Kieran O'Donnell
Question:9 Deputy Kieran O’Donnell asked the Minister for Health and Children her views on the progress being made in tackling hospital acquired infections; and if she will make a statement on the matter. [22256/08]
View answerThursday, 5 June 2008
Questions (11, 12, 13)
Bernard J. Durkan
Question:46 Deputy Bernard J. Durkan asked the Minister for Health and Children the action taken to eliminate MRSA and similar hospital based infections from all hospitals or institutions where patients are exposed to such infection; if particular steps have been taken or are expected to be taken with a view to combating the problem; and if she will make a statement on the matter. [22277/08]
View answerBernard J. Durkan
Question:110 Deputy Bernard J. Durkan asked the Minister for Health and Children if she expects or intends that all hospitals or health centres throughout the country are operating and providing a high quality and delivery of services with particular reference to the need to eliminate MRSA and other hospital associated infections; the extent to which steps are being taken to deal with such issues; and if she will make a statement on the matter. [22476/08]
View answerWritten answers
I propose to take Questions Nos. 9, 46 and 110 together.
The HSE launched a National Infection Control Action Plan in March 2007. An Infection Control Steering Group is responsible for overseeing the implementation of the plan. Over the next five years, the HSE aims to reduce HCAIs by 20%, MRSA infections by 30% and antibiotic consumption by 20%. Achievement of these targets will benefit all patients who are at risk. The Steering Group is supported by eight Local Implementation Teams which will ensure that all local facilities are focused on achieving the national targets.
A new National Surveillance System has recently been established by the HSE to collect data and provide information on a quarterly basis on four key areas, to monitor HCAIs in our health system:
1. Staphylococcus bacteraemia (blood stream infections);
2. Antibiotic consumption;
3. Alcohol gel use;
4. MRSA Surveillance in Intensive Care Units, from 2008 onwards.
This data (excluding MRSA in ICUs) has been compiled and published for 2006 and 2007. The report represents a significant step forward in terms of providing essential data that will serve as a benchmark for assessing progress in the future. I firmly believe that you cannot manage what you don't measure. We have now with this system begun a very useful measurement process.
The results so far show some improvement in 2007 over 2006. The overall S. Aureus bloodstream infection rate was lower in 2007 (0.36) compared to 2006 (0.37). The overall proportion of MRSA was also lower in 2007 (39.4%) compared to 2006 (42.4%). The overall acute in-patient antibiotic consumption rate is marginally up in 2007 over the 2006 rate by 2.4%. The overall alcohol gel use is up by a significant 50%. This data has many limitations that does not allow for direct comparison between hospitals. Also, areas like the antibiotic prescribing are calculated on a bed-days usage basis and is affected by the different procedures and data collection and processing systems applied in hospitals. However, the results are soundly based and will provide a good benchmark to enable us to measure the progress of each hospital. From now on, this data will be available on a quarterly basis.
In March 2008, the Chief Medical Officer of my Department instructed the HSE to make C. difficile a notifiable disease and since May 4th all cases are required to be notified to the relevant Department of Public Health.
Since 2006, over 30 new staff in posts of Senior Pharmacists, Senior Infection Control Nurses and Surveillance Scientists have been appointed specifically to enhance infection control. I have instructed the HSE that designated private beds should be used for isolation purposes where required for patients who contract HCAIs. New environmental building guidelines to inform infection control policy in all new builds and refurbishments are expected to be published by the HSE later this month.
The Health Information and Quality Authority (HIQA) undertook a comprehensive review of hygiene in our acute hospitals in 2007 and published its report last November. The report represents a thorough assessment of how hygiene services are provided and managed in 51 HSE-funded acute care hospitals. This allows individual hospitals identify strengths and areas for improvement. HIQA is following up on this review to ensure that deficits identified during that process are rectified and the Authority will be undertaking a further national review this Autumn. In addition, this week HIQA published draft Infection Prevention and Control Standards for public consultation. When finalised, these, along with the National Hygiene Standards, will provide a comprehensive framework to control infection in all healthcare settings.
While accepting that not all HCAIs are preventable, I am satisfied that significant steps are being taken to reduce the rates of HCAIs generally and to treat them promptly when they occur.