Concerns raised over UK hospital disinfection practices

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Wednesday, November 8, 2006

A survey, conducted by the Patients' Association, an independent charity devoted to defending the interests of patients, has revealed "unease and concern among health professionals" that infection control practices in the United Kingdom's National Health Service are "endangering patients' lives". The survey published today, revealed that NHS infection control staff felt that infection control was inadequately financed, that training was inadequate and that much time has to be spent reassuring patients.

The Association is concerned that the financial deficits of many NHS trusts may prejudice good infection control practice because the resources allocated for this are not effectively ring-fenced. There was evidence of inadequate training and execution of good practice. The report also listed shortcomings in way supplies were acquired and delays in getting supplies of the preferred disinfectant: 2% Chlorhexidine-based solution.

BBC reported that a recent paper to a Society for General Microbiology conference by a University of Leeds team has shown that two chemical cleaners commonly used in hospitals, far from reducing the prevalence of Clostridium difficile (C. difficile) bacterium, actually increased its ability to survive. Only cleaners containing bleach had been proved effective in disposing of this bacterium. Authors of the paper refused to disclose what those two cleaners were.

There is particular concern in the Patients' Association about the absence of adequate data on the spread of C. difficile. The Telegraph quotes Katharine Murphy, of the Patients' Association, as saying: "Collection of data about this very dangerous infection is haphazard to say the least, and we are not getting the true picture. How can patients have confidence in their hospitals if the real threat posed by C. difficile is being played down?"

The Report found that only a fifth of respondents confirmed the collection of surgical-site infection data and that only 27% reported infection data about C. difficile; despite the requirement that Trusts collect and report these data.

Trusts are also required to report the incidence of surgical-site infection, but the Patients' Association survey found that only a fifth of respondents confirmed the collection of these data.

The Patients Association called this a "worrying and haphazard situation".

The Telegraph reports that experts consider that C. difficile is an even greater threat to patient's health than MRSA.

Leicester NHS Trust has reported 49 deaths associated with C. difficile. in three of its hospitals. Six deaths have been reported at Maidstone Hospital and the Healthcare Commission has been asked to investigate. C. difficile was associated with the deaths of nearly 1000 patient in 2003.

A new Code of Practice "for the prevention and control of healthcare associated infections" was issued by the Department of Health in October 2006 under the Health Act 2006. This refers to the NHS in England and Wales only.

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