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Friday, October 12, 2007

More about the hospital hygiene problems, C Diff and MRSA...

The Big Question: Why can't we keep our hospitals clean and protect patients from infection? - Independent


"Yesterday an investigation by the Healthcare Commission revealed an astonishing litany of failings at three hospitals in Kent run by the Maidstone and Tunbridge Wells NHS Trust which allowed the lethal bug Clostridium Difficile to spread unchecked. Between 2004 and 2006 it infected more than 1,100 patients, directly causing the deaths of 90 and contributing to the deaths of 345. The commission found appalling standards, akin to a Third World health service, including beds crammed together, wards dirty and understaffed, and patients with urgent diarrhoea told to "go in the bed" because nurses were too busy to take them to the lavatory.

Is this just an isolated case?

Sadly not – though it is the worst to have come to light. Last year an investigation into a similar outbreak at Stoke Mandeville hospital, where 334 patients were infected and 33 died from C Difficile between 2003 and 2005, painted a very similar picture of a poorly run hospital operating under extreme pressure where doctors and managers had failed to heed warnings about the threat from the bug. Last July, the 900-bed Barnet and Chase Farm Hospitals NHS trust in north London became the first in the country to receive an official warning from the commission for putting patients at risk of infection. Serious breaches of the Hygiene Code, introduced in October 2006, which sets minimum standards for all trusts were found at the hospital.

But can we assume that hospitals are generally clean?

No. In June the Healthcare Commission reported that 99 NHS trusts admitted failing to meet minimum hygiene standards. That is one in four of the total in England. Worryingly, Barnet and Chase Farm was not among the 99. It had claimed it was meeting minimum standards but a spot check revealed poor provision of gels for cleaning hands, inconsistent and confusing messages to staff and inadequate isolation facilities. If other trusts are similarly deceived about their performance then hygiene problems may be even more widespread than the one in four figure suggests."