Sunday, 21 September 2008

Dilemma

First a praise. The girls' swabs came back clear, no nasty growths whatsoever in any of the most growth promoting parts of their bodies (groin, armpit, stoma and nose). Hurrah. Two girls, officially MRSA free now - in Mog's case, this has taken a year so that is excellent news.
Now the dilemma. Since hearing that the girls were infected (or in Mog's case, still infected), our carers have been superbly brilliant at maintaining a hygienic environment. Gloves, aprons and alcohol gel have all been used freely in addition to handwashing, they have been washing hands when switching from one girl to another, and inbetween different parts of the girls' care, all the things we are all supposed to do all the time. They're doing this because they know the girls have nasty lurgies, and they do not want to carry them home to their families or pass them on to other vulnerable children.

If I tell them, the hygiene standards will drop. Aprons will disappear (to be fair, I'm not convinced how much protection is given by a plastic pinny anyway, but there we go), glove consumption will be dramatically reduced (again, I'm not certain that gloves need to be worn whilst spoon feeding, but I'd like them to continue to wear them for pad changes), and crucially, handwashing will become perfunctory and the many bottles of alcohol gel will start moving to the back of the shelves again.

If I don't tell them, they will continue with the barrier nursing, but they will also be worried about the risks of passing the nasties on to other vulnerable children and to their own children and grandchildren.

My peace of mind or theirs is what it comes down to I suppose? I have to tell them, I can't leave them worrying. So how to tell them in a way which will ensure that they keep up the good standards?

I'm now sidetracking but I wonder if cloth aprons on a boil wash would be as effective as the plastic ones? I know they don't like to wear the plastic ones as they are so sweaty - they have my sympathy there. But if I ran up half a dozen real aprons and kept them just for caring, with pockets for gloves and spray etc., and had them on a hook by the door, I wonder if I could train them into wearing those to save their clothes and still keep the clean thing going. Hmmmmm.

Tia

7 comments:

MOM2_4 said...

CONGRATULATIONS to being MRSA free - WOOT!!! Now to keep the girls that way...hummmmm....

I really like the idea of the "apron by the door". Maybe the apron would be a helpful "reminder" to keep up the extra hygene care. A cloth apron would be cooler and could be pretty and bright which the girls would enjoy. Praying the idea will work!

Hugs & Prayers,
Laura

Anonymous said...

How about bright tabards with a pocket ont he front. These are really popular in children's wards, keeps the clothes a little cleaner and has a pocket (normally) for gloves and gel.

Tina said...

yes cottonaprons with the pocket for glovesand alcogel would potentially work well.

A least they oulnt be stretching over you whilst tooth cleaning toreach the alcogel!
Sadly it may allow them to forget the hand washing part of the routine but there will never be a perfect!
Glad the results were clear!
many hugs

Alesha said...

Well, I don't have any experience with carers. (YET! yes, I may have some good news soon!!!) But, I think the apron idea is a really good one! It would save their street clothes from splashes and spills.

If you want the glove usage to continue, you'll have to lead by exaple, I'd think, after informing them what you want done.

Maybe a little basket with hand sanitizer in it, hanging from the hook with the aprons would help them to remember to wash when arriving and when leaving.

I will be paying attention to your situation, to see what works!

Alesha

Anonymous said...

I vote for the cloth aprons or tabbards and the basket of gloves and alcohol hand santizer next to them. Congrats!
The only time we have had infections go from one child to another was the brief times we had help a couple times a week.
Virginia

Michelle said...

Tell them the good news, and tell them that the reason the girls are finally bug-free is because of the great way they have kept everything clean and sterile. So, with that said, "we are going to continue taking care to wash and use gloves at all times so they will stay bug-free."

Hope this works!

Michelle & Emily

PMDPeter said...

Glad you now have 2 'clean' girls.

Any carer who is dealing with multiple clients whether in one building or many buildings should automatically wash hands on entering and leaving a building and between clients and use clean gloves for each client.
I had social services, where my Dad lived, sack one of their contracted care companies because they were not using gloves or washing hands either coming into or leaving my Dads house when they were assisting him with washing and dressing twice a day. It was built in to their contract that the company will supply their employed carers with gloves. If the carers are working for you direct on Direct Payments then you are entitled to put that into their contract and control it.

Peter

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