Third National Hygiene Audit Underway With Rigorous New Assessment Procedure, Ireland

Main Category: Public Health
Also Included In: MRSA / Drug Resistance
Article Date: 03 Aug 2007 - 3:00 PDT

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Background to Health Care Associated Infections (HCAIs)/MRSA

Healthcare-associated infections are not new. For centuries they have been a side effect of medical treatment, especially in hospitals. There are a number of types of HCAI, MRSA is one type. The more medical care a person requires, the more likely they are to develop a health care associated infection. These infections are, therefore, more common among people with serious illnesses or at high risk such as, patients with a weakened immune system, patients who have been treated for leukaemia or cancer, or who have had an organ transplant.

Tackling Healthcare Associated Infections (HCAIs) including MRSA is a priority for the Government and for the Health Service Executive (HSE). As part of the campaign to reduce HCAI's, a system of National Hygiene Audits was introduced.

Hygiene Services Assessment Scheme

Two National Hygiene Audits have been conducted to date, in 2005 and in 2006.The second National Hygiene Audit was carried out over the months of February, March and April, 2006. It was clear from the results of the second audit that significant work has been carried out at hospital and national level. Almost every hospital has improved its overall score. 32 hospitals were classified as 'GOOD' (compared to 5 in the first audit), 19 were classified as 'FAIR' (compared to 23 in the first audit), and 2 were classified as 'POOR' (compared to 26 in the first audit).

With the establishment of the Health Information and Quality Authority (HIQA) this scheme is now being coordinated by the Authority's Healthcare Quality Division and replaces the previous audit system.

The third National Audit Hygiene Audit is currently being undertaken by HIQA.All self assessments were completed by March this year and HIQA are currently midway through the unannounced visits. It is envisaged that the remaining hospital visits will be completed by mid September with reports on the findings completed by the beginning of October next.

Participation by the acute hospitals is mandatory and the process involves

-- Self Assessment
-- Unannounced visits involving peer assessors
-- Report on the findings
-- Hygiene Award decision

HSE Proposed Actions on HCAI's

The HSE has established a National Infection Control Action Plan. An Infection Control Steering Group has been established under the chairmanship of Dr. Pat Doorley, National Director (Population Health) and is responsible for reducing infection levels in Ireland's health care facilities by:

- Reducing the spread of infection; and
- Reducing and altering antibiotics usage.

Over the next three to five years the Steering Group aims to reduce HCAIs by 20%, MRSA infections by 30% and antibiotic consumption by 20%.

The Steering Group is supported by eight Local Implementation Teams which will ensure that all local facilities are focused on achieving the national targets, standards and protocols and report results back to the Steering Group. The HSE has recruited about 40 healthcare professionals as part of its Action Plan and the recruitment of a further 12 is underway.

While accepting that not all HCAIs are preventable, the Minister is satisfied that significant steps are being taken to reduce the rates of infection and to treat them promptly when they occur. The Department of Health and Children will be monitoring and evaluating the progress being made by the HSE in the management of this issue so that patients can be assured that in the future the risk of contracting an infection will be reduced to the minimum level possible.

About the Health Information and Quality Authority

Established as part of the Government's overall Health Service Reform Programme, HIQA's mandate extends across the quality and safety of the public, private and voluntary sectors. Reporting directly to the Minister for Health and Children, the Health Information and Quality Authority has statutory responsibility for:

-- Setting Standards for Health and Social Services- Developing the quality and safety standards, based on evidence and best international practice, for health and social care services in Ireland (except mental health services).

-- Monitoring Healthcare Quality - Monitoring standards of quality and safety in our health services, implementing continuous quality assurance programmes and accrediting service providers towards excellence.

-- Health Technology Assessment - Ensuring the best outcome for the service user by evaluating the clinical and economic effectiveness of pharmaceuticals, medical devices, diagnostics techniques and health promotion activities.

-- Health Information - Advising on the collection and sharing of information across the services, evaluating and publishing information about the delivery and performance of Ireland's health and social care services.

-- Social Services Inspectorate - registration and inspection of residential homes for children, older people and people with disabilities.

Monitoring day and pre-school facilities and children's detention centres; inspecting of foster care services

Department of Health and Children
http://www.dohc.ie