Tackling healthcare-associated infections

8042193-article-handwashAs Christmas approaches, hospitals up and down the country are bracing themselves for the busiest time of the year and the annual surge in cases of norovirus - commonly known as the winter vomiting bug.

Outbreaks of the bug have already forced some hospitals to cancel operations and issue warnings for people not to visit hospital if they have symptoms of the norovirus.

The most up-to-date figures, from 2009, reveal that 77 trusts in England reported 831 outbreaks of norovirus, the majority of which led to some form of ward closure.

Tackling this bug and other healthcare-associated infections (HCAIs), such as methicillin-resistant staphylococcus aureus (MRSA) and clostridium difficile infection (CDI), is a major challenge for hospitals.

In 2009/10, there were nearly 2,000 reported incidences of MRSA and over 25,000 reports of CDI at a cost to the NHS of around £260 million.

Infections remain a real threat

While there have been major improvements within the NHS in infection control with pockets of excellence among some trusts, HCAIs remain a very real threat to patients, staff and visitors.

To help tackle this issue, NICE has produced a quality improvement guide on the prevention and control of HCAIs in secondary care which sets out a vision for excellence.

Developed in collaborated with the Health Protection Agency (HPA), the guide identifies the organisational characteristics, arrangements and practices that describe excellence in care and practice to prevent and control HCAIs.

It is aimed at trust boards and senior management in secondary care settings including commissioners, auditors, managers and providers.

The guide sets out eleven quality improvement statements describing a level of excellence in infection prevention and control at a management or organisational level.

Quality improvement statements in the guide include:

  • 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 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 ensure standards of environmental cleanliness are maintained and improved beyond current national guidance.
  • Trusts work proactively in multi-agency collaborations with other local health and social care providers to reduce risk from infection

Assess your progress

8042194-article-infectionEvidence of achievement markers accompany each statement allowing trust boards to assess their compliance or progress towards each statement.

In addition, the guide provides practical examples of the types of management and structural processes and associated interventions that need to be in place in order to reduce harm from infection.

NICE has also developed a range of support tools to help with this guide, including a shared learning podcast, as well as costing report and template.

Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE, explains why the new guide is necessary.

“There have been major improvements within the NHS in infection control, particularly in relation to Clostridium difficile and MRSA bloodstream infections, but evidence suggests there is wide variability in trusts' success in reducing the impact of HCAIs.

“Therefore, it is important that there is advice in place that can help trusts achieve excellence in management and organisational practices in order to prevent and control infections.

“Based on the best available evidence in this area, the guide illustrates how secondary care organisations can take a whole system approach in tackling the problem.

“The guide is aspirational and aims to engage trust boards and clinicians to improve the quality of care and practice in the area of infection prevention and control over and above current mandatory standards.”

Ensuring patient safety

Professor Roger Finch,Consultant in Infectious Diseases at Nottingham University Hospitals Trust and Chair of the Topic Expert Group which developed the advice, adds:“The control and prevention of healthcare associated infections is essential to ensuring patient safety.

“The nature of HCAI is complex and demands leadership and systems that are supportive and continuously refined.

“These quality improvement statements take an organisation-wide approach to support hospital trusts achieve excellence and meet the high public expectations of healthcare delivery.”

Paul Unsworth, Area Director for the NHS Institute for Innovation and Improvement in London, who was also involved in developing the statements, believes that the quality improvement guide will result in a better understanding of what infective organisms exist in hospitals and the community.

“It will be a crucial step in taking the initiative to collectively reduce the spread of infections throughout hospital, community and social care,” he says.

Let us know about your local experiences of tackling HCAIs within and across your organisation. Do you have any examples, tips or ideas that you could share with others? Are there any templates, or processes that you have set up that others may be able to adapt or learn from? If so, submit your work to our shared learning database.

8 December 2011

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.