Questions to ask if making a complaint about MRSA

1.                  Do you normally screen patients prior to admission for procedures / surgery?  [Was the patient screened?]

2.         What strain of MRSA was it?

3.         Is this strain of MRSA usually regarded as life threatening? [Was the patient’s life in danger?] [If your loved one has passed away - Was this a contributory factor in the patient’s death, and is this recorded on the death certificate?]

4.         What risk does MRSA present to patients and visitors, and how is that risk managed, for example through isolation nursing?

5.         At what stage do you normally inform the patient and visitors of the acquisition of MRSA, once this has been established?

6.         What precautions do you tell patients and visitors to take when the acquisition of MRSA has been established?

7.         Do you have an information leaflet that outlines the precautions needed to protect visitors and patients?

8.         Have you thought of personalising leaflets so that patients know what type of MRSA they have, and what is being done to treat it?

9.         How do patients/relatives access the Infection Control nurse?  Are they mentioned in the MRSA information leaflet?

10.       Are all clinical staff trained in aseptic technique for invasive procedures?

11.       Do all nurses including agency nurses receive training in hand washing practice, and aseptic technique?

12.       How do you audit compliance with hand washing?

13.       Was information about the patient’s infection shared with the Primary Care Trust, and other Healthcare Teams or Agencies?

14.       Have all clinicians and consultants access to laboratory results?  Are there follow up mechanisms on computer for the results and actions needed on this system?  Are all relevant staff trained on how to use the system?

15.       Does the hospital have the Clinical Negligence Scheme for Trusts accreditation for the quality of entries in health records?

16.       [Cancer patients]  Does the Trust screen patients for MRSA prior to prescribing chemotherapy or radiotherapy / palliative or curative treatment?

17.       Does the Trust have policies for the management of diabetic patients who may be immuno-compromised and at risk from infection?

18.       Does the Trusts Healthcare Facilities Cleaning Manual reflect the latest changes in cleaning technologies and practices?  Are cleaning teams directly managed on wards, and are staff trained in the Trusts Infection Control procedures?

19.       Do you offer patients and carers contact with support agencies, such as MRSA Action UK, or CRUISE?

Ask if your Hospital Trust is Compliant with the Hygiene Code and if there are any measures in the Hygiene Code they have not met, what date they will be compliant.  This is a statutory requirement, a copy of the Hygiene Code is available here

The ratings for your hospital are available on the Department of Health website here

You may wish to ask additional questions relating to the Trust’s Annual Self Assessment, particularly if your Trust is not showing a year on year reduction in the numbers of MRSA cases. 

What response will the Trust be giving in its self assessment this year, for the core standard C4(a) in the safety domain?  Will it be compliant, not met, or insufficient assurance?

[Standard C4 (a) - Healthcare organisations keep patients, staff and visitors safe by having systems to ensure that the risk of healthcare acquired infection to patients is reduced with particular emphasis on high standards of hygiene and cleanliness, achieving year on year reductions in MRSA]

Does the Trust meet Developmental Standard D1?

[Developmental Standard D1- Health care organisations continuously and systematically review and improve all aspects of their activities that directly affect patient safety and apply best practice in assessing and managing risks to patients, staff and others, particularly when patients move from the care of one organisation to another.]