Nigel Hawkes
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WINCHESTER Tougher rules on the use of intravenous fluid tubes have been shown to cut the incidence of MRSA infections
No new cases of MRSA have been reported at the Royal Hampshire County Hospital in Winchester and the Andover War Memorial Hospital since last November when the Winchester and Eastleigh Healthcare NHS Trust introduced the new rules.
Since then use of cannulae has had to be authorised by a specialist and signed off by a doctor to ensure that they are used only when absolutely necessary. Once in place, the tubes are flushed with a saline solution and inspected daily.
In 2007-08 the Trust had 11 MRSA bloodstream infections - one under the maximum level that the Government says is acceptable for a trust of its size. Four of the cases were believed to have been cannula-related. The trust believes that if the same practice were adopted nationwide by the NHS, MRSA levels would fall sharply.
Sister Rachel Wright, who worked with Dr Gordon to implement the changes, said: “It just illustrates that simple measures, when strictly followed, can work.”
Derek Butler, chair of MRSA Action UK , welcomed the new practice and called for it be taken up by other trusts around the country.
He said: “It is an excellent step forward, a big improvement. I applaud what they are doing and I would like to see it rolled out nationally.”
Cannulation involves a needle being used to insert a tiny, flexible plastic sheath under the skin.
The needle is then removed and the medicine or fluids can be introduced through the sheath, which remains just under the skin.
Previously, patients who were likely to need IV fluids or drugs in this way were given a cannula as a routine part of their medical care. As well as its new cannulation procedures, the trust is implementing hand hygiene audits and deep cleaning as ordered by the NHS.
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We have been advising various cannulae manufacturers (since 1989) about the problem of multiple attempts & association with high infection rate. Unfortunately they have not been supportive and claim there is no problem. I commend this work as it proves our hypothesis.
www.u-cann.com
Dr Kadiyali M Srivatsa, Guildford, UK
The Y&HSHA chief nurse also informed the board that all Chairs and Chief Executives in the Y&HSHA region had been highlighted to the findings in WOLVERHAMPTON confirming since this discovery Wolverhampton had no reports of MRSA for 3 Months.Perhaps all Acute Trusts should link into these findings
Mary Hoult, Leeds , Yorkshire
Drastic reductions in MRSA cases were made when a pilot at Wolverhampton identified failure in training junior doctors in MRSA/IC .The chief nurse at the last Y&HSHA board meeting stated 30%of the junior doctors failed the IC/MRSA test and that training establishmnts had a lot to answer for!!
Mary Hoult, Leeds , Yorkshire