MANAGING MRSA
Grant Crawshaw, infection control and immunisation clinical nurse specialist at Colchester PCT, is aware of the need for healthcare professionals to provide sensible, realistic information: 'People get very stirred up, particularly when it comes to things like MRSA. I know youngsters who have MRSA, whose parents have been told by health professionals that their children must be segregated at school… That is poor advice and it has a dramatic effect on quality of life.
'I also get regular calls from people worried about visiting friends and family in local hospitals. They want to know if MRSA is on any of the wards and, if so, how do they protect themselves.'
Mr Crawshaw insists that basic infection control methods, scrupulously applied, remain the practice nurse's best option.
'Remember, we don't know for certain who has MRSA and who hasn't, so there is little sense in segregating patients. And there is no justification whatsoever for excluding MRSA-positive people from the practice.
'Of course, if someone has a wound that is heavily contaminated with MRSA, it is common sense to offer treatment at the end of the session. But that would also be best practice for a patient heavily contaminated with Staphylococcus aureus.'
He dismisses the idea of routine MRSA screening for practice staff: 'For a start, it would miss people who simply carry the organism on their hands -- and who are most likely to pass it on.'
He warns that the rules are most likely to be broken when practice staff are working to the limit.
'There is no evidence on handwashing in primary care, but we know it is often neglected in the acute sector. I suspect it is just as likely to be overlooked in a very busy general practice.'