A raft of new guidelines has been issued by the Health Service Executive, a handwashing awareness campaign was spearheaded by the Minister, and one hospital has even banned fresh flowers in the past year in an attempt to cut the number of patients picking up hospital-acquired infections, writes Eithne Donnellan, Health Correspondent
While some of these measures may have had an impact, large numbers of patients are still picking up superbugs in Irish hospitals, bugs such as MRSA and Clostridium difficile which in some cases can prove fatal.
How could this still be happening? Lack of awareness of the problem certainly could not be regarded as an issue at this stage.
According to experts in infection control such as Prof Martin Cormican, president of the Irish Society of Clinical Microbiologists, a large number of issues other than just hygiene - which is important in its own right - also need to be tackled in our hospitals if infection rates are to be cut.
These include putting in place more bed capacity so that patients with infections can be isolated, ensuring there are sufficient infection control staff on the ground and proper surveillance systems in place, ongoing education and training to reinforce good infection control practice, proper laboratory support, and a management team that make it clear infection control is not optional.
Prof Cormican says bed occupancy in Irish hospitals is too high, which leaves no room to group together or isolate patients with infections. "It means up and down the country we know we have patients that have MRSA that are sitting in the middle of a long ward who are not being isolated because there is nowhere to put them. And this isn't a rare event. It's day in, day out."
It's hardly surprising then that the numbers of patients in our hospitals found with MRSA bloodstream infections are continuing to rise. They rose from 480 in 2003 to 553 in 2004 and the Health Protection Surveillance Centre confirmed yesterday they rose to 592 in 2005.
When we look at how we compare with other countries, the situation is even more worrying. A study published last year by the Irish Patients' Association showed the number of cases of MRSA reported per million of the population in Ireland to be the highest of 25 European countries.
Prof Cormican says that not all hospital-acquired infection is preventable but "most people estimate that about one third of it could be prevented if what we know was implemented. . . and what we know is not being implemented".
In his opinion the Republic is falling further behind Northern Ireland and Scotland, for example, in terms of what it is doing to combat rates of hospital-acquired infection. The other countries, he says, seem to be taking a much more proactive approach to making things better.
Figures released to this newspaper under the Freedom of Information Act, and published today, indicate that apart from MRSA bloodstream infections, there were also thousands of patients found to have MRSA on their skin in Irish hospitals last year. While for the majority of patients this is of no consequence, it shows how extensively the bug is circulating in Irish hospitals.
And of concern too is the fact that the bug is also now being found to be circulating in the community. Cork University Hospital confirmed the number of MRSA isolates from its emergency department increased in 2005 compared with 2004. This means more cases are being brought into the hospital from the community and with the overcrowding in A&E units we so regularly hear about, the bug could also be spreading among patients here.
So what should be done? The steps outlined by Prof Cormican are essential. He says he and his colleagues are "close to despair" trying to get action and he is extremely frustrated that plans by the HSE to recruit 52 staff this year to work in infection control have so far come to nothing, due to a cap on staffing in the public sector.
Dr Robert Cunney, a consultant microbiologist with the Health Protection Surveillance Centre, says the things that need to be done now all come down to more resources in terms of more isolation facilities and more infection control staff.
"We really can't take solace" from the current figures, he says, adding that in countries like Holland and Denmark, where much of the accommodation in hospitals is in single rooms, infection rates are much lower.
Yet the HSE says that tackling MRSA and other hospital-acquired infections is a high priority for it. It points out that it is pushing hospitals to clean up their act by carrying out hygiene audits. The first was carried out last year and the results of the second one will be published next week.
Prof Cormican reiterates, however, that as a single measure hygiene audits cannot be expected to have any real impact on hospital- acquired infections. His arguments make sense and the HSE and others in authority, such as the Minister for Health, Mary Harney, need to realise this and take action so that large numbers of other patients are not unnecessarily put at risk when they go into hospital in an attempt to get better.
The consequences of doing nothing are obvious. Patients will endure more pain, hospital stays will be needlessly prolonged, precipitating more overcrowding, and the State, already facing a small number of legal actions from patients who picked up MRSA in hospital, could face a flood of compensation claims.