How Sanitary is your Clinic?

[cabarle]

Normally, the Streetsboro, OH treatment center is clean. They wipe down the chairs and machines, bathrooms are clean, etc. However, there is a practice I disagree with which I made the decision to change clinics. On Monday, Sept 2. 2007 I wasn't feeling well. I was able to sleep in the chair after my ca nillation. When a patient has to use the restroom, the practice in the Streetsboro, OH  clinic is to have the patient defecate in a bag with a toilet rim over it. The patient is surrounded by curtains. On Monday, after the patient filled the bag, the staff just left it there. To make matters worse, they were just standing on the other side of the room gossiping about trivial matters such as birthdays, TV shows, etc. I wanted to vomit. I couldn't take the stench anymore, and I complained about it. I also demanded to get the hell out of here. Once the staff realized I was complaining about the bag, they finally got around to disposing it. After I got home, my wife called and complained - but got nowhere. We also talked with the clinic manager and I explained to her how I know more about what's happening in the clinic than she does. I told her about the declining quality of care by her staff, and my opinion how they care more about corporate policy than patients. I was told policy was in place for "patient safety." I gave several examples of various dialysis centers I've been to over the years that contradicted what she was telling me. For example, letting the patient off the machine (with needles in), and letting them back on after using the bathroom. Of course, being a good corporate lackey, she defended her staff and said "I'm sorry you feel this way....I have meetings with my staff so I know what's going on here." My wife asked for a copy of the policies we were questioning and we were told we could get a copy on Friday (Tomorrow). So, because of a cumulative series of things, I have decided to transfer to another clinic. I've also called the Portage County, OH board of health, but they told me they have no jurisdiction over dialysis centers. My wife wants me to "press the issue." However, if no patients complain, nothing else will be done. I'm already labeled a whiner in my clinic, but I don't care - if something is wrong I'm going to speak up. I wish other patients would do the same.

[JerseyGirl]

Sorry that had to happen to you.  There should be a Greivance Poilcy posted in the lobby of your dialysis clinic.  It tells you whom to notify with complaints you may have - usually it is the clinic manager first (you've done that), then their boss (Area Mgr) then their boss (Regional Vice President) and then your Network office. If it is not there, you should have received a copy on admission from your MSW.  If you get no satisfaction you can contact the state agency that certifies your dialysis clinic, CMS, or if your state has a Kidney Commision, as we do in MD, file a complaint with them.  There should be a copy of the facility's license in the lobby as well; you can see what agency to contact on that.  That is really terrible.  We usually do as you first cited; take the patient off ( needles in ) take them to the rest room, let them do their business, and then reconnect. 

[Hawkeye]

When a patient has to use the restroom, the practice in the Streetsboro, OH  clinic is to have the patient defecate in a bag with a toilet rim over it. The patient is surrounded by curtains.

Wow they actually had someone poop while on the floor.  That is completely gross and unacceptable in my opinion.  At my clinic we do have the privacy curtains and urinals for the men to use if they need to pee while hooked up, but even that is their choice to do while still hooked up.  If one of the female patients needs to use the restroom they will be unhooked brought out and back again when done.  Since you didn't list the company name I can only guess what company it may be but I know Fresenius has no such restroom policy.

[Adam_W]

At my old centre, if a patient had to use the bathroom, they were usually taken off, and put back on after they were done. That wasn't the case all the time however. If a patient was in a wheelchair and couldn't get to the bathroom without assistance (being able to move themselves in the wheelchair), out came the bed pan and the privacy curtains. There was one lady in particular who had some GI problems and was always having to go. She was in a wheelchair, and could only be taken somewhere with assistance. She usually had the curtains up for most of her run. She was a nice lady (although sometimes she could be unpleasant if she was in a bad mood), but I was always glad I never had to sit next to her. I never had to be taken off to use the bathroom when I was there, but there have been a few times since I started NxStage where I've had to take myself off temporarily to visit the porcelain thrown. 

Adam

[cabarle]

When a patient has to use the restroom, the practice in the Streetsboro, OH  clinic is to have the patient defecate in a bag with a toilet rim over it. The patient is surrounded by curtains.

Wow they actually had someone poop while on the floor.  That is completely gross and unacceptable in my opinion.  At my clinic we do have the privacy curtains and urinals for the men to use if they need to pee while hooked up, but even that is their choice to do while still hooked up.  If one of the female patients needs to use the restroom they will be unhooked brought out and back again when done.  Since you didn't list the company name I can only guess what company it may be but I know Fresenius has no such restroom policy.

Actually, it is Fresenius. I HOPE they find this board, I talk about it frequently. I even put my picture to show them it's me who told what happened. I've been to other clinics where they allow people off the machine to use the bathroom.

[angela515]

Off topic, cabarle, nice pic. 

[goofynina]

Hi Cabarle,  here is a link that you can print out a flyer so you can show them and they can come and check us out for themselves    http://www.ihatedialysis.com/images/dialysisflyer01.pdf   Thank you for letting others know about us 

[Hawkeye]

Actually, it is Fresenius. I HOPE they find this board, I talk about it frequently. I even put my picture to show them it's me who told what happened. I've been to other clinics where they allow people off the machine to use the bathroom.

Sounds to me like they are just lazy and don't want to have to rinse people back and then re-hook them when they return.  Especially if you run 3rd shift because that adds more time to the treatment length and more time they would have to wait before going home.

[BigSky]

Here is some information from AAKP on what you can do about filing complaints against a dialysis center.

http://www.aakp.org/aakp-library/Concern-With-Dialysis-Facility/



What Should I Do If I Have a Concern With My Dialysis Facility?

By Mark Meier, MSW, LISCW

As a dialysis patient, to a certain degree, you must rely on others for your well-being. You arrive to each dialysis treatment anticipating that the nurses, dialysis technicians, physicians and other clinic staff will appropriately initiate your treatment, monitor you closely during your treatment and safely discontinue your treatment at the end of your prescribed run time. You also rely on your healthcare team to provide you with current treatment and medication options, educate you about your dietary needs and provide you with resource information that pertains to your needs outside of the dialysis clinic. Along with your reliance on the healthcare professional, you also have the right to have expectations about the level of care you receive in your clinic. You should be able to expect that the care you are receiving is performed safely, within the policies and procedures established by the clinic, directed by your physician, and occurring within generally accepted medical practice. Relying on healthcare professionals and having expectations about the level of care you receive are normal aspects of the patient/provider relationship and on their own or in combination should not be problematic.   

However, challenges might arise for you as a patient when the expectations you have for your care are not being met by the very same professionals you rely on for your safety and well-being. It can be a daunting and intimidating task to question or complain to, or about, the professional who is responsible for your care in so many ways. This article will help you to identify positive, proactive steps to take when identifying, reporting, and following up on a complaint about your dialysis clinic or care. You will also be provided with outside resources to utilize if you are unable to obtain a resolution within your clinic system. 

Identifying a Complaint

What type of situation merits reporting as a complaint? The answer to this question is going to be different for each patient and there is not a specific answer about what to register as a complaint.  Generally, complaints fall into three categories: (1) Treatment-related, (2) Staff-related and (3) Dialysis-clinic related. Treatment-related complaints often reflect the perception that some aspect of the initiation, maintenance, or discontinuation of the dialysis run has been performed incorrectly.  Staff-related complaints frequently relate to patient and staff conflicts or disagreements. Dialysis-clinic related complaints focus primarily on the operation and cleanliness of the dialysis center. All three categories have merit and none should be considered more important than the other should. What is important is that once you have identified a complaint that you take the next step and report the complaint. 

Reporting a Complaint

The very nature of the word “complaint” conjures up a negative image and the clichés about “complainers” are numerous. Furthermore, it can be intimidating and stressful to raise concerns about the doctors, nurses, technicians and other healthcare providers who care for you on a daily basis. However, when you have identified an area of concern, it is important to make those aware who have the capability and authority to improve the issue. When reporting your complaint, it is important to understand the complaint or grievance process your clinic has established. The End Stage Renal Disease (ESRD) Federal Regulations, maintained by the Centers for Medicare and Medicaid Services (CMS), require that each dialysis facility have a process in place to address patient complaints. The regulations further require that each dialysis clinic provide patients with specific information that explicitly informs them of the process for filing a complaint and that the patient (or patient representative) is able to file a complaint “…without restraint or interference, and without fear of discrimination or reprisal” (Conditions of Coverage of Suppliers of End Stage Renal Disease, CFR42 405.2138 Patients’ rights and responsibilities). Despite these printed assurances in the Federal Regulations, you still might not feel comfortable reporting a complaint in your clinic. You always maintain the right to forgo the complaint policy implemented by your clinic and report the concern directly to your ESRD Network, which will be discussed later in this article. 

If you have identified a concern, which might be a single incident or a pattern of incidences that you wish to report as a complaint, it is important to be thorough and specific with all components of your complaint. For example, a general complaint about a dirty clinic is more difficult to address than a complaint about unwashed dialysis chairs or used medical supplies being disposed of inappropriately. If you have a concern with a particular staff person, it is important to report your concern in an objective, concrete manner, which describes precise behaviors or actions. The use of offensive language, name-calling or insults will likely exacerbate your concern rather than improve it. Further, it is important to know the person’s name and position when reporting your concern. Specific dates and even the time of an incident will allow those addressing the complaint to narrow down and deal with the concern. 

The method in which you report the complaint is also important. As noted above, the dialysis clinic is required to have a procedure in place for reporting complaints, and they will likely request that you follow this procedure. The procedure will probably contain provisions to put your complaint in writing and to follow a chain of command in filing the report. For example, you might be asked to speak with the social worker first and then speak with the charge nurse, clinic manager, and so forth, working your way up the levels of management in the clinic. This procedure can be useful and helpful to you as a patient for many reasons. First, it provides you the opportunity to put your complaint in writing as an official notice of your concern. Second, it gives both you and the clinic a written description of the specifics of the complaint to refer back to in the process of responding to the complaint. Third, it gives the staff that works in the clinic on a daily basis an opportunity to respond to and resolve the complaint. This method of reporting also allows a measure of confidentiality for the person reporting the complaint.

Reporting a complaint in this written manner allows the clinic staff person who is responsible for dealing with complaints an opportunity to approach the person(s) whom the complaint is about away from the treatment floor and in private. In responding to a complaint, the primary objectives of the clinic management should be to establish the validity of the complaint, resolve the complaint in a reasonable manner and period of time and to educate and provide further training to the staff so the concern is solved for both the short-term and the long-term. In fairness to the staff person about whom the complaint is brought against, they should generally be afforded the opportunity to be made aware of the problem, educated and trained further as necessary and given an opportunity to correct the issue.   

Following Up On a Complaint

In order for a complaint policy to be effective and complete, there must be a mechanism in place for follow up. Most clinic policies state the time period in which the facility will act once receiving a complaint and what action will be taken in response to the complaint. You should receive a response to your complaint in writing with some detail of the plan of correction and future plans to prevent the problem from reoccurring. The response you receive should also contain a description of the process or the resources you can utilize to appeal the decision. If you are satisfied with the resolution, providing constructive feedback and encouragement to those who have helped to solve the issue is helpful to maintain the changes that have been implemented. 

Alternative Complaint Resources

If you have identified an area of concern and you do not feel comfortable reporting a complaint to your physician or using the grievance process put forth by your clinic, you always have the option of reporting the complaint to outside agencies. The two primary agencies are the ESRD Networks and your State Survey Agency. Both are capable of receiving and acting on your complaint either alone or with the other agency. 

The ESRD Networks, of which there are 18 throughout the country, are contracted by CMS to receive and act upon patient complaints. Your clinic should have your Network’s number posted or you can ask a staff person to provide you with the telephone number. You can also access the Forum of ESRD Networks on the Internet at www.esrdnetworks.org. This site contains a detailed map of the areas covered by each ESRD Network, as well as a link to the Web site of each individual Network. 

The other alternative is to contact your State Survey Agency directly. State Survey Agencies are responsible for the licensing and certification of outpatient dialysis clinics and handle individual patient complaints. You can access a directory containing the contact information for your State Agency on the CMS Web site at www.cms.hhs.gov. 

Conclusion

Receiving and providing quality care in an environment free of problems is the goal sought by most patients and healthcare professionals. However, like the rest of the world, problems arise which are uncomfortable to face and sometimes difficult to solve. When a problem does come up, you as a patient have the right to report this complaint, expect action to improve the situation and be informed of a plan to prevent the problem from returning. You should be able to report this complaint without the fear of reprisal or retaliation from the staff that cares for you. Along with these rights, you also have responsibilities in the clinic in relation to complaints. If you identify a problem, it is your responsibility to report the issue in a manner that the complaint can be acted upon and the problem area resolved. You are also responsible for understanding your clinic’s complaint process or to know whom else you might contact to solve the issue. 

The outpatient dialysis clinic is a fast-paced, dynamic and highly sophisticated environment. It is inevitable that certain problems or challenges will surface. However, if complaints are reported and received in a professional manner and you and your clinic staff share the same goal of resolving the complaint to improve the operations of your clinic, the identified problem can be solved in a positive manner to benefit both patients and staff.

Mark Meier, MSW, LICSW has been the Consumer Services Coordinator at Renal Network 11 since 2001. He recently served as the study coordinator for the 2002 National Involuntary Patient Discharge Survey involving 12 ESRD Networks. Mr. Meier is active with the AAKP and was recently elected to the AAKP Board of Directors.

This article originally appeared in the November 2003 issue of aakpRENALIFE Vol. 19, No. 3.

[paddbear0000]

One phone call to the Health Dept would fix most of these problems.

Unfortunately it takes a few calls before they send someone out, unless the accusations are really horrid.

Skip the Health Department--contact OSHA, The Occupational Safety and Health Administration. It may be for "employees," but they are STRICT when it comes to medical facility cleanliness, laws and regulations. I had to deal with them when I worked for a vet. They don't mess around--and they LOVE to fine facilities!

[cabarle]

Hi guys,

It sure is nice to come here and talk with people who actually understand what I am experiencing. To make a long story short, my biggest advocate (my wife) chewed a new anal cavity into both the head nurse and the clinic manager. I decided that no matter who I complain too, nothing is going to change - mostly because the rest of the patients choose to remain silent. So, I start treatment at another facility next Wed. I will post the IHD poster on my last treatment on Monday.

Hawkeye: You hit the nail on the head. I can't say the staff at Streetsboro is "Lazy", but rushed. I understand they're pressed for time between patients. Although, I've always said the center has chosen profits before people, hence my decision to leave. Simple things like temperature (adjusted to the staff's comfort, not the patients), applying the tourniquet on too tight, generally loud conversations while everyone is trying to sleep, etc, etc. Another thing that concerned me was I've heard from the staff how they absolutely hate their jobs. They complain about low wages, long hours, - you get the idea. I suspect everyone here has heard the same complaints. To make matters a tad worse, I suffer from major depression - and even the slightest comments like "Grow Up", "Get off your soapbox", make me just want to end it all. I've since sought counseling and medication and no longer feel that way. Instead, I just tell them the truth - and they don't like it.

BigSky - Yes. all of the complaint procedures are nice if they work. I've made several calls and sent several e-mails to various authorities. However, the reality is because I chose to leave Streetsboro, OH, my complaint will be buried by the clinic and ignored by any authority. I also explained if I decided to stay, the staff can do "little things" to exact their revenge. Although I had assurances from the Clinic Manager they were above reproach to that, I choose not to gamble on her word and leave while I'm healthy enough.

Angela515: I know it's off topic, but for the record: I'm retired Navy and I volunteer with a youth program called the U.S. Naval Sea Cadet Corps in Cleveland, OH. My daughter is in the program. At this stage in life, it's the closest I can come to my beloved U.S. Navy.

 

One phone call to the Health Dept would fix most of these problems.

Unfortunately it takes a few calls before they send someone out, unless the accusations are really horrid.

Skip the Health Department--contact OSHA, The Occupational Safety and Health Administration. It may be for "employees," but they are STRICT when it comes to medical facility cleanliness, laws and regulations. I had to deal with them when I worked for a vet. They don't mess around--and they LOVE to fine facilities!

[Zach]

... generally loud conversations while everyone is trying to sleep, etc, etc. Another thing that concerned me was I've heard from the staff how they absolutely hate their jobs. They complain about low wages, long hours ...

This stuff has happened at my center over the years, but thank God people either get fired or tired and move on.

Never let the bastards get you down!

[kitkatz]

I have written several letters to the head of the dialysis unit I was at when conditions were not good.  They have to deal with a complaint that is in writing.

[Wattle]

It sure is nice to come here and talk with people who actually understand what I am experiencing.

   Support is only the keyboard away. Don't stay away so long next time! 

[goofynina]

It sure is nice to come here and talk with people who actually understand what I am experiencing.

   Support is only the keyboard away. Don't stay away so long next time! 

Wattle is so right,    then again, so is Cabarle  

[Zach]

Another question those on in-center hemodialysis need to ask is how often are the dialysis machines bleached.  After each treatment or just at the end of the day?

And if you're on the Fresenius 2008K dialysis machine, how often do they heat sterilize it?  At the end of the day or just once a week?
 

[BigSky]

Another question those on in-center hemodialysis need to ask is how often are the dialysis machines bleached.  After each treatment or just at the end of the day?

And if you're on the Fresenius 2008K dialysis machine, how often do they heat sterilize it?  At the end of the day or just once a week?
 

Our unit does it at the end of the day.

[Wattle]

Another question those on in-center hemodialysis need to ask is how often are the dialysis machines bleached.  After each treatment or just at the end of the day?

And if you're on the Fresenius 2008K dialysis machine, how often do they heat sterilize it?  At the end of the day or just once a week?
 

I am curious to know what is recommended Zach. At the end of each treatment or the end of the day?

[Hawkeye]

Another question those on in-center hemodialysis need to ask is how often are the dialysis machines bleached.  After each treatment or just at the end of the day?
And if you're on the Fresenius 2008K dialysis machine, how often do they heat sterilize it?  At the end of the day or just once a week?
 

I am curious to know what is recommended Zach. At the end of each treatment or the end of the day?

The Fresenius 2008K and H machines must be acid rinsed (Vinegar rinse) and heat disinfected at the end of each treatment day with the exception of once a week they must be bleach disinfected instead of heat disinfected.

[Stacy Without An E]

The clinic floor is really good about being clean and making sure all cleaning procedures are adhered to.

But because I'm the last patient of the day, I have to deal with a bathroom that never gets cleaned until the end of the day.  People crap on the side of the toilet and the floor, it's really disgusting and considering I'm nauseous when I come in to begin with, it is not a great way to begin treatment.

[Hawkeye]

Another question those on in-center hemodialysis need to ask is how often are the dialysis machines bleached.  After each treatment or just at the end of the day?
And if you're on the Fresenius 2008K dialysis machine, how often do they heat sterilize it?  At the end of the day or just once a week?
 

I am curious to know what is recommended Zach. At the end of each treatment or the end of the day?

The Fresenius 2008K and H machines must be acid rinsed (Vinegar rinse) and heat disinfected at the end of each treatment day with the exception of once a week they must be bleach disinfected instead of heat disinfected.

Just to amend this a bit they should be washing the outside of the machine with a 1:100 bleach solution after every treatment, and if your machines have drain boards on the sides of them they should also be dumping that same solution down them between each treatment as well.

[bdpoe]

So, I'm getting dialysis in a hospital in Florida and even the nurse agrees with
me that the unit is very dirty or unsanitary.

Now that Florida is cutting most agency's budgets by another 10% and hospitals
brace for Medicaid cuts things look rather grim.

So dialysis facilities in Florida will be inspected even less.

Doctors and hospitals are already dumping medicare and medicaid patients.

Seems Florida's solution is to force the disabled poor to move out of state.

Too many can't afford to move. they are trapped.

Well, in between my fighting with various state agencies and health care provider,
and bouts of depression, I'm still here........for now.

[bdpoe]

Too many hospitals and clinics here in Florida need to pay attention to cleanliness, sanitation, personal hygene and
infection control. We are 3 to 4 years behind the UK on addressing MRSA and other hospital/facility borne infections.
Unfortunately this state seems unconcerned....................bd

Staph Fatalities May Exceed AIDS Deaths
By LINDSEY TANNER,
AP
Posted: 2007-10-17 12:56:59
Filed Under: Health News, Nation News
CHICAGO (Oct. 17) - More than 90,000 Americans get potentially deadly infections each year from a drug-resistant staph "superbug," the government reported in its first overall estimate of invasive disease caused by the germ.

 
Deaths tied to these infections may exceed those caused by AIDS, said one public health expert commenting on the new study. Tuesday's report shows just how far one form of the staph germ has spread beyond its traditional hospital setting.

The overall incidence rate was about 32 invasive infections per 100,000 people. That's an "astounding" figure, said an editorial in Wednesday's Journal of the American Medical Association, which published the study.

Most drug-resistant staph cases are mild skin infections. But this study focused on invasive infections - those that enter the bloodstream or destroy flesh and can turn deadly.

Researchers found that only about one-quarter involved hospitalized patients. However, more than half were in the health care system - people who had recently had surgery or were on kidney dialysis, for example. Open wounds and exposure to medical equipment are major ways the bug spreads.

In recent years, the resistant germ has become more common in hospitals and it has been spreading through prisons, gyms and locker rooms, and in poor urban neighborhoods.

The new study offers the broadest look yet at the pervasiveness of the most severe infections caused by the bug, called methicillin-resistant Staphylococcus aureus, or MRSA. These bacteria can be carried by healthy people, living on their skin or in their noses.

 
An invasive form of the disease is being blamed for the death Monday of a 17-year-old Virginia high school senior. Doctors said the germ had spread to his kidneys, liver, lungs and muscles around his heart.

The researchers' estimates are extrapolated from 2005 surveillance data from nine mostly urban regions considered representative of the country. There were 5,287 invasive infections reported that year in people living in those regions, which would translate to an estimated 94,360 cases nationally, the researchers said.

Most cases were life-threatening bloodstream infections. However, about 10 percent involved so-called flesh-eating disease, according to the study led by researchers at the federal Centers for Disease Control and Prevention.

There were 988 reported deaths among infected people in the study, for a rate of 6.3 per 100,000. That would translate to 18,650 deaths annually, although the researchers don't know if MRSA was the cause in all cases.

If these deaths all were related to staph infections, the total would exceed other better-known causes of death including AIDS - which killed an estimated 17,011 Americans in 2005 - said Dr. Elizabeth Bancroft of the Los Angeles County Health Department, the editorial author.

The results underscore the need for better prevention measures. That includes curbing the overuse of antibiotics and improving hand-washing and other hygiene procedures among hospital workers, said the CDC's Dr. Scott Fridkin, a study co-author.

Some hospitals have drastically cut infections by first isolating new patients until they are screened for MRSA.

The bacteria don't respond to penicillin-related antibiotics once commonly used to treat them, partly because of overuse. They can be treated with other drugs but health officials worry that their overuse could cause the germ to become resistant to those, too.

A survey earlier this year suggested that MRSA infections, including noninvasive mild forms, affect 46 out of every 1,000 U.S. hospital and nursing home patients - or as many as 5 percent. These patients are vulnerable because of open wounds and invasive medical equipment that can help the germ spread.

Dr. Buddy Creech, an infectious disease specialist at Vanderbilt University, said the JAMA study emphasizes the broad scope of the drug-resistant staph "epidemic," and highlights the need for a vaccine, which he called "the holy grail of staphylococcal research."

The regions studied were: the Atlanta metropolitan area; Baltimore, Connecticut; Davidson County, Tenn.; the Denver metropolitan area; Monroe County, NY; the Portland, Ore. metropolitan area; Ramsey County, Minn.; and the San Francisco metropolitan area.


Copyright 2007 The Associated Press

[MyssAnne]

That. Is so scary. I have had staph. It is VERY resistant.  Thank goodness they caught it in time. That was the first time I had peritonitis (3 times in one year).  Now, every time I go to the hospital for something I will be thinking of this..

[bdpoe]

Note this article from 2004. Robin Mirrlees and I have been fighting this on both sides of the pond.

Why is the US so far behind on this issue. The "Superbug" has made TV news
here in central florida in the last two days.So we are about 3 years behind
the UK on this and other Hospital Borne Infections..............bd


24 October 2004
KILLER ON WARDS: KNOT ON!
Doctors are told to keep their ties tucked away to beat deadly MRSA bug
By Mike Merritt And Himaya Quasem

DOCTORS are being ordered to tuck in their ties to stop the spread of killer
MRSA.
New NHS guidelines have labelled the neckwear a major hygiene risk.
Experts say they harbour massive amounts of germs, including the deadly MRSA
bug.
But victims of MRSA say such measures are only a fraction of what needs to
be done.
And one, colourful laird Count Robin de la Lanne Mirrlees, says doctors
should be banned from wearing ties entirely.
He believes he was infected by the medics' ties when he was in Hammersmith
Hospital, London, being treated for a stroke in February.

The count, who owns the island of Great Bernera in the Outer Hebrides and is
a friend of actress Joanna Lumley, said: 'Doctors should be banned from
wearing ties in hospital. It is a health hazard.

'The doctors who treated me all had their big ties flapping over me. God
knows how many patients' germs they were carrying. If they need to wear any form
of tie they should wear bow ties.'

Margaret McReight, 68, and her husband Robert, 74, both contracted MRSA
after treatment at the Royal Infirmary in Edinburgh.

Robert, from Edinburgh, was being treated for a blocked artery but ended up
losing his leg because of MRSA. And Margaret caught MRSA while being treated
for a broken leg.

Margaret said: 'I remember drops of blood from my dressing falling on the
floor.

'They were cleaned three weeks later when I was being discharged.

It's all very well getting doctors to tuck away their ties but there are
more basic hygiene standards that need to be meet.'

A spokesman for the Scottish Centre for Infection and Environmental Health
said: 'It would surprise me if there were no germs on ties.

'While doctors may wash their hands in between examining patients, they
cannot wash their ties each time. The only real safe way is not to wear them.'

In July, the Sunday Mail revealed three of Scotland's biggest hospitals -
Glasgow's Victoria, Ninewells in Dundee and Aberdeen Royal - were riddled with
MRSA.

Prof Hugh Pennington, the UK's leading hygiene expert, said: 'In a lot of
cases, our slaughterhouses are cleaner than our hospitals.'

While contaminated ties brushing against patients pose a risk, experts
maintain poor hand hygiene and failure to wash medical instruments properly are
the biggest cause of bugs spreading.

An Executive spokesman said last night: 'We are aware of the risk and the
guidelines make it clear that all ties should not be loose.

'Obviously, wearing ties adds to a smart appearance but if they are loose
there could be a hygiene risk.'
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(http://www.sundaymail.co.uk/news/tm_objectid=14790789&method=full&siteid=86024&headline=killer-o
n-wards--knot-on--name_page.html)