Dáil Éireann Debate, Thursday - 14 February 2013
12. Deputy Niall Collins asked the Minister for Health his response to the recent Health Information and Quality report that indicates that patients are at severe risk of infection in six hospitals; and if he will make a statement on the matter. [7502/13]
View answer39. Deputy John Paul Phelan asked the Minister for Health the actions taken to tackle MRSA in hospitals; the impact of these measures; and if he will make a statement on the matter. [7545/13]
View answer343. Deputy Nicky McFadden asked the Minister for Health the current preventative measures taken by hospitals to limit the spread of hospital acquired infections; if the regulatory regime could be strengthened to incorporate the monitoring of private hospitals; and if he will make a statement on the matter. [7955/13]
View answerI propose to take Questions Nos. 12, 39 and 343 together.
I am pleased to inform the Deputies that MRSA rates are at a 6-year low and would like to assure the Deputy that the management of Healthcare Acquired Infections (HCAIs) including MRSA is a key patient safety issue for my Department and the Health Service Executive (HSE) and a number of significant initiatives have been developed to address that important public health issue. These include the HSE's National Infection Control Plan which was launched in March 2007. A National Surveillance System was also established by the HSE to collect data and provide information to monitor HCAIs in our health system along with the establishment of the Clinical Care Programme for HCAIs.
In relation to the recent Health Information and Quality Authority's (HIQA) Reports my Department and the HSE recognise that the HIQA inspection of hospitals against the National Infection Prevention and Control Standards is an important element of the overall strategy to reduce HCAIs across healthcare in Ireland. I welcome the positive comments on the 14 Hospitals inspected. Likewise, both my Department and the HSE recognise that improvement is still necessary in some areas.
With regard to hand hygiene the findings of the Authority would suggest that a culture of hand hygiene best practice needs to become more operationally embedded at all levels. I wish to emphasise that it is of vital importance that healthcare workers recognise their personal responsibility to protect patients by maintaining their own hand hygiene.
To date the HSE has published three national audits on hand hygiene practices with a fourth due in the next six to eight weeks. These reports have shown a level of hand hygiene improving from 78% to 82% against a national target of 90% by the end of 2013. To improve hand hygiene a series of actions are in place a key element of which is the continuing hand hygiene audits. These are happening both in the acute sector and in the long stay area as well.
Other actions include:
- the existing 2005 guidelines on hand hygiene are being revised and will be published this year
- a hand hygiene e-learning programme is being piloted in Dublin North East
- a training video for staff on the WHO 5 Moments for hand hygiene concept
- revised hand hygiene posters were introduced across the system in the summer of 2012
- a major section on website on hand hygiene
- in collaboration with the Department of Education an educational programme for schools - E-Bug
- a monthly national HCA implementation group monitors and reviews all HCA activity in the health system.
All 12 hospitals audited by HIQA are now being asked to develop quality improvement plans that prioritise changes necessary to fully meet the National Standards for the Prevention and Control of Healthcare Associated Infections. These plans must be published by the hospitals concerned on the Internet within six weeks of the publication of HIQA's reports.
All hospitals will receive a letter shortly indicating general outcomes of HIQA investigations and lessons to be learnt.
With regard to the prevention of the spread of MRSA it should be noted that the number of cases of MRSA has fallen by 55% between 2006 and 2011 (from 592 to 263 cases) and the downward trend is holding per statistical returns to date. Individual hospital MRSA rates are also collected and published – annually for 2006 and 2007 and quarterly from 2008 onwards. These results provide a good benchmark into the future to enable us to measure effectively the progress of each hospital on their performance in infection prevention and control. The data can be used by individual hospitals to monitor their progress in the control of HCAIs and the regular reports allow for public assessment of that progress.
Finally, officials of my Department are currently working on the Licensing of Health Facilities Bill which will provide for a mandatory system of licensing for public and private health service providers. The legislative proposals are being prepared broadly in line with recommendations made in the Report of the Commission on Patient Safety and Quality Assurance and are designed to improve patient safety by ensuring that healthcare providers do not operate below core standards which are applied in a consistent and systematic way. The intention is to have a proportionate system which has the confidence of the public. Standards and other requirements will be enforceable through inspection and imposition of sanctions as necessary. Licensing will be targeted at areas which are not currently subject to regulation. It is expected that outline proposals for the new system of licensing should be finalised in the near future.
