As my husband was wheeled into his hospital room after total hip replacement surgery, I noticed a red sign on the patient’s room that was kitty-corner to his. It said, “Stop. Infection risk.” The sign included instructions about donning gloves and gowns before entering the patient’s room.
This was not a good sign.
I waited outside Jamie’s room for a few minutes as two nurses evaluated him. Two medical professionals inside the other patient’s room caught my attention. They were not clothed in protective gowns or gloves, even with the infection risk. They spoke to the elderly patient at her bedside, one with a stethoscope around his neck and clipboard in hand. I overheard them explain to her that they could not release her because of her MRSA infection and that family members had not been reached.
MRSA? I tried to calm myself. Methicillin-resistant Staphylococcus aureus is serious business. MRSA can be life threatening and causes wound infections after surgery, pneumonia, sepsis, and more.
According to the Journal of Clinical Microbiology Reviews, hospital-acquired infections are the fifth leading cause of death in the United States.
I glanced into the patient’s room again, unsure if I’d seen what I thought I had. The clinicians were in fact not wearing gowns or gloves.
According to RID, the Committee to Reduce Infection Deaths, “Clothing is frequently a conveyor belt for infections. When doctors and nurses lean over a patient with MRSA, the white coats and uniforms pick up bacteria 65% of the time, allowing it to be carried on to other patients.”
As I stood facing my husband’s room, the curtain drawn around his bed for privacy, I noticed how close the elderly patient’s room was to his. About three to four feet. I figured that she and my husband might share the same nurses. My fears spiked as I thought about how easy it would be for nurses and other medical professionals to transmit MRSA from one patient to another. In the published study, Hand hygiene for the prevention of nosocomial infections, “Healthcare workers’ hands represent the principal route of transmission of nosocomial pathogens.” Staphylococcus Aureus (MRSA) can survive for over 2 hours on the hands and is found in 10-78% of staff.”
Minutes later, I stood by Jamie’s bed, touching his hand. He looked weary, in pain.
“You okay?” I asked.
I didn’t mention the MRSA patient next door as I didn’t want to worry him. I mulled over how I was going to handle this with his nurses, how to approach them so I could maintain a cordial relationship. That relationship was crucial to his care. But I also wanted him safe.
Nancy, Jamie’s registered nurse, soon entered the room and introduced herself. We chatted about my husband’s surgery, his care, and I asked about dinner for him since he hadn’t eaten since midnight the night before. Nancy was very friendly and exuded an air of confidence, which put me somewhat at ease. I decided to wait to address my concerns about the patient next door.
To say that I was worried about Jamie would be an understatement. His first hip replacement surgery on the other hip 14 months ago had not gone well and had to be redone. After severe pain did not let up for five months after that surgery, we’d met with several orthopedic surgeons for other opinions. Each one recommended revision surgery. We chose the surgeon who performed the most hip replacement surgeries and revision hip surgeries, who had excellent training and education, but who was also a patient-centered physician. He answered all of our questions. He took the time to explain what needed to be done. He made the effort to get to know Jamie, to establish a relationship.
Seven months ago, Jamie’s revision surgery was expected to take about an hour and a half. It turned into a five-hour operation because the previous hip replacement was such a mess. The new surgeon had quite a bit of trouble withdrawing the stem. It would not budge. He had to surgically cut a keyhole into my husband’s femur to pop it out. He was forced to insert a longer stem because of the problems caused by the previous surgery. This surgeon explained in detail what had happened, and that the recovery would be extended.
Jamie’s recovery from the revision surgery was long and arduous. As a previous hockey player for 25 years on a hockey league, and a skier, motorcycle rider and all around athletic guy, he struggled with losing much of what brought him joy.
Because of Jamie’s life-long physical activity, his other hip was also in very bad shape. All of the orthopedic surgeons we met with said that it too would need to be replaced as it was bone on bone. Ongoing pain in the natural hip prompted the current surgery.
Normally, a patient with MRSA in the hospital room next door might not have prompted as much concern on my part. But Jamie had been through so much—3 years of chronic pain. 3 surgeries. I just wanted him to get his life back without complications.
Nancy was very attentive to Jamie and brought him pain medication almost immediately when she realized he was suffering. She also informed us that dinner was on its way. I liked her already and thought about what I could bring the next morning for her and the other nurses that might show our appreciation for their care.
But the MRSA issue burned in my brain. As soon as I sensed we had developed a good rapport, I asked her the question. “The patient next door,” I said, “She has MRSA, right?”
Nancy appeared a bit startled. “How did you know that? “
I explained that I’d seen the sign on the door and overheard the medical professionals’ conversation in her room as I’d waited for Jamie to be evaluated.
“Is my husband at risk for contracting MRSA since her room is so close?” I asked gently, trying to conceal my worry. I apologized for asking, not wanting to doubt her professionalism.
Nancy explained the protocol for donning protective clothing and gloves before entering the other patient’s room and outlined what needs to happen upon leaving it. She added, “We also use the hand sanitizer every time we come into your husband’s room and again before we leave.”
It had been a while since I’d done research on hospital-acquired infections for both of my books, The Take-Charge Patient and Critical Conditions, but I didn’t think that hand sanitizers killed MRSA. I blurted out, “Does that hand sanitizer kill MRSA?” See this article, The FDA Wants Proof Hand Sanitizer Works.
Nancy hesitated for a split second, motioning to the hand sanitizer dispenser on the wall. “Yes, it does.” She probably hadn’t encountered many loved ones who asked that question. And then she whispered to us, “I’m not taking care of her anyway. I won’t be going into her room.”
Two days later, Jamie was home from the hospital and recovering. He still has no signs of infection. A nurse visits him twice a week and he has in-home PT three times a week.
A week after the surgery, I felt able to do some research on hospital-acquired infections. The CDC states that hospital-acquired infections affect 1.7 million people annually and kill 99,000 people each year. A common statistic that many are familiar with.
But what I discovered that was new to me is that hand sanitizers used in hospitals must have a 65%-100% alcohol content to be effective against MRSA, according to the published study, Effectiveness of various hospital-based solutions against community- acquired methicillin-resistant Staphylococcus aureus. I have to wonder if all hospitals provide hand sanitizers with that level of alcohol content. Hand washing is still considered the gold standard for preventing transmission of infection. But with understaffing, lack of time and patient emergencies, it’s a wonder nurses have time to hit the restroom.
Then, I looked up the patient safety grade of the hospital Jamie had been in. I could have researched this before his surgery but I’d decided against it.
My husband’s surgeon has privileges at that hospital and could not have performed the surgery in another facility. We were committed and very confident in this surgeon. My husband was not going with anyone else because of a hospital’s infection rates. He had been through too much. Besides, I knew this hospital to be much better than the other one covered by our health insurance.
Hospital Safety Score for the hospital my husband was in?
However, it was a relief to see that their safety scores for MRSA were higher than most.