Fact Sheets

 

These fact sheets have been designed to assist you with understanding the importance of hand hygiene, how healthcare associated infections occur, the common germs that can cause infections, and to provide you with a greater understanding about "Golden Staph".

Hand Hygiene

Health Care Associated Infections

MRSA - Methicilin Resistant Staphyloccocus aureus

 

Additional Consumer Fact Sheets

(courtesy of the Australian Commission for Safety and Quality in Health Care and NHMRC)

Healthcare Associated Infections

MRSA

VRE

Clostridium difficile

  

Hand Hygiene

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Background

Everyone has germs.  Our bodies are covered with germs that help us stay healthy.  In addition to the germs that are usually present on our skin, we also pick up germs from contact with other people or objects in our surroundings.  These germs are easy to pick up and transfer.  In this way, they can cause you, or others, to get sick.  Although people usually think that germs are spread through the air, the fact is that germs are most easily spread through hand contact.

One of the best ways to stop the spread of germs is to wash OR decontaminate your hands.  Hand hygiene is a new term to describe washing or decontaminating hands. 

Washing hands helps to physically remove germs by friction, and to rinse them down the drain.

Decontaminating hands reduces the amount of germs present on hands through the use of special alcohol based preparations, in the form of solutions, gels or foams. 

Alcohol based preparations have two distinct advantages over soap and water:

1 - They kill many more germs

2 - They are less drying to your skin

While alcohol based preparations reduce the germs on your hands, they cannot remove visible soil or contamination.  It is always important to WASH hands with soap and water any time they are visibly dirty.

When should you wash your hands with soap and water?

 Adults and children should wash their hands:

  • When hands are visibly dirty
  • Before you eat
  • Before you prepare food items
  • After touching raw meats like chicken or beef
  • After contact with any body fluids like blood, urine or vomit
  • After changing infant or adult nappies
  • After touching animals or pets
  • After blowing your nose or sneezing
  • After going to the toilet

When can you use alcohol based hand rubs?

Adults and children can rub hands:

  • For routine cleaning of hands anytime they are visibly clean
  • If you have contact with contaminated objects in the environment eg. dirty tissues/nappies
  • Before and after you care for or have contact with someone who is very sick, very old or very young
  • Whenever you want to decontaminate your hands 

How to wash your hands correctly                       How to rub your hands correctly
(click on picture to enlarge)                                       (click on picture to enlarge)

WHO - How to Handwash                            WHO - How to Handrub

 References:

World Alliance for Patient Safety. Who Guidelines on Hand Hygiene in Healthcare (Advanced Draft): Global patient safety challenge 2005-2006: Clean care is safer care. World Health Organisation; 2005.

Prevent Infection website
www.preventinfection.org

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Health Care Associated Infections

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Infections that people get whilst being cared for in a healthcare facility are known as healthcare-associated infections (HCAI).

For a patient, an infection can result in:

  • illness
  • an extended stay in hospital
  • a slower recovery
  • increased stress
  • lower morale

HCAIs are costly to the patient, hospital and the community.
HCAIs can occur for several reasons, not all of which are preventable.  In most cases both patients and hospital staff can help to reduce the risk of getting HCAIs.

Why do infections occur?

Some patients in hospital are more vulnerable to getting an infection because they are very sick, or have had an operation.  They may also be at greater risk of getting an infection if they:

  • are very young or very old
  • have underlying medical conditions eg. diabetes
  • have a weakened or compromised immune system eg. patients receiving chemotherapy

Other reasons why HCAIs may occur may be due to the type of procedures that are performed or the environment around them such as:

  • Surgery (length of surgery, type, antibiotics given)
  • Poor hand hygiene by both staff and patients
  • Presence of invasive devices eg. intravenous drips or urinary catheters
  • Longer length of hospital stay
  • A hospital stay in a high risk area eg. Intensive Care Units (ICUs)
  • Use of particular medications

Types of Healthcare Associated Infections

Some common HCAIs are:

  • Urinary tract infections
  • Pneumonia
  • Wound infections

These HCAIs are usually easy to treat and cure, but occasionally may be serious. Treatment often includes the use of antibiotics; drugs that are effective in treating infections caused by bacteria.

Unfortunately, some bacteria are more difficult to treat because they have developed resistance to standard antibiotics. These bacteria are sometimes referred to as “superbugs”.  Two examples of “superbugs” are:

  • Staph’ or ‘golden staph’ - the real name of which is methicillin resistant Staphylococcus aureus (MRSA)
  • Vancomycin resistant enterococcus (VRE), which is caused by a resistant germ

The appropriate use of antibiotics, and good Hand Hygiene are important in minimising the spread of these "superbugs".

Reducing your risk

There are several things that you can do to optimise your health and reduce your risk of HCAIs:

During your stay
  • Wash your hands carefully after handling any type of dirty material, and after you have gone to the bathroom/toilet 
  • Do not be afraid to remind doctors and nurses about hand hygiene

References:

VICNISS Patient Information Brochure: Hospital Acquired Infections

http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cd33_hai_brochure_131106.pdf

National Patient Safety Foundation (NPSF), Preventing infections in the hospital - what can you do. A consumer fact sheet.
http://www.npsf.org/?page=preventinginfections&hhSearchTerms=%22preventing+and+infections%22  

World Alliance for Patient Safety. Who Guidelines on Hand Hygiene in Healthcare (Advanced Draft): Global patient safety challenge 2005-2006: Clean care is safer care. World Health Organisation; 2005.

Prevent Infection website
www.preventinfection.org

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MRSA or Methicilin Resistant Staphylococcus aureus

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This information sheet is designed for use by family and community members who may come into contact with a person who is infected or colonised with methicillin-resistant Staphylococcus aureus (MRSA) which is often called “Staph” or “Golden Staph”.

What is MRSA?

  • Staphylococcus aureus (S. aureus ) is a type of bacteria commonly found on the skin and in the nose of healthy people. Occasionally S. aureus can enter the body and cause an infection. This infection may be minor (such as pimples, boils and other skin conditions) or serious (such as blood infections or pneumonia).
  • Methicillin represents a type of antibiotic which has been used to treat S. aureus infections. Although these antibiotics are very effective in treating most S. aureus infections, some S. aureus bacteria have developed resistance and can no longer be killed by these antibiotics.
  • These resistant bacteria are called methicillin-resistant Staphylococcus aureus or MRSA.

What are the risk factors for getting MRSA?

Patients who have been in a hospital for a long time, sick with a long term illness, are on dialysis, or those who use IV drugs are at risk of getting MRSA.

 

How do I know if I have MRSA?

Your doctor may order a test sample from your wound, blood, urine, nose, or sputum to be sent to the lab. This test is called a culture. If there is MRSA in the sample, the culture is positive. This means you have MRSA in your body. 

 What is the difference between colonisation and infection?

Colonisation means that MRSA is present on, or in, the body without causing illness.·

Infection means that MRSA is making the person ill.

How common is MRSA infection/colonisation?

MRSA accounts for approximately 30-50% of S. aureus strains isolated in hospitals from normally sterile sites such as surgical wounds.

Is MRSA infection treatable?

Yes.· Although MRSA is resistant to many antibiotics and often difficult to treat, a few antibiotics can still successfully cure MRSA infections.· Patients who are only colonised with MRSA usually do not need treatment.

How is MRSA spread?

In hospitals, MRSA is usually spread to a person through contact with the hands of a person who
already has it on their skin. It is not normally spread through the air. You may have acquired
MRSA before you came into hospital, or you may have acquired it in hospital.

How can the spread of MRSA in hospitals be prevented?

All hospitals have infection control policies in place to address this. Stopping MRSA spreading
between patients in hospital depends on staff, visitors and patients all cleaning their hands well,
before and after touching other people.

What happens when a patient with MRSA is isolated?

If a patient in hospital is known to have MRSA either on their skin or causing an infection, special
soaps, ointments or antibiotics are sometimes given to try and get rid of the MRSA. The patient
may also have a room by themselves, and hospital staff may wear gloves and aprons to reduce the chance of them spreading the MRSA to other patients.

How long does a patient with MRSA have to be isolated?

Hospital staff will determine when it is appropriate for a person with MRSA infection or colonisation to come out of isolation.· Because MRSA infection or colonisation is difficult to treat, this period of isolation may last from a few days to a few weeks or longer.

When a person with MRSA is being cared for at home, should the same precautions be followed?

Prior to the patient leaving the hospital you should ask the staff (nurse or doctor) about the precautions, if any, you should take at home.

You may also wish to check with your general practitioner for additional advice.

Generally speaking the following precautions are recommended for the care of a person with MRSA infection at home:

  • All persons should practice normal hygiene and should wash their hands if in contact with any of the patient’s secretions·
  • Wear gloves if you handle body substances (blood, urine, wound drainage) and wash your hands after removing your gloves.

Is it safe to be in the same room as a person with MRSA?

Yes.  Healthy people are at very little risk of becoming infected or colonised with MRSA. If family members and other visitors are healthy then it is okay for them to be in the same room with a person with MRSA.· Casual contact, for example, touching or hugging, is also okay. However, you may wish to wash your hands before your leave the patient’s room or home.
However, people who are very ill or who have weak immune systems (for example, on chemotherapy) should avoid handling the body substances of a person with MRSA. They should also limit their physical contact to no more than casual touching. They should also wash their hands after physical contact with a person with MRSA.

Can my children get MRSA by being around a person with MRSA?

Healthy people including children are at very little risk of becoming infected with MRSA.

When may a person colonised with MRSA return to community activities?

When well enough. You should ask your doctor for advice on returning to general community activities.  Once you have recovered from a severe infection you are able to return to any appropriate activities.  Your doctor will be able to advise you on appropriate activities. Those persons with a MRSA infected wound may continue to take part in community activities provided the wound (for example, leg ulcer) is completely covered with a dressing.

What precautions should I take to protect others?

No special precautions are necessary apart from the following:

  • Everyone should practice good personal hygiene as described above.
  • For example:
    • Washing your hands
      • After using the toilet
      • Before and after preparing food
      • After cleaning
    • Housekeeping: Damp dust to prevent airborne dust particles
    • Crockery, cutlery and cooking utensils should be washed in hot water and detergent, or throught the dishwasher.
    • Linen may be washed in the washing machine using hot water and detergent.

Where do I get more information?

Whislt in hospital, ask your doctor or the infection conrtol staff about any of your concerns regarding MRSA. Your General Practitoner will also be able to give you advice.

References

VICNISS Patient Information Brochure: Multidrug Resistant Organisms  http://www.vicniss.org.au/Consumer/FactsheetMRO.aspx

VICNISS Patient Information Brochure: Hospital Acquired Infections http://www.vicniss.org.au/Consumer/FactsheetHAI.aspx

National Health and Medical Research Council. Infection Control in the Health Care Setting. Canberra, April 1996.

Centres for Disease Control and Prevention. Hospital Infections Program, MRSA FAQ’s for Patients. Date last modified: June 30, 2008
http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html

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