12/23/2008

The frightening truth about MRSA screening at the Norfolk and Norwich University Hospital

My mother went in to the Norfolk and Norwich Hospital last week for a minor operation, and she was pleasantly surprised to be taken to one side shortly after arrival and told she, like all other patients would be screened for MRSA with them taking a mouth swab and a groin swab to test.

Great news, you would assume. After all, this is what they do in Holland as a matter of course in order to isolate MRSA carriers and ensure they are kept away from other patients and treated with the correct drugs to eliminate MRSA before it gets in to open wounds.

But no, the hospital's actions is a piecemeal attempt to pretend at trying hard to control infections. Why ? Because they told my mother it that they results would not be known for three days, which was pointless as she was actually having the operation that day and she would be home before the results would be known.

What an utter joke infection control is in the Norfolk and Norwich University hospital is, and I am sure that other hospitals are no better.

Update : It appears from this BBC story this morning that there is a 2 hour MRSA test available (which costs £17) but there is also a cheaper 3 day test (£6). So it appears that the Norfolk and Norwich Hospital are simply doing the cheapest test and wasting £6 each time in to the bargain.

7 comments:

Anonymous said...

Ah, the Big Mac generation, I want it and I want it now...never mind the quality!

A little knowledge can be a dangerous thing. The "quickie" MRSA tests are not entirely reliable and certainly not suitable for mass screening.

The microbiologists have to grow a culture in a selective broth ad incubate it overnight. At that stage you can get a negative but it's another 24 hours before a positive can be established.

The N&N must be doing something right:

Health Protection Agency. MRSA bacteraemia rate per 10,000 bed days April 2008 - September 2008.

West Suffolk Hospital 0.14
Ipswich 0.30
NNUH 0.38
James Paget 0.43
Queen Elizabeth, King's Lynn 0.53
Peterborough 0.85
Hinchingbrooke 1.01
Addenbrooke's 1.06

Norfolk Blogger said...

And the three day tests are totally unsuitable if you are going in to hospital THAT DAY !

What an utter waste of £6. It is simply an exercise in ticking boxes and has nothing to do with infection control.

Letters From A Tory said...

Surprised? No. Horrified? Yes.

How I long for the day when the NHS responds to patients instead of targets.

Anonymous said...

It's got nothing to with the money. It has everything to do about the using best and most reliable screening test.

A "quickie" test can give a false positive result and that could lead to antibiotic prescribing to deal with the Staph A, which in turn, can lead to the development of antibiotic-related C diff, especially in elderly people.

The greater the exposure to antibiotics the more likely it is that the "good" bacteria in the gut will be killed off and the C diff which naturally lives in the gut will flourish.

So, taking care with robust testing ensures that people are not unnecessarily treated with antibiotics that can lead to resistance and further problems.

MRSA screening works in three ways:

Patients who are booked for an elective procedure likely to require an in-patient stay, and are assessed at the preadmission clinics, will be screened for MRSA at that visit (usually 2-3 weeks before their hospital admission) This gives the hospital time to ensure the results are available, in time for those very few that are found to be carriers to be decolonised.

The few that for a number of reasons – distance, age, infirmity, - cannot make these preadmission clinics are screened by their GPs before admission(and the hospital pays for this to happen).

Then there are some patients coming in for “minor procedures”, where the only way to do the screening is on attendance, but all positive cases are followed up by the Infection Control (IC) team, in liaison with the Primary Care Trust IC outreach nurse, who will make contact and ensure decolonisation is carried out at home.

Infection control works on the basis of rigorous risk assessment. Patients coming in for invasive, big surgery are most at risk and are all pre-screened, those having minor treatment are least at risk.

The overall detection rate on screening is 2.5%.

James Higham said...

This is close to L'Ombre's post about his mother and she died. Sad thing to have to psot about.

Merry Christmas to you, Nich.

Anonymous said...

Happy New Year Norfolk Blogger

Hope you're mother's well. What was the result of her MRSA screening test in the end?

Norfolk Blogger said...

Presumably she is fin as we have heard nothing from the hospital.

Best wishes to you also.

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