Wiping out MRSA

Garvey, M. et al. | Wiping out MRSA: effect of introducing a universal disinfection wipe in a large UK teaching hospital | Antimicrobial Resistance & Infection Control | 2018 7:155 | published: 19 December 2018

Background

Contamination of the inanimate environment around patients constitutes an important reservoir of MRSA. Here we describe the effect of introducing a universal disinfection wipe in all wards on the rates of MRSA acquisitions and bacteraemias across a large UK teaching hospital.

Methods

A segmented Poisson regression model was used to detect any significant changes in the monthly numbers per 100,000 bed days of MRSA acquisitions and bacteraemias from April 2013 – December 2017 across QEHB.

Results

From April 2013 to April 2016, cleaning of ward areas and multi-use patient equipment by nursing staff consisted of a two-wipe system. Firstly, a detergent wipe was used, which was followed by a disinfection step using an alcohol wipe. In May 2016, QEHB discontinued the use of a two-wipe system for cleaning and changed to a one wipe system utilising a combined cleaning and disinfection wipe containing a quaternary ammonium compound. The segmented Poisson regression model demonstrated that the rate of MRSA acquisition/100,000 patient bed days was affected by the introduction of the new wiping regime (20.7 to 9.4 per 100,000 patient bed days).

Discussion

Using a Poisson model we demonstrated that the average hospital acquisition rate of MRSA/100,000 patient bed days reduced by 6.3% per month after the introduction of the new universal wipe.

Conclusion

We suggest that using a simple one wipe system for nurse cleaning is an effective strategy to reduce the spread and incidence of healthcare associated MRSA.

Full article available here

Antimicrobial resistance (AMR)

Department for Environment, Food & Rural Affairs, Department of Health and Social Care, Public Health England, and Veterinary Medicines Directorate | December 2018 |Antimicrobial resistance (AMR)

The Department for Environment, Food & Rural Affairs, Department of Health and Social Care, Public Health England, and Veterinary Medicines Directorate  have updated  information and resources on the government’s plans to slow the growth of antimicrobial resistance.

Full details here

‘The gloves are off’ campaign [Shared Atlas of Learning Case Study]

NHS England | December 2018 | ‘The gloves are off’ campaign’

The use of non-sterile gloves has been associated with a significant potential for cross-contamination and transmission of healthcare-associated infections (HAIs). This is because they are often used when they aren’t needed, put on too early, taken off too late or not changed at critical points (Source: NHS England)

A case study recently added to NHS England’s Shared Atlas of Learning, addresses the over-use of non-sterile gloves through education and training. The Lead Nurse for Infection Prevention and Control and two Lead Practice Educators at Great Ormond Street Hospital NHS Foundation Trust (GOSH).

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Actions included establishing a working group to develop an educational awareness programme for staff. This included an updated educational package for when gloves should be worn generally in practice and a risk assessment strategy for use of gloves when preparing intravenous medication.

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Staff were asked to risk assess when they would wear gloves for giving medication. Gloves were only needed for:

  • any medication where you could be in contact with a bodily fluid. e.g. eye drops, nose drops
  • any therapeutically active cream
  • any liquid hormones or cytotoxic medications.

As a result of the nurses’ actions, the case study reports:

Better outcomes – There has been a reduction in staff attendances to occupational health for hand or skin related problems. The CVL infection rate remains within normal parameters and there has been no adverse rise in hospital acquired infections including Vancomycin-resistant Enterococci (VRE), viral respiratory and enteric infections.

Better experience – The father of a child with learning disabilities gave feedback that his child is hospital and gloves phobic and the project has improved the quality of their life.

The main focus of the project was to provide education and training so that staff felt empowered to risk assess when they used gloves, which has been achieved.

Better use of resources – There has been a significant reduction in the amount of gloves ordered into the hospital. The most recent mean for gloves ordered is 163,125 per week, which is taken from the baseline period between the weeks beginning 15 April 2018 and 29 July 2018, which is a significant reduction on the previous mean of 199,733 units per week a difference of 36,608.

The outcomes of the project are continuing to be monitored and are reported quarterly to staff across the Trust and Nursing Board.

Read the case study at NHS England 

World Antibiotic Awareness Week: Research in review

University of Liverpool | November 2018 | World Antibiotic Awareness Week: Research in review

The University of Liverpool has collated a series of their research stories from the past year to mark World Antibiotic Awareness Week, which is every November. 

Among the stories are a feature in the collection is researchers  using snake venom to treat eye infections as an alternative to antibotics, a discussion about antibotics overuse in the farming industry and a project that is working to develop new antibiotics for multidrug-resistant bacteria. 

 

Each of the news stories are available to read from the University of Liverpool

New funding to tackle antibiotic resistance

Latest podcast: Antibiotic resistance and farms  

Snake venom treatment investigated as antibiotic alternative for eye infections 

£1.6m to develop novel meningitis blood test

 

 

Keep Antibiotics Working campaign

Campaign returns and will run from Tuesday 23 October 2018 across England for 8 weeks and will be supported with advertising, partnerships with local pharmacies and GP surgeries, and social media activity | Public Health England

The ‘Keep Antibiotics Working’ campaign aims to educate the public about the risks of antibiotic resistance, urging people to always take healthcare professionals’ advice as to when they need antibiotics. Antibiotics are essential to treat serious bacterial infections, but they are frequently being used to treat illnesses such as coughs, earache and sore throats that can get better by themselves.  The campaign also provides effective self-care advice to help individuals and their families feel better if they are not prescribed antibiotics.

The campaign is part of a wider cross-Government strategy to help preserve antibiotics. The Government’s ‘UK Five Year Antimicrobial Resistance Strategy 2013 to 2018’ set out aims to improve the knowledge and understanding of AMR, conserve and steward the effectiveness of existing treatments, and stimulate the development of new antibiotics, diagnostics, and novel therapies.

Full detail at Public Health England

Double check patients with ‘penicillin allergy’ to avoid increased MRSA risk

NICE | October 2018 |Double check patients with ‘penicillin allergy’ to avoid increased MRSA risk

Healthcare staff should be aware of this and ensure that only people with a true allergy to penicillin are documented as such, NICE is urging.

penicillin-2946054_640.pngIncorrectly identifying people as allergic could also contribute to antimicrobial resistance, as these people are likely to instead be given broad-spectrum antibiotics.

The warning comes in a new medicines evidence commentary (MEC) on research conducted in the UK and published in the BMJ in June 2018 (Source: NICE).

Full details at NICE