Outbreak Management - Visitors no longer required to wear PPE

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Outbreak Management - Visitors no longer required to wear PPE


Something needed to change
A patient advocate tells her story

First, it was her father.

“My father had a heart operation and spent a lot of time in the ICU where he contracted MRSA,” said Cindy Dumba.

MRSA along with VRE and ESBL are antibiotic-resistant organisms that can stop certain antibiotics from treating infections. Patients can contract these organisms through unwashed hands or surfaces that have been contaminated.

“Because there was a fear that guests would transmit the [bacteria], we were required to gown, glove and mask every time we visited my father. We couldn’t hug him, or kiss him,” Dumba explained. “He felt isolated, and it seemed like his care changed as soon as he became MRSA positive because it became difficult for nurses or support staff to just pop in and say ‘hi’.”

For years it has been routine to require visitors to wear personal protective equipment (PPE) – gowns, gloves and sometimes a mask – when visiting a patient with an antibiotic resistant organism. The concern was that visitors would contribute to spreading these organisms to other patients and wearing PPE would mitigate the spread. But at what cost, Dumba asks?

“We were in the hospital with my father for months and months, for 12 to 15 hours a day and we had to sit there with a mask on. My mom couldn’t touch him, he couldn’t see her smile, it was just awful,” Dumba explained. “What does that do to a person’s ability to get better,” she asked.

Dumba’s father was very ill, and passed away after a long battle in hospital. Then her mother became ill, and it all started happening again.

“Because mom was in contact with dad, she was flagged as being MRSA positive. Infection control suspected she may have tested a false positive, yet because of that first flagging, she was isolated every admission until she could test negative three times,” Dumba explains.

Dumba’s family was faced once again with the reality of having to gown, glove and mask.

“It was frustrating and disheartening to be faced with this situation again. After seeing how isolated my father was, it really took a toll on my mom, and all of us who were often there with her,” Dumba said.

That’s when she started to make some calls.

“I dealt closely with the Region’s infection control people to get a bit of leeway. They knew me by name,” Dumba said with a chuckle. “By the end, we were able to visit with my mom wearing only the gown, but it was too late, the damage was already done.”

To Dumba, the isolation families and patients with these antibiotic-resistant organisms felt due to the protocol was hindering their recovery. If anything, Dumba said, it made it more difficult for her parents to heal. Something needed to change.

“When I heard the news I was elated. I felt it was a long time coming and a welcome change,” Dumba said.

“As of October 5, 2015 visitors are no longer required to wear PPE when visiting a patient with an antibiotic-resistant organism,” said Kateri Singer, the Region’s manager of infection control. “The risk of visitors contributing to the spread of VRE, MRSA, and ESBL organisms from their loved ones to other patients in our healthcare facilities is low. If proper hand hygiene is completed and direct patient care is not being performed, there is no meaningful added value in asking visitors to wear gowns and gloves.”

And, its patients like Dumba that help make these changes happen.

“When we establish protocol and make decisions, we need to look at the best evidence and best practices. Our patients have clearly told us that removing the barriers imposed by PPE between them and their loved ones while in our healthcare facilities will significantly improve the patients’ experience,” Singer explained. “Looking at the evidence, we believe no harm will come to others by granting these wishes, so we are able to accommodate.”

Dumba has volunteered hundreds of hours in the last four years to make health care better for patients and families in Regina Qu’Appelle Health Region. She commits her time for a couple of reasons – she doesn’t want others to experience the frustrations she and her family have when navigating the health care system, and she believes that each of us has an important role to play in making health care patient- and family-centred.