MRSA Study Admission and discharge testing for MRSA in Scottish hospitals

Transcription

1 MRSA Study Admission and discharge testing for MRSA in Scottish hospitals Version 2.1

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3 This information sheet tells you about a study (research) we would like you to participate in. The aim of this study is to find out more about the hospital bug MRSA and how we can prevent its spread in our hospitals. Please take some time to read this information it will help you decide if you would like to take part. If you have any further questions, please speak to your doctor or nurse. This study involves MRSA screening where swab samples are taken from your skin to be tested for MRSA and a short questionnaire about your health and any previous hospital stays. The swabs will be taken when you are admitted to hospital and once again when you leave. Do I have to take part in the study? NO. You are under no obligation to take part in this study and you do not have to give any reason for this. If you don t want to take part, your care will not be affected in any way. Before any swabs are taken, you will be asked to sign a consent form: once on admission and once on discharge. At all times, staff will be happy to answer any questions before taking the swabs. What is MRSA? MRSA is a germ which can cause serious infections in some people. MRSA is short for meticillin resistant Staphylococcus aureus. It s a type of germ that has become resistant to some antibiotics, but it can still be treated. Your doctor or nurse can give you more information about MRSA.

4 MRSA is one of the most well known healthcare associated infections (HAIs). These infections mainly occur in hospitals. Most people coming into hospital will not pick up an infection, but some individuals such as those who are elderly or those with underlying health problems are more at risk. Can people carry MRSA without knowing it? Yes. This is called colonisation, where the MRSA is carried in the nose or on the surface of the skin, but does no harm. Colonisation is not the same as having an MRSA infection. Around three out of every ten people are estimated to be colonised with the Staphylococcus aureus germ, but only a small proportion of these are MRSA. Why do we need to know who is colonised with MRSA? Most people who are colonised will be completely unaware of it, and they will have no symptoms. However, people who are colonised with MRSA while in hospital can spread the germ to other more vulnerable patients. MRSA on your skin can also get into your own body and cause an infection for example if you have an operation, if you have a drip put in, or if you have a catheter. MRSA infection can range from mild skin problems to more serious wound or blood infections. While these infections can be treated, they can cause pain and discomfort, and might mean a longer stay in hospital. It is necessary to identify patients who are colonised with MRSA as early as possible to make sure any risks of infection are kept as low as possible.

5 Why am I being asked to take part in the study? You have been admitted to a hospital in Scotland that is taking part in this study. Using the information from these hospitals will give us a good idea of what s happening with MRSA across all hospitals in Scotland. Being asked to take part in this study does not mean that we think you are more likely to have MRSA. What is the advantage of participating in the study? The advantage of taking part in the study is that you will be tested for MRSA and can be treated for it, if you are MRSA positive. What does taking part in this study mean for me? If you agree to take part in this study, a ward staff member will take samples from you using swabs (similar to cotton buds) twice: the first time when you are admitted to the hospital and the second time when you leave the hospital. These swabs will then be tested in the laboratory for MRSA. The swabs taken from your nose are part of the normal MRSA screening for this hospital, and we are asking for some extra swabs for this research study. When you come in to hospital, we will also ask you a few questions about your health and any previous stays in hospital.

6 Where are the samples taken from? And will it hurt? Taking the swabs is quick and painless. Swabs will be taken from the following areas: the skin inside each nostril the inside of your throat the skin of each armpit the skin on the surface of the perineum (the area between the anus and the genitals). If you have an open wound or if you have been fitted with a catheter, we will also swab those sites. Your privacy and dignity will be respected at all times while we are taking these samples. If you would rather not have one or more of these swabs taken, please say so at any time and we will respect your wishes.

7 What if my tests show I have been colonised with MRSA? If your admission swabs show that you are colonised with MRSA, the doctor who is in charge of your care will discuss with you what the best thing to do is. It is possible to give you decolonisation treatment, using antibiotic creams and antiseptic washes. Patients who are colonised with MRSA while in hospital are usually cared for separately from other patients in a single room or cubicle. This room may be situated in a different unit or ward depending on availability. Visitors will also be asked to wash their hands more often to avoid spreading MRSA to other patients. If your discharge swabs (when you leave the hospital) show that you are colonised with MRSA, you will be discharged without any delay or measures taken. Your GP will be informed. In most cases the GP will decide that you don t need any treatment after leaving the hospital. This is because usually it is not harmful to yourself or to others to be colonised at home. Also many people lose the germ naturally without any decolonisation treatment when they are outside the hospital. Please remember that being colonised is not the same as being infected. It is very common to be colonised without suffering any symptoms or ill effects, whether in or outside the hospital.

8 Some more background information on the study What will the findings of this study be used for? The NHS in Scotland is working hard to reduce illness due to MRSA and other hospital bugs. However, we need to know more about what works best. We think that swabbing patients for MRSA is effective, but this study will help us to prove this. Why am I tested twice? When you enter the hospital, we test you to find out how many people carry MRSA on admission. After testing you for MRSA, we will be able to treat you if necessary. We will test you again on discharge to find out about any spread of MRSA within hospitals. How will I get my screening results? And will my own GP know? While you are in hospital, the doctors and nurses treating you will give you the results of your admission swabbing tests. Once you leave hospital, your GP will be sent a standard package of information about your stay in hospital. This will include the results of your discharge screening for MRSA. If you would like to know the results of your discharge swabs and discuss whether or not decolonisation is right for you, please contact your GP after you have left the hospital.

9 What will happen to my results and samples? HPS takes its responsibilities under the Data Protection Act 1998 very seriously and has adopted a Data Protection Policy, which is available on request from the HPS Data Protection Officer see address below. Any samples taken for this study which are negative for MRSA colonisation will be destroyed. Positive samples will be examined and the germs isolated may be stored for up to 15 years for use in future MRSA research. Samples will not show your name and all laboratories involved in handling them follow strict confidentiality and data protection procedures. Will the results of this study be published? The study results will be published by HPS. No information which could be used to identify you personally will be published. We expect that the overall study results will be published in early 2010 on the HPS website at scot.nhs.uk. Results may also be published in medical journals.

10 Who is organising the study? The Scottish Government has asked HPS to conduct studies into screening for MRSA, so that the national screening programme is based on the best possible information. HPS is part of NHS National Services Scotland, a public body delivering strategic support services and expert advice to NHS Scotland. Two health board areas (Ayrshire and Arran and Grampian) are taking part in this study. Ethical approval for this study has been granted by a national ethics committee in Edinburgh. Who can I speak to for more information? You can get more information on MRSA from a leaflet called MRSA Information for Patients. You can find this leaflet in the patient information leaflet rack on the ward / department, or ask a member of staff to get you a copy. Medical and nursing staff are also happy to discuss MRSA with you at any time.

11 Questions I may want to ask

12 If you would like more information about this study and the swabs which will be taken, please contact the local co-ordinator at this site: This publication can be made available in alternative languages as well as large print, Braille (English only) and audio. To request copies in any of these formats, please contact the HPS Communications Officer on the details below. Health Protection Scotland Clifton House, Clifton Place Glasgow G3 7LN