To ask the Minister for Health the reasons five hospitals were found to have lapses in standards for infection control; and if he will make a statement on the matter.
Reply from the Minister for Health James Reilly T.D.
I am pleased to inform the Deputy that MRSA rates are at a 6-year low and I would like to assure the Deputy that the management of Healthcare Acquired Infections (HCAIs) 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 the issue. These include the HSE’s National Infection Control Action Plan, launched in 2007 and a National Surveillance System to collect data and provide information to monitor HCAIs; the establishment of the Clinical Care Programme for HCAIs also supports this aim.
In relation to the recent Health Information and Quality Authority (HIQA) reports on four hospitals 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 in the delivery of healthcare in Ireland. With regard to hand hygiene the findings of the Authority suggest that hand hygiene best practice needs to become more operationally embedded at all levels. I must emphasise that it is of vital importance that healthcare workers recognise their personal responsibility to protect patients by maintaining their own good hand hygiene.
To improve hand hygiene a series of actions are in place, a key element of which is the HSE’s continuing bi-annual hand hygiene audits which occur both in the acute sector and in the long stay area as well. Additionally, from July this year it will be mandatory for all staff to receive hand hygiene training as part of staff induction and a hand hygiene education programme as continuous training.
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 and national participation in the WHO’s annual Hand Hygiene Day on 5th May 2013 with all hospitals engaging in local initiatives
· 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 HCAI implementation group monitors and reviews all HCAI activity in the health system.
The four 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. The hospitals in question will receive a letter indicating general outcomes and lessons to be learned.
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 (a drop to 242 cases (59% decrease) to end-2012 (provisional figures)). 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.