Your hospital survival guide: The ingenious tricks that can save you from superbugs and other hospital disasters

By Matthew Barbour
Last updated at 11:54 PM on 15th February 2010

A trip to the hospital - whichever side of the sheets you're sat - is not meant to be fun, but the prospect of ending up ill as a result of your visit is enough to make anyone afraid.

Hospital-acquired infections are still a major concern. A recent Parliamentary report warned that the NHS has become so focused on MRSA and c.difficile - responsible for just 15 per cent of hospital-acquired infections - that there is a risk of ignoring much more common dangers, such as e.coli, which soared by 33 per cent between 2003 and 2007, to around 22,000 cases.

'The best available evidence is that other - equally deadly, but also avoidable - infections, such as surgical site infections and pneumonias, have increased,' said the report committee chairman Edward Leigh.

But it's not just infections that pose a danger to hospital visits - in 2008 more than 8,000 patients were more malnourished leaving hospital than when they went in.

'Malnourished patients have 30 per cent more complications and a 40 per cent higher mortality rate,' says Dr Mike Stroud, consultant gastroenterologist at Southampton University Hospital.

'This is because when you're seriously ill, your body often needs more energy in the form of calories and vitamins than a healthy person to recover.'

So if you have to venture through those swinging doors, what can you do to make sure you leave in a better state than when you went in?

DOSE UP ON ASPIRIN

Swallowing 300mg daily for three days prior to surgery can halve your risk of developing a deadly infection, according to research from Dartmouth College in the U.S.

It won't help once you've got one of the Staphylococcus infections (which can include MRSA) it can help prevent it in the first place. It works by stopping the bacteria multiplying.

However, you should avoid aspirin if you're already taking any anticoagulant drugs - as aspirin also thins the blood - or if you have a stomach ulcer as it can further irritate the stomach lining, says Sean Woodward, of the Royal Pharmaceutical Society.

'In high doses it can prevent blood clotting, so don't take any on operation day, without your surgeon's consent.'

It also shouldn't be given to under 16s, as it can cause Reye's syndrome, a rare brain and liver condition, or to asthmatics as it can trigger attacks. 

KEEP VISITORS OFF THE BED

If they truly wish you a speedy recovery, your visitors should take a seat in a chair, not on your sheets.

In a study published in the British Medical Journal, researchers found that a combination of infection-control strategies that included eliminating visitor contact with a patient's bed was able to stop the spread of MRSA and reduce the number of infections by 70 per cent.

'Clothes can carry potentially dangerous bacteria and viruses, yet aren't washed like your hands as you enter a ward,' explains Dr Ron Cutler, microbiologist at Queen Mary University, London.

'Chairs are seldom properly cleaned, so can harbour millions of bacteria, which can be picked up by the hands when sitting down or getting up, so you then transfer those bacteria to sheets when you sit - avoiding contact with a patient's bed has to be at the top of anyone's list.'

ASK FOR AN EARLY MORNING OPERATION

Patients whose procedures started near 9am were four times less likely to have anaesthesia complications - nausea, post-operation pain, fluctuating blood pressure - than those wheeled in around 4pm, according to an analysis of 90,000 operations by U.S. researchers.

Blame fatigue and overbooked doctors arriving late to the operating theatre, they suggest.

WASH YOUR HANDS

The infection risks from sharing a bathroom are obvious. What isn't so apparent is the risk you pose to yourself.

'More often, organisms that cause infections come from the patient's own home-grown bacteria,' explains Dr Ron Cutler.

Regularly throughout the day, as well as after every trip to the loo, wash your hands with antibacterial soap and hot water for a full minute.

'It won't kill bugs, but it will help dislodge them, so there's less chance of them entering your system,' Cutler says.

'Most importantly, always dry your hands completely after washing, as any lingering moisture can harbour harmful viruses and bacteria.'

While washing every hour is a sensible plan of action, be especially wary every time you've touched door handles or are about to eat, he adds.

TAKE A PHOTO OF YOUR DOCTOR

You will see countless doctors, nurses and other people during the course of a day, so it's important to know exactly who the doctor in charge of you is.

Grab your camera phone and take a picture of him. In a recent study published in The Lancet, researchers found that patients with a snapshot of their doctor were better able to identify them.

This, in turn, helped cut down on the number of medical mistakes caused by patients giving information to the wrong medical personnel, who might not spot relevant changes in your condition or give misleading advice.

'Make sure everyone who talks to you identifies themselves, and convey changes in your condition only to the doctors and nurses involved in your case,' says Gail Van Kanegan, an advanced practice nurse and author of How To Survive Your Hospital Stay.

DON'T TOUCH THE TOYS

Any children coming to visit need to be kept away from toys littering the waiting room.

When University of Nottingham researchers swabbed the surfaces of 12 toys in an intensive-care unit, they found half of them swarming with various strains of bacteria, including staphylococcus aureus (linked to everything from minor skin ailments to pneumonia and meningitis).

'Bacteria and skin cells from patients are easily transferred to objects like toys, magazines and books, which, unlike medical equipment, aren't cleaned frequently,' explains researcher Dr Jacqueline Randle.

'Just because it's not actually used during surgery, don't assume it's not a danger.'

DRINK PLENTY OF WATER

Hydration equals healing. 'In order for the body to heal, the cells must have sufficient amounts of water,' says Dr Ron Cutler.

'If you're dehydrated, you're at risk of infection, pressure sores, electrolyte imbalances in your blood that can leave you feeling nauseous and weaken your immune system, heart irregularities and other complications, especially if you're older. Dry airways also give harmful bacteria open access.'

Aim for two litres of fluids a day in the two weeks before your hospital visit and keep topped-up with the same intake during your stay.

COVER THE STETHOSCOPE

While your doctor's checking your heartbeat, millions of bacteria are going on to your body - so ask them to sanitise the stethoscope first.

Just as effective: a disposable latex glove over its round bit, or an antimicrobial coating called AgIon (ask - they'll know what you're talking about, as it is a standard product used in hospitals).

Similarly, while a small percentage of healthcare workers are compulsively clean, 'others wash their hands only when they think they've got them dirty,' says Gail Van Kanegan.

Ask for a pump dispenser of alcohol-based sanitiser for your bedside table - the staff will get the hint, as will your friends and family.

This is particularly important before any procedure that breaks your skin, from an injection to a minor operation, says Hugh Pennington, emeritus professor of bacteriology at Aberdeen University.

'Insist the GP or nurse cleans their hands with the sanitiser and check the equipment is sterilised.'

EAT MORE

If you've noticed any weight loss before or during your hospital visit - rings become loose, your belt needs to be tighter - increase your calorie intake with nutrient and energy-rich foods to avoid malnutrition.

'Your body needs more energy than usual to repair and fight off bugs, so opt for full-fat milk, butter, fill up on carbohydrate-rich foods such as pasta and always have pudding,' says Eileen Steinbrock, of the British Dietetic Association.

'Too many elderly people live off bread and butter and tea because they don't cook for themselves, which means they often enter hospital with a calorie deficit - it's much better to worry about your weight when you're fit and well than to take risks.'

Men should aim for at least 2,500 calories a day, and women at least 2,000 calories, including three main meals, snacks and plenty of fluids.

ASK FOR ANOTHER BLANKET

On the morning of your operation, clip all your nails short (minimising the chances of bacteria hiding underneath), then have a 15-minute piping-hot shower, using antibacterial soap to scrub every nook and cranny of your body, advises Derek Butler of the campaign group MRSA Action UK.

Try Boots Antibacterial handwash (99p), containing ticlosan, an antibacterial chemical used in many cleaning products.

Before you go under anaesthesia, ask for an extra blanket for your bed.

The combination of a cold operating room and anaesthesia can lead to mild hypothermia, which can slow the post-operation healing process.

TAKE AN APPLE (BUT REMEMBER TO WASH IT FIRST)

DO YOUR PREP
Before going under the knife, find out the infection rates of the hospital you�re being booked into, advises Derek Butler of the campaign group MRSA Action UK.

Under the new "Book and Choose" system, it's your right to choose any hospital in the country or, if you can't get surgery in the required time, even to go abroad, with the NHS paying," he explains.

Find out all comparative infection data at NHS Direct, NHS Choices, or at mrsaactionuk.net which updates the latest figures monthly. "In my experience, GPs can be very reluctant for you to go anywhere other than the local hospitals where they trained, but don't take no for an answer if you're not satisfied," adds Butler.

GIVE UP SMOKING

Smoking reduces the amount of oxygen carried in your blood, which means you not only heal slower - so you'll be stuck in hospital longer - but your immune system is weakened, leaving you more vulnerable to any nasty bugs around the ward.

In fact, according to one U.S. study, smoking just ten cigarettes a day in the two weeks preceding a hospital operation can increase your length of stay by up to a third.

Another study found that cigarettes also contain large numbers of bacteria linked to lung, blood and food-borne infections, which the authors believe can survive the smoking process to enter your system. Quit, and in just six months your blood will be restored back to its full healing potential. 

PACK WELL

"Pack a bag with a change of clothing, two sets of pyjamas and slippers, all wrapped in clean carrier bags to keep them free of dirt, along with awash kit, two toothbrushes (one for pre-op use and one for post-op, to reduce the risk of infection), and plenty of washed fruit to keep your energy reserves up - don't assume others will bring it for you," Butler adds.

http://www.dailymail.co.uk/health/article-1251327/Your-hospital-survival-guide-The-ingenious-tricks-save-superbugs-hospital-disasters.html

Rising obesity prompts higher antibiotic doses call

Emma Wilkinson

Health reporter, BBC News

Friday, 15 January 2010

Patients may have to be prescribed higher doses of antibiotics because of rising rates of obesity, say doctors.

The standard "one-size fits all" dose may not clear infection in larger adults and increases the risk that resistance will develop, they argue.

More work is needed to guide GPs on how and when to alter doses, an editorial in The Lancet to accompany the study by doctors from Greece and the US says.

GPs said it was an interesting theory but may end up being expensive.

Around one in four adults in England is classified as obese - an increase from 15% in 1993.

Patients are getting taller and larger and it does seem right that patients are given the appropriate strength of drug

Professor Steve Field, Royal College of GPs

Given the fact people are getting larger, use of standard doses of antibiotics in all adults, regardless of size, is outdated, argue two doctors from Greece and the US.

Size and even the proportion of body fat a person has, can affect the concentration of antibiotics in the body, potentially reducing how effective they are in larger patients, they say.

And failure to clear an infection because too small a dose is given may raise the risk of resistance - already an increasing problem for doctors.

Likewise, smaller than average patients may get too much drug, and suffer greater side-effects as a consequence.

Guidance

An accompanying editorial said dose adjustments could easily be made if research was done to guide doctors in treating obese patients.

Professor Steve Field, chair of the Royal College of GPs said he would encourage "appropriate" antibiotic prescribing and lots of patients are given them unnecessarily.

But he added: "Patients are getting taller and larger and it does seem right that patients are given the appropriate strength of drug.

"However, this might cost a lot of money because pharmaceutical companies would have to provide different doses of medication.

"At the moment, most come in two strengths and we would not want to see an increase in costs."

He added that GPs will already use their judgment to alter medication doses where necessary.

Professor Hugh Pennington, an expert in antibiotics from the University of Aberdeen, said antibiotics would differ in how size altered their effectiveness.

"But studies on this would not be hard to do.

"If you have too little of a drug it's not going to be good for treating the infection but it also raises the possibility that the organism will become resistant.

"They're such powerful drugs, we want to make sure we are using them properly."

Derek Butler talks to Phil Williams, BBC Radio 5 Live

Friday 27 November 2009

Derek Butler, talks to Phil Williams BBC 5 live, about the damning findings revealed during spot checks by the Care Quality Commission, and asks whose responsibility is it to ensure a clean, safe environment?

Derek Butler, you'll know, the Chair of MRSA Action UK, you'll have anecdotal evidence of how widespread this is across the UK, how widespread is it, this problem of dirty hospitals?

"It's quite widespread, because in 2007 when the Maidstone and Tunbridge Wells incident was reported we actually gave the Health Minister Ann Keen information to show that there were 50 trusts worse than Maidstone and Tunbridge Wells.  When the Mid Staffordshire incident came out in March of this year we presented to the Department of Health the Dr Fosters Hospital Guide showing there were hospitals with standardised mortality rates similar to Mid Staffs, and we actually said that if they looked at that information they would see that, the Department of Health appear not use the information in Dr Foster's Hospital Guide for some reason we don't know why, but we have actually asked them to use it and to correlate this data to send Improvement Teams in.  What we are annoyed at as a patient group, is that these are human beings that are being affected and their families, what we seem to forget is that these people have had unnecessary deaths and the effects ripple through to their families and their lives have been changed forever, they are never going to be the same.  The Government have to take some responsibility for this, because we have evidence that the Department of Health are removing the Improvement Teams from April, who go in to look at these hospitals. They're removing the central support from NPSA and the cleanyourhands campaign and leaving the hospitals to get on with it themselves. There was supposed to be a patient and public information campaign to go out to the public to ask them about the hospitals and hand hygiene, and to make them aware of the problems and infections, and they've delayed that now til spring 2010, it was supposed to be done this year but the Government have delayed it. Now with respect to them these are not isolated incidents, we've heard Alan Johnson say it twice, I hope Andy Burnham doesn't say it, they are not isolated, it is happening and it will happen again until the regulators tighten up."

Derek what are we talking about is it lack of staff?

"It's not just lack of staff.  It's the general ethos within the NHS, I work for an industry that's the most regulated in the world, and I heard your first speaker talk about things on the floor and reporting them.  You don't report dirty bloodstains on the floor, you clean them, it's getting the nursing staff to clean up, it's getting whoever spots it to clean up."

You are not saying that nurses are wilfully ignoring that kind of stuff are you?

"No what it is, is the demarcation, if you look at the nurses there are certain things they'll clean and certain things they won't.  The Basildon example was the catheter bag on the floor, that's a nurses responsibility, you've got torn curtains in the ward, surely the staff must have seen them and reported them and said they wanted something doing about it, in my industry the staff take responsibility for their environment and they take ownership of that."

Baroness Young, former Head of the CQC resigned later that week with reports in the media of a rift with the Health Secretary over the way the reports were released.

A&E patients are admitted minutes before Government deadline 'to meet targets'

By Daniel Martin
Last updated at 10:50 PM on 18th November 2009

Patients from casualty units are being admitted to hospital wards in pre-deadline surges to beat the Government's four-hour waiting target, it emerged yesterday.

Medical chiefs said the practice meant people with minor needs were being prioritised ahead of those with more serious conditions --and that it is hitting the fight against superbugs.

Figures from the NHS Information Centre indicate that thousands are being bundled on to wards to avoid breaching the target that no one should have to wait longer than four hours to be treated in A&E.

Although most A&E patients are seen within the four hour guideline, figures a disproportionate amount are admitted in the last 10 minutes of the window.

Earlier this year, pressure to meet Whitehall targets was blamed by the health watchdog for the deaths of up to 400 patients at Mid Staffordshire Hospitals Trust.

Derek Butler, chairman of MRSA Action UK, said yesterday: 'The four hour target is good but we know that hospitals are fiddling them so they don't breach the target.'

Figures from the NHS Information Centre reveal that there is a peak in the number admitted to a ward in the ten minutes before the four hour deadline is up.

Almost all patients in England are seen within the four-hour target, and 21 per cent are admitted.

But the percentage admitted peaks in the last ten minutes before the cut-off, when 66 per cent go on to a ward. Six per cent of all people are dealt with in this final ten minutes, although at some trusts 15 per cent wait this long.

Dr Mark Porter, of the British Medical Association's consultants committee, said: 'It is worrying that in some areas there is an increase in the number of patients leaving emergency departments just before the four-hour deadline.

'This suggests that when patients have been waiting close to four hours, there is a rush to discharge or admit them so that the hospital meets the four-hour target.'

Those admitted to hospital wards in the pre-deadline surge are often not screened for superbugs, putting other patients at risk, it is feared.

Mr Butler said: 'Not everyone who gets placed on a ward will be tested for a superbug because to do so would grind departments to a halt.'

'Patients should not be put at risk in any way shape or form just to meet a target,' he added.

Health minister Mike O'Brien said: 'Meeting the standard does not mean that the quality of care is compromised. We have always made it clear that quality of care and clinical need must come first and we expect trusts to ensure that patient safety is their first priority.'

NHS is 'losing track of rising death toll from hospital bugs'

By Daniel Martin

Last updated at 9:45 AM on 10th November 2009

Thousands of patients are dying because the Health Service has 'taken its eye off the ball' on many types of hospital infection, warn MPs.

They say the NHS has become so focused on tackling two types of bug - MRSA and C.diff - that it has lost track of the rest.

Only 15 per cent of health care-acquired infections are down to MRSA and C.diff - meaning that more than 80 per cent are falling under the radar.

Studies show there have been dramatic increases in the number of hospital patients coming down with other bugs such as E.coli.

But the NHS says it has no idea how many deaths there are every year from healthcare-acquired infections other than MRSA and C.diff.

Ministers have ignored calls to force trusts to record all cases but experts say annual fatalities run into the thousands.

A report today by MPs of the Commons public accounts committee warns that the cost of dealing with the hospital bugs crisis costs more than 1billion pounds a year.

It says the situation could get worse because bugs are becoming resistant to antibiotics because of overuse.

Whitehall waiting-time targets have also put people at risk because beds are not being left empty long enough for them to be properly cleaned, according to the report

Committee chairman Edward Leigh said: 'The Department of Health has achieved significant reductions in MRSA bloodstream and Clostridium difficile infections, for which it set national targets. But, in so doing, it has taken its eye off the ball regarding all other healthcare-associated infections.

'The best available evidence is that other - just as deadly but also avoidable - infections, such as surgical site infections and pneumonias, have increased.'

He said progress was being hit by a lack of decent data.

'The Department is refusing to introduce mandatory surveillance of all hospital acquired infections - as we have recommended twice,' he said. 'If it had, it would now have a better grip on what is going on.'

One estimate is that 300,000 people suffer from a healthcare-associated infection every year - 8 per cent of all hospital patients.

Derek Butler, of campaign group MRSA Action UK, said there were likely to be up to 20,000 deaths a year from infections not being monitored by the NHS.

Figures in the MPs' report show that while MRSA and C.diff rates have fallen, other infections - which can be just as dangerous - have shown dramatic increases.

Cases of E.coli soared 33 per cent between 2003 and 2007 to around 22,000, while the bug 'Klebisella spp' is up 34 per cent to 5,000 cases.

The number of victims of 'coagulase negative Staphylococcal' has risen by 90 per while MSSA is up nine per cent.

The total number of bloodstream infections - not including MRSA and C. diff - is estimated to have risen from 80,000 in 2003 to 105,000 in 2007.

Exclusive: Nurse who caught MRSA in 'dirtiest' hospital ward sues NHS

Oct 25 2009 Marion Scott

A NURSE is making legal history by suing the NHS after contracting MRSA in the hospital where he worked.

Mark Thompson, 45, from Glasgow, is launching a 50,000pound claim against Greater Glasgow & Clyde NHS.

He claims his health has been destroyed after being infected while working at the city's Victoria Infirmary three years ago.

Mark said the working environment in his medical ward was dirty and little attention was paid to patient hygiene.

He became infected after grazing his shin while moving beds around the ward and remained off sick for a year.

The MRSA infection "ate away" a quarter of an inch of flesh from his right shin.

He said: "The ward I worked on, 17, wasn't particularly clean.

"There were also patients who had abused drink or drugs and sometimes their personal cleanliness wasn''t a priority.

"While I was in the Victoria Infirmary being treated for the infection, a cleaner from ward 17 stopped by to see me and told me it was the dirtiest in the whole hospital.

"The graze got infected and tested positive for MRSA.

"I had four flare-ups and also developed the very similar and painful infection cellulitis because my skin and system had been compromised.

"In the end, I was hospitalised twice and my health has completely broken down.

"I was forced to spend so much off, almost a year, my contract was terminated.

"Because my system has been so badly compromised with MRSA, I'll probably never be able to work in a hospital or nursing home again. There must be thousands out there suffering the same risks."

In a report prepared for the legal action, infection expert Professor Hugh Pennington said: "On the balance of probabilities, the source was a hospital as it is much more common there than in the community."

Last year, Mark's lawyer Cameron Fyfe launched the first MRSA test case to be heard in a Scottish court.

The case involves great-gran Elizabeth Miller, 72, of Kilsyth, Stirlingshire, who contracted MRSA while recovering from a heart op at Glasgow Royal Infirmary in 2001.

She was given the go-ahead to proceed in the Court of Session last summer and the landmark case is due to start in next month.

Irenee O'Neill of the Independent Federation of Nurses said: "We don't believe there's nearly enough screening."

An NHS Glasgow spokeswoman said: "It would be inappropriate for us to comment any further on the circumstances of his departure from the NHS."

m.scott@sundaymail.co.uk

Friends of a teenager who died of MRSA at the University Hospital of North Staffordshire took part in a fun run in her memory.

More than 40 runners donned fancy dress to take part in the event at Westport Lake, in honour of student Sam Fallon who died in May last year, aged 17.

Organisers have already collected 370 pounds and are hoping to be able to donate a total of about 700 pounds to MRSA Action UK.

Eighteen-year-old Jade Hampton, who had known Sam for seven years, organised the event.

Sam, from Campbell Road, Stoke, had suffered from an auto-immune liver condition since she was 12.    

Pictured left is runner Clive Duncan, dressed in May And Mar Lady attire

Read tributes to Sam and leave your message at Lasting Tribute

Blackburn baby unit superbug spotted by 'vigilance'

5:21pm Monday 28th September 2009
By Neil Docking

HEALTH bosses have said how "constant vigilance" helped them identify a superbug in the neonatal intensive care baby unit.

Seven children contracted MSSA - methicillin sensitive staphylococcus aureus - at Blackburn Royal Hospital, leading to admissions being limited.

MSSA is bacteria found commonly on the skin and can be treated with anti-biotics. If it turns into an infection in the bloodstream it can cause serious illness.

The babies have the bacteria on their skin - but it is not in their blood-streams, and none are currently ill, according to hospital chiefs.

They are being treated in isolation and may remain in hospital for several weeks to ensure they are free of the bacteria.

Rineke Schram, director of infection control for East Lancashire Hospitals NHS Trust, said the superbug had been caught at a very early stage thanks to the hospital's screening processes.

Beverley Aspin, lead infec-tion prevention and control matron, said the hospitals employed a huge range of infection control procedures.

She said: "Hand washing is only the first line of defence.

"Bacteria are invisible to the naked eye, and reproduce very quickly, so can still linger undetected on soft furnishings and clothing."

Measures include:  Screening patients for MSSA in advance of planned operations, and prescribing antibacterial wash to use if necessasry in the days before the operation;  Isolating in-patients found with a resistant organism or potential infection to prevent its spread; Ensuring staff are fully trained in a non-touch technique to reduce the risk of acquiring infections;  Insisting staff adhere to the "bare below the elbows" protocol, meaning they can decontaminate hands effect-ively and prevent micro-organisms passing from one person or surface to another.

Ms Aspin said: "Any area which is known to have had an infection-causing bacteria is deep-cleaned.

"This means it is emptied, with all hard surfaces cleaned with anti-bacterial agents."

Derek Butler, chairman of MRSA Action UK, advises patients and families who have experienced superbugs such as MSSA and MRSA.

And the 54-year-old from Kirkham said MSSA can be lethal if it enters the bloodstream.

He said: "With these babies the doctors and nurses in Blackburn now have to be very careful.

"If they are infected with it on their skin and then are given intravenous treatment this will increase the risk.

"I am sure these doctors and nurses will be highly- trained and will follow these procedures but everybody needs to know MSSA can be contracted in a number of ways."

MRSA Action welcomes new CQC study into hospitals and care homes

Wednesday 23rd September 2009

A new study by the Care Quality Commission (CQC) involving the prevention of avoidable infections has been welcomed by MRSA Action UK.

The CQC is examining arrangements for care homes and hospitals to work in conjunction with each other in this area and the charity said it hopes the research will enable it to better understand the measures required to make improvements.

MRSA Action claimed to be in favour of a "joined up approach" to care and stated that good communication is the key to making this work.

Pointing to a programme by the Improvement Foundation that has had success in this regard, it stated: "We would like to see the CQC look at this good practice and ensure that all care providers are taking their responsibilities seriously and not working in isolation."

Founded by a number of people who have had their lives affected by MRSA, the organisation campaigns for better standards in hospitals and other healthcare facilities in order to improve safety.

Written by Alex Franklin Stortford

Official number of superbug deaths falls 30 per cent in a year, but campaigners say figures don't give true toll

By Jenny Hope
Last updated at 7:55 PM on 19th August 2009

Stringent hygiene measures were introduced in hospitals following an explosion in the number of superbug cases

The number of deaths linked to the hospital infections MRSA and C.difficile fell last year for the first time, official figures show.

Latest data from the Office for National Statistics showed the number of death certificates mentioning C.diff as a contributory factor was down 29 per cent on 2007 to 5,931.

It is the first fall in mentions of the debilitating stomach bug since records began in 1999.

The number of death certificates mentioning MRSA fell by 23 per cent over the same period, to 1,230  -  the second drop running.

But figures covering the past five years put the toll at almost 34,000, with more than 7,000 deaths linked to MRSA and just under 27,000 to C.diff.

Campaigners claimed that was the 'tip of the iceberg', and said there was under-reporting of the infections.

The 2008 figures showed that deaths involving C.diff fell by 27 per cent for men and 30 per cent for women from 2007.

For MRSA, there was a 31 per cent drop among men but only a 13 per cent drop among women.

Derek Butler, chairman of MRSA Action, said the ONS figures were under-reporting the real picture and a study had found many death certificates were wrong.

He said: 'One of our members lost a loved one who had cancer.

'He contracted MRSA in hospital, which prevented him from having chemotherapy that might have helped him live another two years. Yet the death certificate reported only the cancer and made no mention of MRSA.

'The Government and the management of the NHS should introduce technologies used by the Dutch to save lives  -  reducing bed occupancy and providing more isolation facilities and screening. We must not become complacent.'

Dr Peter Carter, chief executive of the Royal College of Nursing, said: 'For any patient to die as a result of MRSA or C.difficile is an absolute tragedy, but these figures do show a move in the right direction.

'Nurses have worked hard to ensure infection rates are reduced, improving the quality of care for all patients.

'However, there is no room for complacency  -  nurses need to be given the necessary authority and resources to ensure that infection rates continue to fall.'

Chief nursing officer Christine Beasley, said: 'Preventing healthcare-associated infections continues to be a top priority for the Government. While one avoidable infection is one too many, we welcome the reduction in deaths associated with MRSA and C.difficile.'

Shadow health secretary, Andrew Lansley, said: 'Despite the welcome decrease in the last year, there are still an appalling number of people dying from hospital infections - nearly three times as many as are killed on the roads every year.

'These statistics expose Labour's failure. Despite years of repeated warnings, many hospitals are still treating patients in crowded wards and lack basic facilities to isolate patients who have an infection.

'The Conservatives are the only party with a zero tolerance policy to tackle hospital infections.

'We would double the number of single rooms in NHS hospitals so that all patients who need to be isolated can be. We are calling on the Government to do the same.'

Read more:
http://www.dailymail.co.uk/health/article-1207619/Official-number-superbug-deaths-falls-30-cent-year-campaigners-say-figures-dont-true-toll.html#ixzz0Oex9AtPb

Public Service Events Conference
The Barbican London - 1st October 2009 
Overview

- Hospitals don't have enough space to create isolation wards, but without them can infections spread?

- Should hospital staff be screened for HCAIs along with patients?

- Can the government help in HCAI prevention or must it be a hospital-based solution?

- Will we ever find a solution to this problem?

Also in this month's edition of
Public Service Review: Health Issue 20: Infection Prevention and Control, Derek Butler shares his thoughts on the drive to improve quality in healthcare in "A pro-patient performance"

NHS faces call for inquiry into 'MRSA death'

Sophie Goodchild, Health Editor
09.07.09

MRSA screening bill pushed in Congress

Wednesday, June 24, 2009

New legislation recently introduced in Congress would help to significantly reduce the incidence of an antibiotic-resistant, hospital acquired infection that kills nearly 19,000 Americans every year.

HR 2937, introduced by Representative Jackie Speier (CA), would require hospitals to screen patients to identify those who are carriers of Methicillin-resistant Staphylococcus aureus (MRSA) bacteria as part of a strategy aimed at preventing the spread of MRSA infections to other patients. The bill requires hospitals to disclose MRSA infection rates to the public and encourages hospitals to follow other measures to improve patient safety. A similar measure (S. 1305) has been introduced in the Senate by Senator Robert Menendez (NJ).

 Patient advocate Jeanine Thomas is pictured speaking on Capitol Hill, Washington, D.C. with Congresswoman Jackie Speier - Photo courtesy of: Politics & Pictures/Linda M. Palmer

The bill seeks to enact nationally what advocates such as Jeanine Thomas have achieved in 32 states, and requires:

-        hospitals to screen all patients entering high-risk units for MRSA infection

-     adoption of best practices including contact precautions among health care professionals to prevent MRSA's spread within hospitals

-     patients testing positive for MRSA be informed of the result and given instructions on how to prevent the spread of their infection when discharged.

-      hospitals to report the number of cases of hospital-acquired MRSA that occur within their facilities.

To track progress click here

World MRSA Day Momentum Builds In The US And The UK

23 Jun 2009   

MRSA Survivors Network, the Chicago-based nonprofit and the official organization that launched World MRSA Day earlier this year is building momentum in the US, the UK and worldwide in its humanitarian grass-roots effort to raise awareness of the MRSA epidemic.

"As governments and world agencies continue to put their focus on swine flu and prepare to spend billions of dollars on it as they did with Avian flu; the true epidemic/pandemic, MRSA continues to be virtually ignored", states Jeanine Thomas, president of MRSA Survivors Network and the National Spokesperson for MRSA. "It is unconscionable what has been allowed to happen and MRSA has been swept under the carpet in healthcare facilities for decades and the purpose of World MRSA Day is to raise awareness."

Healthcare industry companies are stepping up and sponsoring World MRSA Day in the US and in the UK to raise awareness and save lives. In the U.S.; 3M, Tec Labs, Cepheid, Pfizer and others have lent their support and all have become true heroes in this movement to save lives.

The inaugural pre-launch kick-off event in the U.S. will be held Oct. 1st at Loyola University in Chicago with an international press conference, followed by the event. MRSA Action UK, who shares and alliance with MRSA Survivors Network are planning their event for Oct. 2nd. MRSA activists are organizing and holding events in their communities on Oct. 2nd and throughout October, MRSA Awareness Month. Activists can list their event on the official site- www.worldmrsaday.org.

MRSA Survivors Network and fellow activists are pushing for immediate action, legislation, funding, more stringent and pro-active infection control measures and enforcement by the World Health Organization, the Centers for Disease Control and governments to stop the massive loss of life and human suffering from preventable infections. World MRSA Day is embracing all survivors and their families who have suffered or lost a loved one from any multi-drug resistant infection.

Jeanine Thomas of MRSA Survivors Network was the first advocate in the U.S. to raise the alarm about MRSA and other healthcare-acquired infections and began her crusade in 2003. Ms. Thomas is a survivor of MRSA, sepsis, osteomyelitis and C. Diff and became critically ill and nearly died from the results of ankle surgery. She now lives with chronic MRSA infections.

Source
MRSA Survivors Network

Article URL: http://www.medicalnewstoday.com/articles/154878.php

By Jenny Hope
Last updated at 5:54 PM on 18th June 2009

Hospitals have met their target of a 30 per cent cut in patients affected by the potentially deadly C. diff bug.

But the new figures come as cases have started creeping up again, along with a small rise in MRSA infections.

Health Secretary Andy Burnham welcomed the figures, saying the NHS had hit its target of cutting C. diff infections two years ahead of schedule.

New figures have revealed that hospitals have successfully slashed superbug cases by a third - but one in 12 still contracts an infection

But critics claimed efforts to eradicate the bugs had reached a plateau and a new drive was needed to tackle these and other health-care associated infections.

One in 12 patients contracts an infection while in hospital in England, according to the National Audit Office.

Latest figures from the Health Protection Agency for January to March in England show there were 8,358 cases of C. diff in patients aged two and over.

This was a 36 per cent reduction over the same period last year, when 12,967 cases were reported, but a six per cent increase in the 7,908 cases reported from October to December 2008.

Over the first three months of 2009, there were 692 bloodstream infections of MRSA which was a cut of 29 per cent over the same quarter last year.

But it was a two per cent rise compared to the three month period October to December 2008, when 678 cases were reported.

In the financial year April 2008 to March 2009, 2,932 cases of MRSA were reported - a 34 per cent cut compared with the previous year.

Professor Mike Catchpole, deputy director of the HPA's Centre for Infections said: 'The substantial drop we have seen in MRSA bloodstream infections and C. difficile over the past year is impressive and a credit to the hard work of our colleagues in the NHS, strengthening good practice in infection control.

'Although very small, there have been increases in MRSA cases and C. difficile cases from the previous quarter but we have observed these before, within an overall annual fall, particularly in the first quarter of the calendar year.

Health secretary Andy Burnham welcomed the figures - but critics said the Government needed a new drive to tackle the issue

'If we are to continue to see reductions in healthcare associated infections it is vital that the measures which have won this significant success remain in place and that the public and healthcare workers recognise their importance.'

Mr Burnham said: 'I am exceptionally proud of the NHS staff who have truly risen to the tough challenge we set them to substantially reduce healthcare associated infections.

'Because of their tireless hard work the target to reduce C. difficile infections by 30 per cent has today been met and exceeded with numbers down by 36 per cent - two years ahead of schedule.'

However, Derek Butler, chairman of campaign group MRSA Action said the Government was relying on major reductions in infections at a few hospitals to make the overall picture look good.

It masked a postcode lottery with some hospitals making virtually no headway, he said.

During the last quarter one-third of trusts had a rise in MRSA cases, with 18 per cent standing still, so less than half had made real improvements.

'It's worrying because we seem to have reached a plateau where hand hygiene and general cleanliness fail to make any further impact. We need a fundamental change in approach,' he added.

Shadow Health Secretary, Andrew Lansley, said 'Patients will be extremely worried that MRSA and C diff infections have started to increase again.

'It is extraordinary that on the day we find out that these deadly infections are on the rise that the new Health Secretary Andy Burnham has boasted that he is "proud" of Labour's record.

'These figures expose Labour's complacency and their failure to tackle this blight on our hospitals.

'Just last week the National Audit Office said that almost a quarter of hospitals still do not have the facilities to isolate patients with an infection to stop it spreading. Instead of taking real action Labour have pursued gimmicks like Gordon Brown's flawed deep-cleaning programme.

'A Conservative Government would take a zero tolerance approach to hospital infections.  We are committed to doubling the number of single rooms in NHS hospitals so that all patients who need to be isolated can be.'

Dr Peter Carter, Royal College of Nursing chief executive and general secretary, said: 'The leadership and innovation of nurses has been central to driving down  infection  rates, and improving  the quality  of care for all patients.

'However, these figures do show  that while the general trend is a reduction  in infections, the increase last winter demonstrates  that challenges remain.'

Government guilty of taking their eye off the ball on hospital bugs 

12 June 2009

The National Audit Office report into progress in tackling healthcare associated infections has revealed what the National Charity MRSA Action UK has been saying for months.

 

Despite the great efforts being made in many NHS Acute settings there is still a long way to go before we can say the endemic spread of healthcare associated infections has been quelled.

The postcode lottery remains and many hospitals are seeing dramatic increases in deadly infections.  In April we reported that 22 Acute hospital areas were seeing a rise in infections, and worryingly this was happening outside of the Acute hospital setting.

MRSA Action UK fears that with cuts to budgets in community hospitals where investment is badly needed this worrying trend may well continue.  We know that technology is now contributing to reducing infections, the Design Bugs Out programme was welcomed by patient groups and hospitals, sadly without investment being made across the healthcare setting we will continue to see people moving between care settings being exposed to environments that are not conducive to reducing infections.  The estimated saving of between 141 million and 263 million pounds made by reducing infections nationally must be reinvested in preventing further infections across the board.

Hand washing remains a challenge for some, with patients observing doctors in particular not following guidance on bare-below-the elbow and not adhering to key moments for hand hygiene.  Poor recording of antibiotic prescribing and resistance in hospitals is also a significant concern, we are much better at it in the community setting and hospitals should learn from their peers.

 

Our campaign to record and publish more than the MRSA bloodstream infections is backed by the National Audit Office findings.  There are indeed many infections that go largely unreported and unmeasured. You cannot reduce infections if you are not measuring infections, you cannot measure infections if you are not recording therefore you cannot improve performance.  Surgical site infections, urinary tract and catheter infections account for significant number of people who become ill with infections and sadly die.  These drop below the radar in the government figures and should be published.  MSSA also contributes significantly to the burden on the system and the suffering it causes to patients. Methicillin resistant strains have not actually displaced methicillin susceptible strains: all they done is add considerably to the burden of disease.

We have asked that the Department of Health consider stepped targets for hospitals who are not improving at the same rate as the top performers, so that the focus can be put onto bringing about the culture change needed to drive a zero tolerance ethos into the failing hospital trusts.

 

Whilst the "can do attitude" is one of the biggest factors in driving improvement, it cannot be done unless staff are well resourced, both in terms of investment in the environment and staff numbers, but also in terms of the skills needed.

With greater powers than its predecessors, the Care Quality Commission has a major role in helping to maintain the drive to reduce infections.  Our charity's hope is that the regulator will work with the poor performing trusts.  Where trusts fail to maintain year on year reductions the Care Quality Commission must use swift enforcement.  This should not disrupt services to patients; if Boards and Senior Executives are culpable then they should be replaced by those who are competent.

Monitor must make better use of patients' views and ensure that Foundation Trusts are truly engaging with their local communities to avoid future tragedies such as the deaths and suffering at Mid Staffordshire NHS Foundation Trust.

The Department of Health's Cleaner Hospital Programme has listened to our concerns and Improvement Teams are working with poorer performing trusts to drive improvements in infection rates.  The policy makers and the regulators must continue to work together for the benefit of patients.

This really is an "all or nothing affair" and everyone should have access to clean, safe care, wherever they live, the postcode lottery must end.

Reducing Healthcare Associated Infections
in Hospitals in England