Learning Workshop 2
Wednesday 20th January 2010
  

Leasowe Castle, Wirral

MRSA Action UK were delighted to be able to attend the second workshop with Care Homes and staff from Wirral Primary Care Trust.  

Dr David Lyon opened the event and gave an update on the monthly measures that care homes in the programme had taken part in and the importance of measurement "without measurement it is impossible to know whether you have improved". 

Dr Lyon highlighted some of the examples of work on infection prevention that had been done to bring about improvements in Care Homes in the Wirral area.

Brookfield Nursing Home had reported improvements they had developed for ensuring commodes were cleaned after each use, using the correct cleaning products and effective use of personal protective equipment.  All members of nursing and cleaning staff were observed in their technique and spot checks were carried out.  Having found that some commodes were not being cleaned effectively a training programme was implemented on correct technique, use of the right products and personal protective equipment, and information on healthcare associated infections and how they are spread.

Elderholme Nursing Home reported improvements with measures to ensure all staff were compliant with cleaning standards and effective hand hygiene was being followed by staff and residents.  Observation and the use of light boxes identified the need to improve hand hygiene and appropriate use of personal protective equipment.  Training was delivered to all residents and visitors with the use of the light boxes and training packs were prepared on infection control and hand washing and facilities made available at reception.  Hand hygiene will continue to be monitored.

Barnston Court Nursing Home reported improvements in compliance with hand washing before meals, observations had been carried out and some service users were identified as lacking knowledge about the importance of hand hygiene in preventing infections.  The home provided training and now service users always wash their hands before meals and have indicated they do not wish to eat until they have done so.

Maria Cann facilitated two breakout sessions on Multi Agency Working and the importance of communicating and working together to ensure residents who are in the healthcare system are protected from healthcare infections.  Sharing information on infection status and treatment was important even though good infection prevention and control carried out assiduously is the best way to stop the spread of an infection, it is important that those who need to know are aware of treatments and measures that are in place with the residents care plan.  Maria covered the role of informal carers who played a very significant role in helping to look after people who may have invasive devices such as catheters or feeding tubes in place.  Infection prevention and control is important to those people, and communicating with the patient and carers to ensure these measures were in place was important.

Data on cases of Clostridium difficile showed that although cases were reducing in the hospital setting, proportionately there was a rising trend in the proportion of cases identified outside of the hospital setting.  Clostridium difficile stays in the gut for around 6 months so if a patient has had the bug previously they remain at risk of contracting it or contaminating the environment or hands for some time afterward.  Around 65% of the cases that had been reported were outside of the hospital setting over the last year, in some Primary Care Trusts it was as high as 75%.  The North West region had the most cases, and in January 2009 there were 1,000 people reported as having Clostridium difficile infection in the region. 

Mavis, Dale and Karl Law attended on behalf of the charity and shared their experience with those who attended.  Staff were moved by the experience and it helped put the importance of preventing infection into context.  Colin's story was particularly poignant as he had passed away just one day before his 33rd birthday through contracting MRSA in an IV line, something that could so easily been avoided.  Maria spoke of the multi agency approach that was needed with her mum when she had cancer, involving everyone who needed to know in treating her MRSA was key to ensuring she was protected due to being immune suppressed when receiving palliative chemotherapy.  Maria highlighted good practice in communicating.  There was some debate over whether the programme developed by the Department of Health was bringing about improvements.  It was felt that there had been a great deal done to bring the importance of infection prevention and control to the forefront of care, but this was something that would need to continue across all care settings, with antimicrobial resistance always on the horizon resources would always have to be put into prevention rather than cure.  Maria had expressed concern over funding only being available to 2011 for the Improvement Teams and there was also news that central support would cut on promoting hand hygiene through the National Patient Safety Agency.  Work would continue on lobbying for infection prevention and control to remain a top priority for the Department of Health.