Johnson Outlines New Measures To Tackle Hospital Bugs, UK

Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: MRSA / Drug Resistance;  Public Health
Article Date: 18 Sep 2007 - 18:00 PDT

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Health Secretary Alan Johnson outlined a package of measures to help reduce healthcare associated infections in hospitals including new responsibilities for matrons, new guidance on clothing and the isolation of patients who are infected.

Alan Johnson said:

"I'm determined that patient safety, including cleanliness, should be the first priority of every NHS organisation. Across the NHS we continue to bring the number of MRSA cases down and make progress on measures to reduce C.difficile. Today's package of measures will give more responsibility to matrons and set guidelines on clothing that will help ensure thorough hand washing and prevent the spread of infections. This is a clear signal to patients that doctors, nurses, and other clinical staff are taking their safety seriously."

Further options that may be needed to tackle healthcare associated infections will be examined in Lord Darzi's interim report into the future of the NHS, due to be published in October. The announcement comes as the Government carries out one of the biggest public engagement exercises in NHS history on the issues that matter to staff, patients and the public.

The new package includes the following measures:

1. Matrons and clinical directors will report quarterly directly to trust boards on infection control and cleanliness. These reports will focus on compliance with statutory obligations and will increase the ability of senior clinical staff to raise concerns over infection control with trust boards directly.

2. New guidance on clothing will mean that hospitals will adopt a new "bare below the elbows" dress code i.e. short sleeves, no wrist watch, no jewellery and allied to this the avoidance of ties when carrying out clinical activity. The traditional doctors' white coat will not be allowed. The new clothing guidance will ensure good hand and wrist washing.

3. New clinical guidance to increase the use of isolation for those patients who are infected with MRSA or Clostridium difficile. Although the best trusts will already be meeting this standard, for the majority of trusts this will mean greater use of single rooms, cohort nursing and better management of isolated patients.

4. The National Patient Safety Agency will extend its sccessful cleanyourhands campaign to care settings outside hospitals. The campaign, designed to improve hand hygiene among healthcare workers in order to combat healthcare associated infections, will be rolled out to primary care, ambulance, mental health and care trusts as well as to care homes and hospices.

5. A new legal requirement will be placed on all chief executives to report all MRSA bacteraemias and C. difficile infections to the Health Protection Agency. It will be backed up by fines for non compliance - failure to report will be an offence.

This package follows the announcement in July from Alan Johnson of an extra £50 million to tackle healthcare associated infections, asking each Director of Nursing in every Strategic Health Authority to make sure that frontline clinicians are supported in the work they do to reduce infection and doubling the size of the Department of Health's infection Improvement Team. The cash is being spent on a range of things, including: staff training and education; increased infection surveillance; more sinks for handwashing; upgrading isolation facilities; and new cleaning equipment.

England's Chief Nursing Officer Professor Christine Beasley said:

"Working alongside their clinical directors, we are asking matrons to monitor staff compliance with the 'bare below the elbow' recommendation and the implementation of the Saving Lives high impact interventions. They will be required to report to the Trust's Director of Infection Control and Prevention on at least a quarterly basis."

General Secretary of the Royal College of Nursing Dr Peter Carter said:

"We support any initiative that promotes good hand hygiene in clinical practice. This guidance offers a positive step forward in introducing dress code standards across all health professions to help reduce healthcare associated infections.

"Nurses are at the forefront of initiatives to tackle healthcare associated infections but in order to be successful we need commitment from the entire NHS team; from all staff, in all disciplines and in every healthcare setting."

Dame Karlene Davis, General Secretary of the Royal College of Midwives said:

"Before the inception of the NHS, one of the biggest killers of child bearing women was puerperal sepsis. This has improved significantly with the recognition of the need for hand hygiene to reduce cross infection.

"This situation remains as relevant today as it did many decades ago and the RCM wholly supports any measure which seeks to avoid infection and harm to mothers and newborns."

- Uniforms and Workwear: An evidence base for developing local policy can be found at http://www.dh.gov.uk. The guidance suggests that white coats should not normally be worn, as the cuffs are likely to be heavily contaminated. Where staff have direct patient contact, then suitable protection - for example, plastic aprons - should be worn.

The guidance can be found here. - All acute Trusts are expected to go 'bare below the elbows' by January 2008.

- New clinical guidance on the isolation of infected patients can be found here.

- The extension of the National Patient Safety Agency's cleanyourhands campaign is being piloted by 19 'pioneer' organisations, selected to represent a mix of non-acute care settings throughout England and Wales. More information on cleanyourhands is available here.

- Patient Environment Action Teams (PEATs) were established in 2000 to assess NHS hospitals. Under the programme, every inpatient healthcare facility in England with more than ten beds is assessed annually and given a rating of excellent, good, acceptable, poor or unacceptable. Cleanliness and the environment are two of the areas that PEATs cover.

http://www.dh.gov.uk