UK Registered Charity 1122246 This website would not be possible without the kind help of Tony Martin of the “AV Martin Charitable Foundation”

To screen or not to screen

Apart from the legal issues around the protection of personal health information and data, there are practical considerations that affect whether we advocate screening of staff for bacterial colonisation.

The first of these is why we might undertake screening. Generally, routine screening is not helpful if we cannot connect it to a situation in the practice; therefore, unless we have reason to believe that a need exists to screen staff, it will tell us nothing about our practice to undertake it.

If, though, we encounter a situation in which repeated infections can be connected to the practice, then there may be a strong temptation to screen staff in order to find the ‘culprit’; this would be to oversimplify.

Repeated infections in a practice might indeed indicate that one or more members of staff are the source, but, more importantly and more likely, will indicate that the standards of hygiene being practiced by staff are inadequate and it is these that should be addressed.

In fact, a good case can be made for encouraging staff to assume that they carry resistant and virulent pathogens in order to focus their attention on hygiene protocols. Being told, or having it confirmed, that one does not carry problematic bacteria and therefore cannot pose a serious risk can lead to the kind of complacency that causes problems.

Additionally, one-off screenings only tell us whether a person may be a carrier or not at a particular point in time; it does not tell us how long they been positive for MRSA nor how long they will stay so. For that we need to repeat the process, perhaps many times. Even if this did not impinge on the data protection laws and regulations, it would place a significant burden on the practice for little benefit.

If a practice does need to screen the practice environment or staff this should always be done under the guidance of an occupational health specialist. Such services are readily available on a commercial basis to the practice. By doing so, the correct consent is obtained and the results of the swab will then be properly given to the member of staff and his/her general practitioner.

Clients may believe, and indeed ask, that staff should be screened for resistant bacteria; it is always best to resist these requests with an argument based on the importance of good risk-based hygiene than on the perceived benefits of finding someone to blame. Infection rates within a practice are the responsibility of everyone, and singling out individuals to see if they carry the bacteria acts only to divert attention from the real issue; good hygiene.

 

“MRSA infections in pets continue to cause concern to veterinary surgeons and owners. The work of the Bella Moss foundation has focused on providing clear and helpful information for pet owners which has made it easier for many pet owners to understand the requirements and implications of treating MRSA infected animals. The Bella Moss Foundation has also helped to promote awareness and research on MRSA in veterinary medicine.”

Anette Loeffler, DrMedVet, DVD, DipECVD, MRCVS, Lecturer in Veterinary Dermatology, Royal Veterinary College, University of London.

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