking their own health by not taking precautions.The doctors and nurses should be washing their hands at all times

But I haven't said that doctors and nurses should not wash their hands... are you reading the same posts as I am here? My point is that the responsibility extends heavily onto visitors and relatives, especially those with MRSA

Hospitals should not allow any situation that spreads the disease to occur.It's not rocket science.All it takes is a little divorce from the lazy couldnt be bothered or ah shur it will do approach.

Presuming that extends to evicting visitors from the hospital who simply walk in and make contact with patients without bothering to use the required precautions first and to clean their hands, then I agree with you.
People like you who blame this all on medical staff and fail to recognize their own responsibility are a huge part of the problem.

nesf

InFront wrote:

Right, and a lot of patients 'are exposed to' far more visitors than they are to doctors. If you watch visitors when they come in the first thing they do is walk over and shake hands, and sit around the bed. Next time you're ina hospital, ask visitors in the next bed to wash their hands/ use the gel and see what sort of reponse you get.

Without completely isolating patients diseases will manage to find their way into the wards. Considering that we can't completely isolate all patients, stopping the spread of these diseases within hospitals is extremely important.

Think of it in terms of probabilities, your chance as a patient of picking up MRSA or whatever from the handful of people who visit you is very small. Now, say there are 500 people in this hospital, the odds of one of them picking up MRSA is significantly higher than just you. Now if the hospital staff don't have a good hygiene the disease will spread out from the one or two cases that caught it from the outside. It will tend to spread expotentially and very quickly as more patients get ill. The odds of you picking up the disease if this happens are far more significant. Then add in patients themselves who come in with it and your odds of getting it become, well, problematic. We can't MRSA-proof hospitals, no more than we can keep any infectious disease completely out, we can however prevent the spread of the disease once it gets in and prevent an isolated 'freak' case becoming a mulititude of cases.

Steps can be taken to try and 'stop it at the door' but in reality some will get in and there have to be actions taken by both hospital staff and management to try and stop diseases spreading once this happens. Most of the staff take these actions already, thankfully, but there are a minority that don't and that is a significant issue in this.

InFront

nesf, that is not contradictory to what I've said at all, I can agree with it entirely. There are excellent hygiene facilities as it is, and unfortunately not all staff members and students observe them. But the point that some people are missing is the huge importance of visitor hygiene. As I said earlier, medics and nurses and all other hospital workers have a major responsibility with regard to MRSA. That responsibility extends to visitors too.
The amount of visitors whose first thought is to simply sit down and chat or to shake hands, ignoring the notices, is completely baffling.

InFront

InFront wrote:

It's a pity you can't even attempt to back that up with a quote. I did not imply that, which if you read my posts, should be pefectly obvious to most people.

Look,I'm not going to trade smart comments with you because we will only further mis understand each other.
You said it is "always brought in to a hospital" here .
I rejected that statement as false here

No bugs? Get real.
Also, can you comprehend how lingering MRSA has nothing to do with medical staff, but to do with resources available to them and to cleaners?

Well earlier I alluded to 2 rather snazzy private hospitals not short by any means on resources being rife with MRSA which suggests resources are not the problem.

But I haven't said that doctors and nurses should not wash their hands... are you reading the same posts as I am here?

Again I have no interest in trading smart comments with you I've already pointed out that you have denied that you said MRSA is always brought into a hospital and clearly such a definite cannot be said.Patients without it get it in hospital when they shouldn't.
Regarding your earlier comments on doctors and nurses not washing their hands, you said whats the point of them doing that if visitors don't do the same.
The simple reality is they of all people should be doing that as a minimum.There is a point to it even if the visitors to individual patients don't as the visitors aren't in close contact with other patients.
Allied to this, if the hospital is practising proper barrier nursing, then non MRSA and MRSA patients arent mixed - ergo further underlining the point of Doctors and nurses washing hands between visits to those patients.

My point is that the responsibility extends heavily onto visitors and relatives, especially those with MRSA

Not heavily,I would say equally.It is the responsibility of the hospital to run itself properly.
A hospital not enforcing barrier nursing properly when it comes to MRSA is as serious as sharing needles.It has the same relative impact ie the lack of simple policing of rules spreads MRSA.

Presuming that extends to evicting visitors from the hospital who simply walk in and make contact with patients without bothering to use the required precautions first and to clean their hands, then I agree with you.

Good.

People like you who blame this all on medical staff and fail to recognize their own responsibility are a huge part of the problem.

I'll take exception to that straight away as I always adhere to barrier nursing methods.
I'll also point out that I'm emphasising the hospitals responsibility to enforce barrier rules when it comes to MRSA as part of a duty of care to their patients and clearly that is not happening otherwise our incidence of MRSA would be like that of Holland or somewhere that theres an iota of respect for how to tackle MRSA.
I never put the total blame on all medical staff either,I emphasised their responsibilities.
It's all a programme and its sadly defecient in most hospitals.Lives could be saved were it to be tackled effeciently and it is not.

On a more political note,health pen pushers and politicians won't close wards due to MRSA infestation,it might get the opposition screaming about more ward closures.That just makes the problem bigger.

hunnymonster

I've only skimmed this thread but thought I would add my personal experience. I had MRSA about 6 years ago. It was detected when I was in the Louth Co Hospital and my care would not have been better. As soon as the test results were returned, I was moved into an isolated room. A single nurse atteneded to me and (s)he was gowned, masked and gloved all the time. I was restricted to one visitor (my mum) who also had to gown up and wash hands etc before and after visiting me.

InFront

Tristrame wrote:

You said it is "always brought in to a hospital" here .
I rejected that statement as false here

Yes, I said it is always 'brought in' in response to a poster who was suggesting that MRSA was in hospitals regardless of the conduct of the visitor. My point to him is, quite simply, that you can just about eradicate MRSA from a hospital and one careless visitor will begin the entire cycle again. Given the persistent nature of this bacteria on inanimate objects, good medical practice and diligent cleaners alone will not solve the problem. In every hospital in the country, MRSA has come in from an outside source.

Staph aureus can be on around a third of the general population at any one time. Whilst staff hygiene is of major importance, and lack of hygiene is inexcusable, the importance of visitor hygiene is also absolutely necessary. You think that this responsibility does not extend "heavily" onto them, I'm sorry, but that is just incorrect.
I'm really not trying to shift the blame, or anything like that. As I said earlier, the reasons why MRSA is a problem is: bad infrastructure and lack of beds, lack of isolation, exposure of wound, post-op and delicate patients, bad medical practice/ hygiene, bad or incomplete cleaning, and people bringing in the bacterium on their bodies. There is also an attitude issue to antibiotics of course
All staff need to observe best practice. But anybody (and I don't think you believe this, but in general) who thinks that doctors washing their hands diligently is going to solve the MRSA crisis on its own, is just fooling themselves.

Well earlier I alluded to 2 rather snazzy private hospitals not short by any means on resources being rife with MRSA which suggests resources are not the problem.

Oh okay, resources have nothing to do with it do they not? Why are we even bothering with the million-Euro Beaumont study if Tristrame can give us the answers... lets just go off and buy a truck of soap and hope for the best. MRSA has nothing to do with resources, apparently. I wonder if that study you carried out would stand up to more comprehensive exams.
In private hospitals, you also have a phenomenon you spoke about yourself in your post, not wanting to close off areas because of an MRSA incidence. In public hopsitals, this is impossible because of resources, in private hospitals, it's to do with a private income, a bit like a hotel not utilising its bedrooms: A very cross manager. What kind of cleaning was carried out? What kind of access was given to MRSA patients? What procedures were in place for their rooms and in terms of isolation? How early or late were the problems seen?

A hospital not enforcing barrier nursing properly when it comes to MRSA is as serious as sharing needles.

It's very serious, but to say it's as serious as sharing needles sounds a bit hysterical.

On a more political note,health pen pushers and politicians won't close wards due to MRSA infestation,it might get the opposition screaming about more ward closures.That just makes the problem bigger.

Oh, so the opposition ought to apologize quietly for that other government blunder - the absence of infrastructure - while this one is being sorted out? No. The problems are connected, the government have to do their part. If they're after making a mess of things over the past decade, nobody is going to apologize for them, and rightly so.
There are major resource problems within the health service. Keeping quiet about that so the government can put band-aids on individual problems serves to do nothing but endow the government with an artifically good name in order to help to bring them back again, that's not the job of the opposition, and I'm surprised anyone would even suggest otherwise.

Dr Galen

i'm not really sure where this discussion is going anymore. What are we actually trying to talk about here? It seems that people are just getting bogged down in the blame game, as opposed to maybe putting forward their views on what could be done to eradicate (as far as possible) MRSA.

Can i also point out that their are several other nasty infections that people can and do pick up in hospitals. And to be honest I've seen them have a much worse effect on people than MRSA.

So anyone got any ideas on how we could deal with it. And I think we've done the "get the nurses/doctors/physios/visitors to wash their hands" tack to death by this page

gandalf

TBH nurse baz you touched on what I believe is the real problem with regard to MSRA and other hospital based infections and that is the fact that most wards are running at 100% occupancy. I believe I have read somewhere that a hospital should be running at around 60% occupancy to allow for proper cleaning of wards and to allow for capacity in the time of an emergancy. God help the health service if a real crisis arises like a Avian Flu pandemic or any kind of disaster.

Dr Galen

yep thats one of the major problems. i've lost the source and now i can't find it, but afaik, wards shouldn't be more than 83% full at anytime. Meaning that 83% of capapcity is the max that we should run our wards at to allow for emergencies etc

when i say emergencies though i don't mean avian flu, i mean car crashes, building site accidents etc. things like avain flu would be a totally different matter.

there is also a lot of research pointing to understaffing being a contributary factor. I'm hunting for references now, but mortality rates change dramatically as staffing levels drop.

i'll add em in when i find what i'm talking about

InFront

InFront wrote:

You think that this responsibility does not extend "heavily" onto them, I'm sorry, but that is just incorrect.

The primary responsibility should be with the hospital-Holland style.That works.

I'm really not trying to shift the blame, or anything like that. As I said earlier, the reasons why MRSA is a problem is: bad infrastructure and lack of beds, lack of isolation, exposure of wound, post-op and delicate patients, bad medical practice/ hygiene, bad or incomplete cleaning, and people bringing in the bacterium on their bodies. There is also an attitude issue to antibiotics of course
All staff need to observe best practice.

OK but they don't all the time that should be policed-Holland stye and fcek the people that moan about it.

But anybody (and I don't think you believe this, but in general) who thinks that doctors washing their hands diligently is going to solve the MRSA crisis on its own, is just fooling themselves.

Washing hands is but one part of it.That part and the rest is academic in my view if we can police the control - Holland style.

Oh okay, resources have nothing to do with it do they not? Why are we even bothering with the million-Euro Beaumont study if Tristrame can give us the answers... lets just go off and buy a truck of soap and hope for the best. MRSA has nothing to do with resources, apparently. I wonder if that study you carried out would stand up to more comprehensive exams.

I thought I told you that I wasn't interested in your smart comments?
Also why waste time doing another study here when there have been several of them already done internationally and the results of how to beat MRSA are already well known, eg in Holland.

In private hospitals, you also have a phenomenon you spoke about yourself in your post, not wanting to close off areas because of an MRSA incidence. In public hopsitals, this is impossible because of resources, in private hospitals, it's to do with a private income, a bit like a hotel not utilising its bedrooms: A very cross manager. What kind of cleaning was carried out? What kind of access was given to MRSA patients? What procedures were in place for their rooms and in terms of isolation? How early or late were the problems seen?

Yes and in this country you can close down a restaurant for dirty kitchens but not a ward infected with MRSA? Ludicrous.

It's very serious, but to say it's as serious as sharing needles sounds a bit hysterical.

It amounts to the same thing when MRSA can kill an already ill patient.

Oh, so the opposition ought to apologize quietly for that other government blunder - the absence of infrastructure - while this one is being sorted out? No. The problems are connected, the government have to do their part. If they're after making a mess of things over the past decade, nobody is going to apologize for them, and rightly so.
There are major resource problems within the health service. Keeping quiet about that so the government can put band-aids on individual problems serves to do nothing but endow the government with an artifically good name in order to help to bring them back again, that's not the job of the opposition, and I'm surprised anyone would even suggest otherwise.

Who said anything about keeping quiet?
I merely pointed out that closing wards for MRSA would lengthen queues and no government wants to add to them not withstanding the harm not closing an MRSA ward for thorough disinfection would do.
What actually needs to be done is to educate the public as to what MRSA is and to get them to accept what needs to be done about it.
But thats not going to happen either.
Lets face facts MRSA is going to stay a problem in Ireland because people with the power to do something about it including politicians and health service managers dont want to grasp the nettle.
Fixing it is too politically dangerous,its not a hyped up enough problem to be more important than window dressing other parts of the health service that are more visible to Joe public.

InFront

Tristrame wrote:

The primary responsibility should be with the hospital-Holland style.

For someone who doesn't think that this is a resources issue, you seem to place a lot of faith in the Dutch system.

Going by what that article says, their government have taken a lot of responsibility for the MRSA problem by having what sounds like a pretty excellent healthcare infrastructure. You seem to believe that there are enough resources here as it is. That is where you are completely wrong. Unless, of course, you think this is indicative of the typical Irish hospital:

"When you look around the wards here there are obvious differences with the usual NHS scene - more staff, less pressure on beds, and more single rooms where patients can be isolated." - From the link

Also why waste time doing another study here when there have been several of them already done internationally and the results of how to beat MRSA are already well known, eg in Holland.

This is Ireland. We need to find out what system works well for us given the resources that are available or we can hope to become available. Bad management shouldn't be the case, but it is. The Beaumont study looks the most promising (for us) without going to the extent of what the Dutch are doing - we don't have their resources, but hey - that's not a problem according to you. For example:

Originally posted by Tristrame
Well earlier I alluded to 2 rather snazzy private hospitals not short by any means on resources being rife with MRSA which suggests resources are not the problem.

Originally posted by Tristrame
All it takes is a little divorce from the lazy couldnt be bothered or ah shur it will do approach.

This leads me to believe that, with respect, you really don't know what you are talking about.

InFront

InFront wrote:

For someone who doesn't think that this is a resources issue, you seem to place a lot of faith in the Dutch system.

I didn't say it wasn't a resource issue,I said it seems that since it happens in private well staffed hospitals,resourses is not the problem.
Stop twisting what I'm saying into something that suits you...

Going by what that article says, their government have taken a lot of responsibility for the MRSA problem by having what sounds like a pretty excellent healthcare infrastructure. You seem to believe that there are enough resources here as it is.

I never said that.In actual fact I pointed out how private hospitals are very well resourced and yet MRSA is endemic there too.

That is where you are completely wrong. Unless, of course, you think this is indicative of the typical Irish hospital:

"When you look around the wards here there are obvious differences with the usual NHS scene - more staff, less pressure on beds, and more single rooms where patients can be isolated." - From the link

Thats not a very good way to try and twist what I'm saying into what I'm not saying.Private hospitals do have isolation facilities for MRSA patients yet they are far from working on their own.They do have all the resources a well resourced hospital could have but still resources aren't the panacea on their own.Thats the very simple point that I made, grasp it please like I grasped some of yours rather than just twist it into something I didn't say.I shouldn't have to repeat myself a third time but how and ever here I go...Of course the problem is worse without proper resources thats obvious but then I'd already said that- here so don't be lecturing me on not reading posts.
Again I made the point about this country and attitudes later.Of course it is obvious that the attitude in Holland is different.We need some of their attitudes,they work.

This is Ireland. We need to find out what system works well for us given the resources that are available or we can hope to become available. Bad management shouldn't be the case, but it is. The Beaumont study looks the most promising (for us)

yeah study the subject see what gets rid of it when theres plenty of evidence already on how to defeat MRSA in hospitals.
Thats the "throw another money wasting time wasting report at it" view.

without going to the extent of what the Dutch are doing - we don't have their resources, but hey - that's not a problem according to you.

yeah so? Saying that a private hospital can isolate patients and yet still be rife with MRSA means that isolating them on its own and having a perfectly resourced hospital on it's own is not the solution-repetition number 4.

This leads me to believe that, with respect, you really don't know what you are talking about.

Well with respect,I do know what I'm talking about and more than most.I've been a regular visitor in several hospitals over the last decade,I've seen the filthy ones and the clean(er) ones and both my parents died recently from MRSA.
Throwing an unnecessary time wasting report at this problem when solutions and reports are readily available is just an idealic way for this government to put the issue on the long finger untill after the next election.

InFront

Look I don't see the point in debating with you, I've listed what I think are the problems and you seem to be agreeing with them while trying to maintain some sort of argument to the contrary.
Having seen the inside of a hospital does not make you an expert on this issue by any standards. The attempt to shift your opinion on resources is painfully obvious. Dismissing hospital studies for the Irish system commissioned and being carried out by extremely well educated leaders in their respective fields strikes me as nothing more than arrogance for the sake of arrogance.

InFront

InFront wrote:

Look I don't see the point in debating with you, I've listed what I think are the problems and you seem to be agreeing with them while trying to maintain some sort of argument to the contrary.

Funny thats the impression I got from you.

Having seen the inside of a hospital does not make you an expert on this issue by any standards.

Never said I was.I do know that I can have a valid opinion though,express it here and reason it out with other posters including you and vice versa.

The attempt to shift your opinion on resources is painfully obvious.

Where?I repeated the exact same thing 4 times,is it a 5th ,6th and 7th you want?

Dismissing hospital studies for the Irish system commissioned and being carried out by extremely well educated leaders in their respective fields strikes me as nothing more than arrogance for the sake of arrogance.

Nope I'd just have the same view as those that were on the late late show a few weeks back who said it was a waste of time and money when decisions could be taken now based on for example the Holland experience.
I also proffered the view that I thought it was a handy way for the government to delay having to take action untill after the election that might expose their incompetence further (as it would involve amongst other things ward closures) in terms of hospital ineffeciecies and bad management.
Thats a valid opinion and not arrogance

Dr Galen

tristrame you make some good points man. and i especially agree with your thoughts on money being wasted on consultant reports etc etc. i think though that we really need to get a handle on what the situation is with regards to the whole picture in our hospitals.

as i've said before, these hospital acquired infections are the byproducts of loads of different issues. To be fair I think we agree on that.

what would stop us doing whats being done on say Holland or anywhere else, is most definetly about resources, but also and maybe more so, about capacity as well. then we also have procedures too.

take for example the following situation:

i admit you to my ward, you've just been transferred to us from another hospital. standard procedure is that i screen you for MRSA, because your a transfer. thats takes around 2 days for the results (3 at the weekend). now to my mind, i'd love to have you isolated, just in case, but that can't happen, because the ward is already full and the 6 isolation rooms are already being used by other patients (for various reasons). so you go into a 6 bedded ward and i hope that you don't got MRSA/C Diff/ Norovirus etc etc.

now where is the probelm here? is it resources? capacity? you? me? the cleaners? the A&E crisis? the cold weather?

you get me?

if we only fix one bit of all this mess, nothing will change. we need to fix pretty much all the bits at the same time.

Dr Galen

just saw this on RTE.ie and it seemed relevant

A total ban on visitors has been introduced at St Mary's Orthopaedic Hospital in Cork due to winter vomiting bug.

The ban also remains in place at Cork University Hospital (CUH) and St Clare's Ward in St Finbarr's Hospital.

The only exceptions are relatives of critically ill patients who are asked to make contact with the hospital in advance of their visit.

AdvertisementDirector of Nursing at CUH Mary Boyd said: 'This virus is extremely infectious and people who have been affected by the virus or have been in contact with persons affected by the virus may unknowingly pass on the bug to sick relatives or friends when visiting them in hospital.

'We would appeal to people who have had symptoms of vomiting and/or diarrhoea not to visit any hospital until they have been symptom free for three days.'