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Focusing on the needs of the patients

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VOL: 99, ISSUE: 07, PAGE NO: 43

Christine Perry, DipHE, RGN, is senior nurse, Infection Control Department, United Bristol Healthcare NHS Trust and chairperson of the Infection Control Nurses' Association

Several years ago I cared for a patient who had bilateral above knee amputations and was isolated for methicillin-resistant Staphylococcus aureus (MRSA) colonisation. As we attempted to clear the MRSA and obtain three negative swabs, the patient, who was isolated from the rest of the ward, became so depressed that we thought he might die.

Several years ago I cared for a patient who had bilateral above knee amputations and was isolated for methicillin-resistant Staphylococcus aureus (MRSA) colonisation. As we attempted to clear the MRSA and obtain three negative swabs, the patient, who was isolated from the rest of the ward, became so depressed that we thought he might die.

He recovered and was sent home, but when I reflect on the care we gave to this patient I still ask myself if we could have done more to make his time in isolation more pleasant. Different people cope with isolation in different ways so it is important that nurses try to understand how patients are feeling (see p54 and 57).

More importantly, we should be doing all that is possible to avoid the need for isolation in the first instance. Standard infection-control practices, such as hand hygiene and cleanliness of equipment, must be an integral part of our practice. Although education is important in promoting hand hygiene, we must promote this essential activity through other routes. The provision of alcohol-based hand decontamination products is a practical solution where access to hand washbasins is limited (see p47).

But infection control extends further than hand-washing and includes activities aimed at avoiding the transmission of infectious diseases, such as vaccination. The chief medical officer's strategy for combating infectious disease - Getting Ahead of the Curve (Department of Health, 2002) - refers to action required to improve the uptake of hepatitis B immunisation among those at risk of sexual transmission (see p50). We must not lose sight of the fact that prevention of infections is preferable to providing cures.

Patients move constantly between the boundaries of primary and secondary care services. The challenge is to provide 'joined-up' infection prevention services that are focused primarily on patients' needs and not on the needs of the service.

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