Hospitals face new infection control challenges

THE REPUBLIC’s hospitals face a significant financial challenge in meeting infection control standards, including major infrastructural…

THE REPUBLIC’s hospitals face a significant financial challenge in meeting infection control standards, including major infrastructural change if they are to comply with new mandatory guidelines for the prevention of healthcare acquired infection.

The National Standards for the Prevention and Control of Healthcare Associated Infection, published by the Health Information and Quality Authority (Hiqa) yesterday, lists a dozen minimum standards that must be in place within the next 12 months.

Healthcare associated infections (HCAIs) include the bacterial infections methicillin-resistant staphylococcus aureus (MRSA) and clostridium difficile.

The World Health Organisation has estimated that at any given time, 1.4 million people worldwide suffer from infections acquired in hospitals. However, a recent report from the Health Protection Surveillance Centre suggests the rate of MRSA here had fallen by 25 per cent between 2006 and 2008.

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The exception to the 12-month deadline is the standard dealing with environment and facilities management, which has a three-year timeframe.

This standard calls for an appropriate number of single rooms with en suite facilities to enable associated infections be prevented and controlled, as well as the availability in each hospital of pressurised isolation rooms with dedicated access lobbies.

The majority of hospitals here do not have pressurised isolation rooms at present, while many hospitals have a relative shortage of single rooms. The Health Services Executive (HSE) now faces a significant capital outlay if it is to meet its obligations to ensure hospitals are “fit for purpose” as judged by Hiqa. In addition, the new standards mean that any acute hospital built in future must have 100 per cent single en suite rooms.

For existing hospitals which do not conform to current best practice in the prevention of associated infections, the document says: “There should be specified implementation timeframes contained with the implementation plan to meet these standards and these should be signed off by the board, or equivalent of the service.

“Specific measures to minimise the risk of the spread of HCAIs in the interim period should be implemented and defined within the implementation plan” the standard states.

Other standards cover issues such as hand hygiene; antibiotic resistance; staffing levels, and the particular infection risk associated with medical devices.

Jon Billings, director of healthcare quality and safety with Hiqa said at the launch: “The public and service users have a significant role to play, through taking an active role in ensuring they maintain personal diligence in hand hygiene and in challenging the implementation of these standards from people providing care.”

Dr Kevin Kelleher of the HSE’s healthcare associated infection governance group said: “We will continue to work with hospitals over the coming months to support them in achieving the requirements set out in the standards. We will build on these assessments to plan and prioritise continued action to achieve compliance over the next 12 months.”

The new Hiqa standards will apply to all health and social care services in Ireland, public and private, including hospitals, community care services, GP and dental surgeries and primary care services.