THE PUBLICATION last week of new standards designed to combat the spread of healthcare associated infections is an important step in the battle against MRSA and other potentially fatal infections. National Standards for the Prevention and Control of Healthcare Associated Infection, published by the Health Information and Quality Authority (Hiqa) lists a dozen minimum standards that must be put in place by hospitals and other healthcare facilities.
The standards cover issues such as hand hygiene; antibiotic resistance; staffing levels; and the particular infection risk associated with medical devices.
Healthcare associated infections include the bacterial infections methicillin resistant staphylococcus aureus (MRSA) and clostridium difficile. Both have been associated with the avoidable deaths of patients as well as a considerable degree of morbidity, especially for individuals already weakened by other diseases.
Of particular importance is the standard dealing with the environment and facilities management. This standard calls for an appropriate number of single rooms with en suite facilities to enable hospital acquired infection to be prevented and controlled, as well as the availability in each hospital of pressurised isolation rooms with dedicated access lobbies. However the majority of Irish hospitals do not have pressurised isolation rooms at present, while many hospitals have a relative shortage of single rooms. Despite financial pressures, the Health Services Executive (HSE) must prioritise an adequate capital outlay if it is to meet its obligations to ensure hospitals are “fit for purpose”. And the new standards mean that any acute hospital built in future must have 100 per cent single en suite rooms.
One of the strengths of the document is the timeline and monitoring procedures it specifies. For existing hospitals which do not conform to current best practice in the prevention of healthcare associated infection the document states: “there should be specified implementation timeframes contained within the implementation plan to meet these standards and these should be signed off by the Board, or equivalent of the service”.
GP, dental and community care services must also adopt these standards as rigorously as hospitals. And in the ever changing world of bacteria and other microbes, new versions of old bugs will emerge to pose additional threats to patient safety. The public and service users have a significant role to play and must not hesitate to remind health professionals of the need to maintain strict hand hygiene and other best practices.