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Care homes need MRSA strategy

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MRSA-colonised nursing home residents are up to six times more likely to develop infection than non-colonised patients, yet very few strategies exist to prevent the spread of infection in this setting, researchers have said.

Despite studies repeatedly reporting that residents are at higher risk, reviewers from the Cochrane Institute found no high-quality research focusing on infection control interventions in nursing homes.

‘Many different ways of preventing the spread of MRSA have been studied, particularly in hospitals,’ they said.

‘However, we found no studies that looked at ways of preventing the spread of MRSA in nursing homes for older people,’ they added.

Close living proximity, use of antibiotics, pressure ulcers and indwelling devices all made nursing home residents more vulnerable to infection, the reviewers warned.

They said that although not all infection control policies used in hospital settings could be applied to nursing homes, the same principles of hand hygiene should be adhered to.

‘Although residents can live with MRSA colonisation, as soon as there is a break in the skin it becomes a problem,’ said Bob Darby, head of infection control at Leeds PCT. He has conducted a pilot study into MRSA prevalence in a number of nursing homes in Leeds.

‘We run intense education sessions for staff, including hand-hygiene sessions, and all care homes should have alcohol handgel,’ he said.

‘Staff also try and encourage nursing home residents to wash their hands but lack of mobility and cognitive impairment sometimes makes this difficult.’

Helen Jenkinson, hygiene code improvement manager at the Healthcare Commission, said: ‘Studies that look at the whole of the patient journey are needed, including robust root-cause analysis of infections across the whole of the health economy.’

In a separate review, another group of reviewers found that interventions to promote handwashing could reduce episodes of diarrhoea by
about one-third.

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