Last update 16th. September 2004
HOSPITALS are opening their doors to volunteer "grime busters" in the latest assault to control the spread of the deadly superbug MRSA.
A Bug Watch team, made up of members of the public, will be invited to spot-check hospitals in Greater Manchester to see if they clean. Hospital infections are now at the top of the NHS agenda after a rise in MRSA cases in Britain this year. Seven out of 10 hospital trusts in the region also saw an increase in the number of people infected with the potentially deadly bacteria Methicillin-Resistant Staphylococcus Aureus.
Public watchdog, the Patient and Public Involvement Forums (PPI Forums), which replaced the Community Health Councils last year, are to tour hospitals on a survey of standards of hygiene and cleanliness.
A total of 150 volunteers have signed up to the Bug Watch project in the north west to tour wards and talk to patients and staff about hand-washing, cleanliness and MRSA cases. It is the first time the public has been allowed into the region's hospitals to do a MRSA spot-check, but if successful the project could go nationwide.
Anyone can volunteer, including former patients and they don't have to have any health expertise. The only bar is anyone with a cough, cold or stomach bug.
Each volunteer will get a checklist of things to look out for including dust, dirt, soap provisions, whether staff wear gloves when handling dirty linen and the state of the toilets.
The teams will be able to access all areas in the hospitals except maternity, intensive care, children's wards and A&E departments.
Volunteers have been told to concentrate on areas where the risk of serious infection may be higher, such as elderly wards, admission and assessment wards, renal units and wards specialising in respiratory illness, orthopaedics and surgery where people may have open wounds.
PPI Forum coordinator for Manchester, Karen Tucker said: "MRSA has become a huge public concern so we wanted to do an observation study to check staff and patients were operating in a clean environment."
The results will be analysed by the Regional Office of the CPPIH (Commission for Patient & Public Involvement in Health) before recommendations are made available to the public next week.
IT IS invisible to the naked eye and can creep undetected into any hospital ward from a single patient or relative who doesn't even know they have the potentially deadly bug. But it doesn't take an expert to find the invisible killer MRSA on this hospital ward. In a side room cordoned off from other patients, a sad, frail 72-year-old lies struggling to fight off the infection which has kept him bed-bound for months after he picked it up in hospital last Christmas.
Resigned to the infection, he said: "The nurses sometimes wash their hands, but they don't do it all the time and they don't take a lot of notice about hygiene. I would say this hospital is fair for cleanliness it could be better. "If you are run-down and old, there isn't a lot you can do about MRSA. It seems to be concentrated in hospitals and there doesn't seem to be much anyone can do about it."
But an army of volunteers from the general public set out to prove him wrong yesterday as they mounted the first-ever Bug Watch in Greater Manchester's hospitals. Cleanliness inspections in hospitals are nothing new, but never before has Joe Public been able to poke about the wards like TV grime-busters Kim Woodburn and Aggie Mackenzie, who hunt for dirt and dust on Channel 4's How Clean Is Your House?
Yesterday, 150 volunteers, many with no health expertise, qualifications or infection experience, took part in a major survey of hospital hygiene organised by public health watchdogs, the Patient And Public Involvement Forum.
Thirty-five hospitals in the north west opened their doors for one day to the inspectors a group including teachers, chefs, part-time photographers, retired businessmen and former patients who roamed freely around the wards and corridors, spot-checking toilets, bathrooms and store rooms.
Each volunteer, armed with a clipboard and pen, was given a grime checklist to inspect everything from linen to staff hand-washing procedures on every ward, except maternity, intensive care, children's wards and A&E departments. Working in pairs, they spent hours touring hospital areas where the risk of serious infection was particularly high, such as elderly wards, admission and assessment wards, renal units and wards specialising in respiratory illness, orthopaedics and surgery, where people may have open wounds. Volunteer Joanne Wilcock, a part-time teacher, is no health expert. Her only experience of Manchester Royal Infirmary is as a patient after suffering a brain haemorrhage.
The 48-year-old from Old Trafford said: "I'd give it four out of 10. I've been a patient here for years and seen nurses go around without any gloves or aprons. Today, staff sometimes weren't wearing gloves. Some were putting on aprons and gloves after leaving a patient to go to another one without washing their hands, which just spreads germs. "The lampshades above patients' beds were dirty and dusty, cleaning equipment wasn't available in some bathrooms and the curtains were coming off the rails in many cubicles." It may not sound like anything much to worry about. But if nurses and doctors forget to do simple things like basic hand washing procedures, that's when MRSA can leap from one bed to the next. Her team-mate, Richard Winterton, 61, said he'd rather go to France for treatment after his inspection: "I'd prefer to go abroad where they seem more efficient and staff are under less pressure. This hospital was better than I'd expected and I'd give it eight out of 10.
"But I think that the hospitals were expecting us and so they made sure that everything was very clean."
MRSA methicillin-resistant staphylococcus aureus is a common type of bacteria carried by three in 10 people in their nose or skin. You can carry the bacteria for years and never be aware of it until you are tired and run down, ill or injured, when it can take hold and cause anything from boils to infections of the bloodstream, bones or joints. People in hospital are particularly at risk, but regular hand-washing, isolation of infected patients and high cleanliness standards can stop the spread of the bug. In the last year, the number of MRSA infections have risen in Greater Manchester by 8.5 per cent after seven out of 10 hospital trusts in Greater Manchester saw a rise.
The government is spending millions of pounds every year to combat MRSA and is about to embark on a costly initiative to put alcohol swabs next to every patient to make sure that nurses and doctors wash their hands after every patient contact. But some staff say ministers are responding to media hype, rather than a serious escalating problem.
One sister said: "There is way too much hype about MRSA. On a 27-bed ward, there is only one person with it at the moment and the truth is that it is really quite rare. "People are becoming frightened to go into hospital, but really it is a matter of public hygiene that staff have known about for years. It is just another target we have to fulfil."
The results of the inspections are now being analysed by the Regional Office of the CPPIH (Commission for Patient and Public Involvement in Health) before recommendations are made public next week.
For more information or to join the PPI Forum team contact 0161 214 3909 or email firstname.lastname@example.org.
10am I arrive at Manchester Royal Infirmary where the wards are divided out between four teams. I walk down the corridor and I am assaulted by the pungent smell of vomit.
10.15 I arrive at Acute Medical Ward One for inspection and it passes all the cleanliness checks.
10.45 I check Ward One and watch a side room being rigorously cleaned by steam-jet ready for another patient after a MRSA patient was transferred.
11.50 Ward Seven (Urology Unit). I find a patient's fluid bag dumped in a sink meant for staff hand-washing.
12.20 Ward 10 (Renal Transplant Unit) passes all the cleanliness tests.