Being Met as marked - patients' experiences of being infected with community-acquired methicillin-resistant Staphylococcus aureus (MRSA).

BACKGROUND: It is known that patients who acquired methicillin-resistant Staphylococcus aureus (MRSA) in hospitals suffer and feel as plague. Moreover, the patient interaction with nurses and physicians is described as frightening. Little is known about patient experiences after having acquired CA-MRSA concerning care and everyday life. AIM: To reveal and interpret otherwise healthy patients' lived experiences of receiving care and their everyday life after having acquired community MRSA (CA-MRSA). METHODS: A phenomenological hermeneutic approach guided by Ricouer was conducted. Interviews with twelve patients were transcribed verbatim into a text. The text was analysed in three phases: naive understanding, structural analysis and comprehensive understanding to reveal a possible being in the world. In this study, this referred to what it means to be infected with CA-MRSA. RESULTS: The findings indicate that patients who acquired MRSA experience a changed body image. They suffer from ignorant and frightened behavior from healthcare workers, social contacts, and also of being bullied by colleagues. Despite this, patients assume great responsibility for protecting others. However, knowledgeable staff alleviate suffering and bring peace of mind to the patients. CONCLUSIONS: Preventing patient's feelings of being a pest, an outsider living with fear, requires urgent education and understanding about resistant bacteria and how to meet an infected patient. The results describing patients, affected with MRSA, may contribute and touch the readers to better understanding of patient's changed body image and suffering and how to mitigate these feelings.

Notification card to alert for methicillin-resistant Staphylococcus aureus is stigmatizing from the patient's point of view.

BACKGROUND: The importance of alerting health care systems of patients carrying multidrug-resistant bacteria (MRB) is highlighted in numerous guidelines. In the absence of electronic alert systems, notification cards are often recommended, but have rarely been evaluated. We evaluated patient experiences of receiving and using a methicillin-resistant Staphylococcus aureus (MRSA) notification card. METHODS: Two cohorts of patients given a card when identified for the first time as a carrier in 1999-2003 and 2008-2010, responded to questionnaires distributed in 2004 and 2011, respectively. The response rate in 2004 was 92 (38 females)/129 and in 2011 was 110 (55 females)/209. In addition, 63% and 49%, respectively, followed the encouragement to provide written comments to the questions. These were analysed using a qualitative method. RESULTS: The patients took responsibility not to infect others, reported high usage, and acknowledged the importance of the card to inform health care institutions about their carrier status, despite experiencing fear, disrespect, lack of knowledge, and unprofessional behaviour when presenting it to personnel. Alarmingly these stigmatizing experiences were more frequent in 2011. Professional behaviour was reported from the infectious disease clinic. A majority of the patients were unaware of how they had acquired MRSA. CONCLUSIONS: The MRSA notification card was felt to stigmatize the patient, which makes its use questionable. Other alert methods need to be developed. Most importantly, the study demonstrates the importance for these patients to meet staff educated about MRB. Thus, there is an urgent need to educate health care professionals at all levels.

Patients' experiences of being infected with MRSA at a hospital and subsequently source isolated.

BACKGROUND: Patients infected with methicillin-resistant Staphylococcus aureus (MRSA) during a large outbreak of E-MRSA 16 between 1997 and 2001 at Sahlgrenska University Hospital, Sweden, were moved from their speciality ward to the Clinic of Infectious Diseases for care in source isolation as long as the patient needed hospital care. AIM: To get knowledge regarding patients' experiences who contracted MRSA at the hospital and subsequently source isolated at the Clinic of Infectious Diseases. METHOD: The interviews were designed according to qualitative research. Six patients, aged 35-76 years, who contracted MRSA at Sahlgrenska hospital and subsequently source isolated for at least 1 week were interviewed. The interviews were tape-recorded and an inter-subjective analysis was accomplished. FINDINGS: The study found that the patients felt violated for having contracted MRSA at the hospital and the isolation was described as traumatic, albeit accepted because they took responsibility for not spreading MRSA. The patients felt that they did not receive rehabilitation on the same conditions as other patients and lacked information about MRSA. They felt vulnerable due to negative reactions from the nursing staff, family members and other patient's surroundings. CONCLUSION: Patients who contract MRSA need information about what the MRSA contagion involves. There is a great need for an elevated knowledge of MRSA among staff members. An increased awareness of how the contagion spreads will allay fears of MRSA among staff and patients. The source isolation should be as short as possible to minimise the feeling of confinement.

Cross-infection prevention, basic hygiene practices and education within nursing and health care in Latvia: a Swedish-Latvian practice development project.

The primary aim of this practice development project was to explore the level of knowledge of nursing and medical staff at the Infection Clinic at Liepaja regarding the spread of infectious diseases. Arrangements were also made for some of the Latvian health care staff to visit the Infection Clinic in Gothenburg to increase their knowledge about basic hygiene and to enable them to study the research in this area. Later we were able to formulate this new knowledge into written guidelines. The theoretical education started with questions regarding staffs expertise in preventing the spread of infections. Areas covered were handwashing, hand disinfection, use of disposable gloves and protective clothing. This revealed a need for development of both theoretical and practical knowledge in this area. However, hygiene practices improved after the theoretical education and the visits to the Infection Clinic in Gothenburg. On our return visit to Liepaja dispensers of liquid soap together with hand disinfectants were evident at every wash basin on the unit. Disposable gloves were also routinely used for the dressing of wounds and invasive procedures. Furthermore, disposable coats and masks were used when caring for highly infectious patients. The key cultural differences were the lack of nursing documentation and the relative absence of a dialogue directly between the nurse and the patient.

[How an outbreak of MRSA in Gothenburg was eliminated: by strict hygienic routines and massive control-culture program]. / Så hävdes MRSA-utbrottet i Göteborg: med strikta hygienrutiner och omfattande kontrollodlingsprogram.

The largest single-strain outbreak of methicillin resistant Staphylococcus aureus (MRSA) in Scandinavia so far occurred at Sahlgrenska University Hospital in Western Sweden 1997-2000. The strain identified was identical to the UK EMRSA-16 strain. 147 patients at 36 different wards became colonised or infected. Established routines for infection control had to be revised. The endemic situation necessitated an MRSA screening programme in October 1999 for all former hospital patients on re-admission. Since May 2000 no patient has been found with the outbreak strain at Sahlgrenska University Hospital.