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Do superbugs know more about nursing than humans do?

May 6, 2005 -- Today the Scotsman web site posted a Press Association piece by Lyndsay Moss about a new study finding that intensive care patients were seven times more likely to be infected with the deadly MRSA "superbug" when there was a "shortage of specially trained nurses." The brief piece, "Superbug Peril Higher During Nurse Shortages," does a pretty good job explaining one of the countless hazards of nurse short staffing. But it has expert comment only from physicians, and none from the intensive care nurses whose care is actually at issue--a small but telling example of the kind of attitudes that help make nurse short staffing possible.

The study examined patients in an eight-bed ICU over a five month period. It was conducted by Dr. Stephanie Dancer, a Scottish consultant microbiologist, and was presented at the annual conference of the Intensive Care Society. According to the piece, the study found that of the patients admitted to the ICU, 7% got MRSA, and that occurred during seven weeks of the studied period. During six of those seven weeks, the unit had "a shortage of trained nurses in the daytime." Moreover, during five of the seven weeks, the ward had a "below average" cleanliness standard. The piece reports that the study results were "a surprise" to Dr. Dancer, who evidently has studied MRSA for years, focusing on hygiene levels. She notes that MRSA acquisition is caused by a "culmination" of things, but in this study "understaffing was a significant factor": "It is assumed that when nurses are particularly busy due to understaffing, they do not have time to wash their hands." The piece also includes good quotes from Dr. Anna Batchelor, a physician who is president of the Intensive Care Society. Dr. Batchelor notes that understaffing is a problem in many ICUs, that the study shows how a "lack of trained staff puts patient lives in danger," and that more nurses should be brought into intensive care and given adequate funding for training.

What is wrong with this picture? The article would have benefited from reactions from ICU nurses who might not be surprised that their working conditions play a role in infection control, and who probably could have offered informed comment, rather than mere assumptions, as to how such infections can occur when they are short-staffed. In this respect, the otherwise commendable article appears to reflect the same lack of regard for nursing that has contributed to the nursing crisis that now plagues Europe and North America.

See the article "Superbug Peril Higher During Nurse Shortages" by Lyndsay Moss in the May 6, 2005 edition of the Scotsman.

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