Posted By Greg Burgess I have been asked for some advice regarding MRSA and checks on members of staff who work with elderly clients with MRSA. Could anyone offer any advice on how they manage this and what if any monitoring is done on staff. Thanks in advance. Greg

Posted By Linda Westrupp As the previous respondant says, this is a much misunderstood subject. As MRSA is very rarely, if ever, a problem to healthy people (which we all hope our employees are) it is not a problem for them to be dealing with and even providing intimate personal care to those with active MRSA. We teach staff the proper application of 'universal precautions', the standard safe system for dealing with any infections, which includes covering open wounds, waering the correct disposable gloves (i.e. not powdered latex or polythene), the importance of changing of gloves and aprons before dealing with a new person and most importantly - the importance of good handwashing technique. We do not monitor staff as only people carrying out invasive practices (i.e. surgeons etc.) would need to be tested, but we do strictly enforce universal precautions and good hygiene not only to protect staff, but more importantly to protect vulnerable service users from cross contamination. More information can be obtained from the Department of Health web site which should show a link to the site for public health professionals.

Posted By Lorna Morris You could also try obtaining a copy of the DoH 'Guidelines on the Control of Infection in Residential & Nursing Homes'. It was published in 96 but most of the content is still relevant.

Posted By John Webster As Linda says, adherence to a strict handwashing regime is by far and away the most effective control measure in the spread of HAIs (Used to stand for Hospital Acquired Infections, but now they have sanitised the acronym and it is Healthcare Associated Infections). Yes, doctors and especially consultants are probably the worst offenders. However, there is rarely any provision in hospital wards for washing hands between patients, and going back and forth to a central sink just isn't going to happen. There are gel products on the market, but their effectiveness is debated and alcohol rinses can cause reactions in sensitive skin. Good old soap (from a dispenser, not a cake) and running water followed by drying with paper towels are proven to be almost as effective - and more cost effective - as more 'sophisticated' antiseptic cleansers. So provision of readily accessible handwashing facilities is important. The infomation on care of patients with MRSA from the Department of Clinical Microbiology Western Infirmary Glasgow at http://www.gla.ac.uk/~aspee001/infmgmnt.htm should be of interest and backs up what has been said by the earlier contributors. PS. Cornwall public health dept have a nice little animated graphic on how to wash hands at http://www.cornwallhealt.../ar2000/handwashdemo.htm