HOSPITALS WILL have to substantially increase their staffing levels and surveillance systems if they are to meet new draft national standards for infection prevention and control published yesterday.
The standards, drawn up by the Health Information and Quality Authority (HIQA), recommend a major increase in the number of clinical microbiologists and infection-control nurses employed in the State.
It says there should be four clinical microbiologists for every 350,000 of the population, and one infection-control nurse for every 115 acute-care beds and every 250 long-stay beds. Informed sources say there are "substantially fewer" than this at present.
Furthermore, they state the bed spacing in wards with multiple patients should be 3.6m by 3.7m. There would be many hospital wards where this criteria is not met. In AE units in particular, pressure on space can result in beds being located in closer proximity to each other.
In total, HIQA has set 12 standards which should be met in a bid to reduce healthcare-associated infections such as MRSA and Clostridium difficile (C diff).
The standards cover accountability, hand hygiene, reducing infection from medical instruments, surveillance of infections, having appropriate multidisciplinary infection-control teams in place which reflect the size and specialities of a facility, informing patients immediately of their infection status, and management of outbreaks.
The report detailing the draft standards says "nearly a quarter of all healthcare-associated infections are device related". This is based on international research.
The report also says the number of ensuite single rooms assigned to infection control in healthcare facilities should correspond to the needs and size of the facility. Where this is not the case there must be a programme of upgrading/refurbishment.
In addition, it says newly-built acute hospital wards or units should be made up of a minimum of 50 per cent single rooms.
The draft standards have now been put out to public consultation until July 18th. HIQA envisages having the standards finalised and ready for ministerial approval by September.
Jon Billings, director of healthcare quality at the authority, said it would monitor the implementation of the standards and report back on its findings but the standards will have no statutory basis. Therefore, the question of penalties or sanctions against those who breach them did not arise. It was up to those providing and planning health services to respond to any findings HIQA might make.
Hospitals or healthcare facilities that do not comply will be named and shamed.
A consultant physician at St Columcille's hospital, Loughlinstown, has called for a full review of cases of C diff at the facility. Dr John Fennell said he "wouldn't consider the hospital meets modern standards" in the area.
He was speaking yesterday at an inquest at the Dublin County Coroner's Court into the death of Eithne Long (81), of Blain Roe Nursing Home in Co Wicklow, who died of septic shock due to C diff infection on July 26th, 2007.