Bring back matrons to fight hospital acquired infections, urges new health forum chairperson

MRSA would never have flourished under old-style matrons as exemplified by actress Hattie Jacques.

MRSA would never have flourished under old-style matrons as exemplified by actress Hattie Jacques.

The new chairperson of the HSE West’s regional health forum is calling for the return of hospital matrons to help in the fight against hospital acquired infections.

Former mayor Cllr Padraig Conneely, who is a member of the HSE West’s regional health forum, was speaking to this newspaper in the wake of the publication of new figures which reveal that two of Galway’s public hospitals had the highest number of MRSA infections last year.

University Hospital Galway and Merlin Park Hospital topped the MRSA league table with a total of 47 cases, according to a national media report.

Cllr Conneely said matrons, these “iron ladies”, ran efficient, clean hospitals and are badly missed on the wards today.

Referring to the high rate of MRSA infections he said these figures bore out what he has been saying about the country’s health system for the past number of years.

“The health system in this country is broken. They [the HSE] have to admit it. Until they do they cannot fix it.”

The MRSA figures were a “serious concern”, especially to families with elderly relatives in hospital, he said.

“When you go into hospital you want to come out alive. This [news about MRSA figures] is an additional trauma for patients and relatives. It is a major concern. In this day of modern technology this should not be happening.

“It might be time to bring back the matron. Matron was always seen as awkward and contrary and was feared by all - nurses, staff and the public. I certainly remember stealing in to the hospital in Clifden to see my father many years ago and being frightened of my life of matron. I say bring back these iron ladies who ran good efficient hospitals. There was no MRSA and no bugs when they were in charge. Now hospitals are being run by laptops and computers and file carrying executives who are walking the corridors but don’t see anything. Matrons would spot a fly on the wall and a speck of dust.”

A spokesperson for the HSE West said Galway University Hospitals [UHG and Merlin Park] is one of the largest hospitals in the country. It provides care to all sections of the community and looks after the most seriously ill and vulnerable patients in the region.

“GUH accepts all patients based on their clinical need including patients who already have MRSA. The prevention, control and treatment of MRSA is a major challenge for all major hospitals throughout the world. The number of patients with MRSA in GUH must be understood in terms of the very large numbers of patients cared for in the hospital each year - 39,294 inpatients in 2008 - and the serious nature of their underlying disease in many cases.

“Galway University Hospitals sends information on all staphylococcus aureus bacteria grown from blood samples to the Health Protection Surveillance Centre (HPSC ) every three months. This includes information on meticillin resistant (MRSA ) and meticillin-sensitive (MSSA ) strains.”

The statement outlined that the number of MRSA blood stream infections which developed in patients while in GUH has declined a little in the past three years - 38 patients in 2006, 37 in 2007 and 36 in 2008.

“The 2009 figures show a further reduction with 15 MRSA blood stream infections from January to June this year giving a rate of 0.14 per 1,000 bed days down from the 2008 rate of 0.22 per 1,000 bed days.

“The HPSC figures for 2008 indicate that MRSA blood stream infection was detected in 47 patients at GUH. This figure includes 11 cases where the patients had already had the infection before they were admitted to GUH (and 36 patients developed MRSA blood stream infection while in GUH ). The number of patients coming into the hospital who already have MRSA blood stream infection on admission has increased.”

The spokesperson explained that staphylococcus aureus is a common organism found in the nose or on the skin of up to one third of healthy people. In most people, this is MSSA (meticillin sensitive ) but in some people it is MRSA (meticillin resistant ).

Sometimes the organism can cause infection particularly if the skin is broken for any reason, eg, infected eczema or ingrown toenail in a community setting or a surgical wound in a hospital setting. In both the hospital and the community, the staphylococcus aureus can sometimes cause deeper infection and spread into the blood stream. The number of people who develop blood stream infection from it varies from year to year.

“GUH monitors the number of staphylococcus aureus infections carefully and is working to decrease the total rate of staphylococcus aureus bloodstream infection whether due to MRSA or MSSA. However, the hospital is much more limited in what it can do to control the increase in the number of patients coming into the hospital who have already developed Staphylococcus aureus infection in the community.

“If a patient develops a hospital acquired Staphylococcus aureus blood stream infection (either MRSA or MSSA ), we carefully investigate why this has happened and try and prevent any other patient becoming affected.”

The statement outlined that GUH has introduced many changes in recent years in response to these infections including increased testing for MRSA in high risk patients, the setting up of an special isolation ward to offer specialised care to people with MRSA - including measures to clear the MRSA when possible - and to help keep people with MRSA separate from patients who do not the infection.

Other measures include revised hospital infection prevention and control policies on MRSA and policies on the placement of and care of venous catheters (IV drips ), in keeping with latest national guidance and the development and revision of patient information leaflets on many hospital acquired infections.

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