PRESS RELEASE
PROPOSALS FOR IMPROVEMENTS IN INFECTION PREVENTION AND CONTROL
21st May, 2007.
The need for action on MRSA and other Hospital Acquired Infections is finally accepted by the Minister for Health and Children, the HSE and the hospitals. However, the proposed reduction of 20-30% over five years is not acceptable. An almost 70% reduction in MRSA has been achieved by Dr. Ian Hosein in Cardiff over a similar period with similar problems about resources. Research from other countries in Europe and from the USA suggests that the HSE targets are abysmally low.
In 2004 there were almost 600 cases of MRSA blood stream infections in Ireland. In the same year there were 4 such infections in Norway and none in Holland. We have no idea how many MRSA bone or respiratory infection there were in Ireland in any year, neither do we have any idea of how many people have died from HAIs. Dr. Kevin Kelleher of the HSE has estimated that around 200 people per year die of MRSA.
It is noted that casualties from other Hospital Acquired Infections, such as clostridium difficile, are not included in these figures. It is also noted that going on the evidence we have seen in Holland, measures to prevent and control MRSA also prevent and control these other infections, and deaths from such infections are almost unknown there, as are closures of hospitals because of so-called ‘winter vomiting bug’ which are a regular feature of life in Ireland.
It makes very little sense to claim, as has been done recently, that the situation here is marginally better than it is in the UK, when, they, along with us, are the worst in Europe. If we aspire to a ‘World Class’ health care system, we need to be looking at truly world class standards.
We fully support the implementation of proper hand hygiene, and would further suggest that it, and other strategies proposed under the SARI guidelines (1995, 2005, 2006), be made mandatory under regulations in an updated 1947 Health Act. We would like to see the appointment of a National Director of Infection Prevention and Control and that s/he should also be empowered to reform hospital management as far as infection control is concerned, and have authority over all hospital personnel, including medical staff.
We fully support a proper National Surveillance System, and demand that the International Classification of Diseases code be fully updated in Ireland so that incidences of death with MRSA as a primary or contributory cause can be fully recorded.
We demand that patients who have an MRSA infection be properly informed, as this is still not happening, and that they and family members are given the necessary knowledge to be able to manage the condition when they are discharged. We also demand that proper and adequate care is given to MRSA casualties in the community immediately without lengthy and distressing lobbying, and that the law about disposal of medical waste is observed by the health care professionals involved. We are receiving reports that patients who have previously contracted MRSA in hospitals are being disrespectfully treated by staff when they go back into hospital, and that some patients have met with difficulties in accessing follow-up care by GPs and hospitals. This should cease immediately, and MRSA patients should receive the care they are entitled to. It is the responsibility of the HSE and the hospitals to deal with infections, not to blame the patient; we feel this is what is occurring in some cases at present.
In addition to more hospital beds which are urgently needed, more isolation rooms should be provided. Increased screening of patients and staff is also needed in order to properly identify infections and to put essential speedy treatment in place. Rapid detection machines have already been approved in the US and in Canada. We are told that they will be subjected to further research here leading to more delays.
For those people who have already suffered as a result of MRSA infection, we are looking for a Compensation Board so that those who have lost limbs, livelihoods, relationships and health are properly and speedily recompensed without having to go through lengthy and expensive legal cases. This, of course, also applies to those who have lost family members through HAI. We have been pointing out for some time that the 1995 SARI guidelines have been ignored. Now we have documentary evidence supporting this claim:
From a consultant in a hospital in the West : “there is continuing failure to isolate patients with MRSA and this is causing what now must be regarded as an epidemic in one particular ward” (Sept. 2000).
“I would obviously be concerned that this standard of infection control is not satisfactory and is putting my patients and the patients of other consultants at risk of cross infection” (Sept. 2000).
(“I believe this is now a matter of public interest because of the ongoing risk now for many years to other patients and staff especially since the appropriate action of supplying additional nurses to facilitate the nursing of all patients with MRSA in single rooms or a cohorted ward used solely for MRSA patients) has not been undertaken ( Sept. 2000)
From a Divisional Nurse Manager: “Proper cleaning on the wards pertains to be a huge problem and the lack of adequate supervision makes it even worse. [names of two wards]… are absolutely filthy with all due respect and this needs urgent attention (Jan. 2001).
From a consultant: “Management did not comply with the request [of nurses] to seek an isolation room for the patient in the eight bedded section and he was left in this area exposing other patients without MRSA to the risk of acquiring this infection. This is most unsatisfactory. Not only is it in the of the hospital guidelines on infection control but in addition the {consultants] do not have adequate facilities in the Ward to deal with MRSA control”. (Feb. 2002).
From a hospital General Manager: “I wish to advise that where possible, every effort is made to nurse MRSA patients in accordance with the Policy, however, this is not possible all of the time. During the period in question, there were high levels of MRSA, CDiff, VRE as well a a requirement to provide isolation facilities for suspected cases of SRV. In this instance, constraints in relation to isolation did not allow for full compliance with Policy”, (April, 2002).
Hospital management should be made to co-operate with the requests for non-personal information from the legal representatives of MRSA casualties under the Freedom of Information Acts, 1997-2003.
SUMMARY.
MRSA and Families Network are looking for the following:
- Adoption of proper ‘World Class’ goals.
- Hand Hygiene and other SARI guidelines be made mandatory under an updated 1947 Health Act.
- The appointment of a National Director of Infection Prevention and Control.
- Incidence of death from MRSA or other HAI be properly recorded.
- We demand that patients who have an MRSA infection (and family members) be properly informed.
- Proper and adequate care is given to MRSA casualties in the community immediately without lengthy and distressing begging, and waste is properly disposed of.
- More beds and more isolation rooms.
- Rapid detection systems.
- A Compensation Board so that those who have lost limbs, livelihoods, relationships and health are properly and speedily recompensed without having to go through lengthy and expensive legal cases. This is supported by evidence that SARI guidelines were not being implemented.
- Hospital managements to provide non-personal information from the legal representatives of MRSA casualties under the Freedom of Information Acts, 1997-2003.
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