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Business theory may have role in MRSA control
(The Irish Times Via Thomson Dialog NewsEdge) An innovative approach to reducing the number of MRSA infections in Welsh hospitals could be used to do the same here, writes Helne Hofman
The MRSA and Families Network is confident that a model of infection prevention and control used in Welsh hospitals could be adapted to help tackle the incidence of MRSA bacteraemia infection in Ireland.
Seven representatives of the network travelled to Cardiff to meet the director of the Infection Prevention and Control Service (IPCS) for the Cardiff and Vale NHS Trust, Dr Ian K Hosain, on Friday.
The Cardiff and Vale Trust is the largest in Wales, with 13,500 staff members catering for about 110,000 inpatients and half a million outpatients at a time. Hosain, who was educated at Trinity College Dublin, has headed an initiative which has seen the rates of MRSA in the trust's nine hospitals and 34 health centres drop by 60 per cent in the past five years.
MRSA, or Methicillan-Resistant Staphylococcus Aureus, is an antibiotic-resistant superbug. About 40 per cent of healthy people are "colonised" by Staphylococcus Aureus (SA), and in the majority of cases it is harmless. However, when it enters open wounds it can lead to septicaemia, serious infections of bones, joints and heart valves and, in some cases, death.
Figures released in July show the number of MRSA infections reported in Irish hospitals continues to rise. A total of 592 MRSA bloodstream infections were reported in Ireland last year, compared with 553 in 2004, and more than 7,600 people were found to be carrying MRSA in their skin. It is not known exactly how many people have died from the infection.
"People arrive in hospitals sick and they want to get better, they do not want to leave sicker than they arrived," says Hosain. "Infection control must be integrated into the way we run our health service and not separated. In order to tackle the issue, hygiene should become part of the mindset of hospital staff."
Hosain has applied business management theory to infection prevention. The IPCS has seven staff members and 200 link practitioners, who are trained in infection prevention and control,working together to implement their strategy.
All staff members, including outsourced staff, are subject to regular independent audits of hygiene and standards.
"It's about looking at a total package. The key is system-based, quality management, where hygiene is integrated into the framework of total services provision. When you're quality orientated, a complaint is good for you," Hosain explains.
Hand-washing is seen as a major factor in preventing the spread of MRSA and other infections. The Cardiff and Vale Trust attributes a significant part of its success in reducing the number of infections to the increase in the number of alcohol gel dispensers in its hospitals.
The trust was the first in the UK and Ireland to introduce the alcohol gel, which is rubbed into hands preventing infection, and a number of healthcare facilities have since followed suit.
"Prevention and control is not about money, or microbiologists, or staff, or resources. The Irish seem to miss the point that if you open up and get it right, you save money in the long run," Hosain says.
"It is not complicated. The working environment sends a message. A clean hospital tells staff you mean business. You don't want your staff to begin thinking that infections are unavoidable. Yes, some are, but you want them to take responsibility. If there is a problem, it's the system that allowed it to happen."
The MRSA and Familes Network intends to use the information gathered during its visit to the Cardiff and Vale and Llandoch hospitals to strengthen its presentation at the Dail Committee meeting scheduled for October 5th.
"What we saw in Wales is that they do what needs to be done and then worry about the rest. That way they prepare for trouble down the road. Rather than wait for it to happen, they react now and prevent it," says Teresa Graham, who helped found the MRSA and Family Network two years ago.
"The attitude in Ireland is that if we do nothing about MRSA, it might go away, which unfortunately isn't the case."
Copyright 2006 Irish Times. Source: Financial Times Information Limited - Europe Intelligence Wire.
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