[Infection Control Professionals' Views on the Handling of MRSA-Colonised Healthcare Workers]. / Der Umgang mit MRSA bei Beschäftigten im Gesundheitsdienst aus Sicht der Krankenhaushygiene.

Background: Colonisation with methicillin-resistant Staphylococcus aureus (MRSA) is a particular challenge for medical staff and their facilities, with a key role being played by physicians alongside infection control and hospital hygiene professionals. Methods: In 2014, infection control and hygiene staff were surveyed on the handling of hospital staff with MRSA colonisation. The questionnaire queried on MRSA management in hospitals and on the cooperation between hygiene staff and hospital physicians and was compared to a survey of physicians' experience with the care of MRSA-positive hospital staff. Results: 124 hospital hygiene professionals participated in the survey. General screenings of staff members were reported mainly for cases of MRSA outbreak. Temporary colonisation is differentiated from permanent colonisation (47%). 2 unsuccessful attempts at decolonisation are normally regarded as an indicator for a permanent colonisation. Generally there was cooperation between hospital physicians and hygiene staff. The responsibility for screening and decolonisation of staff members is shared by both groups with the groups placing emphasis on different focal points. Different approaches for the handling of MRSA-positive staff were reported and recommendations for the work ability vary from merely observing the standard hygiene regulation to refraining from close patient contact or even complete absence from work. Conclusion: MRSA colonisation in hospital staff is being dealt with in different manners. Infection control and hospital hygiene professionals are equally involved in the treatment. Clear regulations would benefit the handling of MRSA in staff members.

Prevention of occupational skin disease: a workplace intervention study in geriatric nurses.

BACKGROUND: Health care workers have an increased risk of occupational dermatosis. OBJECTIVES: To determine whether a skin care programme reduces skin disease on the hands of geriatric nurses and increases protective behaviour and the provision of skin care products at the workplace. The intervention was based on a 2-h skin care training session and an occupational advisory service. METHODS: The study design was a randomized intervention study with a control group. Three hundred and eighty-eight geriatric nurses were included in the intervention group exposed to a skin care programme (IG; n = 146) and in the control group (CG; n = 242). Both groups completed questionnaires on exposure and underwent clinical examinations of their hands at the beginning and after a 12-month period. Preventive measures initiated by the employer at the workplace were documented at baseline and at 3 months after the intervention. RESULTS: At baseline, no difference between the IG and the CG was found with respect to skin changes or work-related behaviour. At follow-up, the frequency of skin disease was significantly reduced in the IG, from 26% at baseline to 17% at follow-up, whereas the frequency remained almost unchanged in the CG. Effects on behaviour in the IG included significant increases in the use of moisturizers and hand disinfection instead of hand washing. The provision of cotton gloves and barrier cream products increased at intervention workplaces. CONCLUSIONS: Effective implementation of an occupational skin care programme for geriatric nurses should include both the training of the nurses and an occupational advisory service for management.

[Health indicators and preventive behaviour of older employees in geriatric care]. / Gesundheitsindikatoren und Präventionsverhalten bei älteren Beschäftigten in der Altenpflege.

STUDY OBJECTIVE: As a consequence of the demographic transition, the proportion of geriatric nurses aged over 50 is increasing. The present study examines whether the prevalence of skin and back diseases and preventive behaviour differ between this group and younger employees. An additional objective was to record the proportion of older employees with a health- and occupation-related impairment. METHODS: 2 149 nurses working in home care settings and nursing homes were questioned in written form about their working ability, their preventive behaviour and their health situation. They were also subjected to dermatological investigation (with the Osnabrück Hand Eczema Severity Index - OHSI) and orthopaedic investigation (based on the multiple-step inventory of examinations). RESULTS: Older nurses more often rated their working ability as "(fairly) poor" than did younger nurses. This applied both to physical demands (11 vs. 4%) and to psychological demands (10 vs. 5%). They were also more affected by symptoms in the cervical spine (28 vs. 13%) and the lumbar spine (56 vs. 37%). Hand eczema was not more prevalent in older nurses. The state of health of 10% of the nurses aged over 50 indicated a health- and occupation-related impairment in regard to work ability and back complaints. Roughly equal proportions of the younger and older groups participated in measures for the primary prevention of back symptoms. The older nurses participated more often in advisory sessions on skin protection and more frequently applied cream to their hands. The younger nurses were in skin contact with water or fluids for shorter periods and more often exclusively used disinfectants after patient contact. CONCLUSION: Geriatric nurses with a health- and occupation-related impairment require intensive measures to support their health and to prevent health damage and to stop them from leaving work prematurely. If at all possible, these measures should not be restricted to a single social insurance agency. The individual preventive behaviour to avoid occupational back symptoms is not dependent on age. An age effect was observed for individual measures to protect the skin. Nevertheless, these had no effect on the risk of disease. The results indicate that more attention should be given to older employees during occupational training.