Surveillance systems are to be stepped up, cleanliness improved and communication enhanced as the NHS increases its efforts to rid wards of healthcare associated infections (HCAIs) such as MRSA and C.difficile.
A new guide has been published by the National Institute for Health and Clinical Excellence (NICE) and the Health Protection Agency (HPA) aimed at improving the prevention and control of infection in secondary care settings.
Evidence suggests there is wide variability in trusts’ success in reducing the impact of HCAIs
The guide identifies the organisational characteristics, arrangements and practices that create the best environment in which to control and eradicate potentially-deadly bugs.
Aimed at trust boards and senior managers, it consists of 11 quality improvement standards, including the need for a surveillance system through which to routinely gather data; mandatory monitoring of HCAIs and other infections locally; clear communication with staff, patients and carers; and improvements to environmental cleanliness. Professor Mike Kelly, director of the centre for public health excellence at NICE, said: “There have been major improvements within the NHS in infection control, particularly in relation to C.difficile and MRSA bloodstream infections, over the last few years, but HCAIs are still a very real threat to patients, staff and visitors. Indeed, evidence suggests there is wide variability in trusts’ success in reducing the impact of HCAIs.
ldquo;Therefore, it is important there is advice in place that can help trusts achieve excellence in management and organisational practices in order to prevent and control infections.”
The guide reveals that in 2009/10 there were nearly 2,000 reported incidences of MRSA and more than 25,000 reports of C.difficile infection, costing the NHS around £260m. In addition, in 2009, 77 trusts reported 831 outbreaks of Norovirus, the majority of which led to some form of ward closure.
It states: “This guide will help secondary care and other healthcare organisations improve the quality of care and practice, reduce the risk of harm from HCAIs to patients, staff and visitors and reduce the costs associated with preventable infection.
It is important there is advice in place that can help trusts achieve excellence in management and organisational practices in order to prevent and control infections
“The 11 quality improvement statements provide clear markers of excellence in infection prevention and control at a management or organisational level. Each statement is supported by examples of the type of evidence that could be used to prove the organisation has achieved excellence, and examples of what this would mean in practice on a day-to-day basis. The aim is to help boards assess current practice, identify areas for improvement, monitor progress and provide leadership and support. The guide may also help to inform investment decisions and give patients and the public information about the quality of care they can expect and how secondary care organisations can improve patient safety and outcomes by improving quality in key areas.”
The 11 quality improvement statements provide clear markers of excellence in infection prevention and control at a management or organisational level. The aim is to help boards assess current practice, identify areas for improvement, monitor progress and provide leadership and support
The 11 quality improvement standards in full
- Trust boards demonstrate leadership in infection prevention and control to ensure a culture of continuous quality improvement and to minimise risk to patients
- Trusts use information from a range of sources to inform and drive continuous quality improvement to minimise risk from infection
- Trusts have a surveillance system in place to routinely gather data and to carry out mandatory monitoring of HCAIs and other infections of local relevance to inform the local response to HCAIs
- Trusts ensure standards of environmental cleanliness are maintained and improved beyond current national guidance
- Trusts prioritise the need for a skilled, knowledgable and healthy workforce that delivers continuous quality improvement to minimise the risk from infections. This includes support staff, volunteers, agency/locum staff and those employed by contractors
- Trusts work pro-actively in multi-agency collaborations with other local health and social care providers to reduce risk from infection
- Trusts ensure there is clear communication with all staff, patients and carers throughout the care pathway about HCAIs, infection risks and how to prevent HCAIs, to reduce harm from infection
- Trusts have a multi-agency patient admission, discharge and transfer policy which gives clear, relevant guidance to local health and social care providers on the critical steps to take to minimise harm from infection
- Trusts use input from local patient and public experience for continuous quality improvement to minimise harm from HCAIs
- Trusts regularly review evidence-based assessments of new technology and other innovations to minimise harm from HCAIs and antimicrobial resistance (AMR)
- Trusts consider infection prevention and control when procuring, commissioning, planning, designing and completing new and refurbished hospital services and facilities (and during subsequent routine maintenance)
