NHS GRAMPIAN

Healthcare Associated InfectionReport

January 2011

Aim

To assure the Board that infection rates and interventions are monitored and that appropriate

action is taken to reduce the number of healthcare associated infections in NHS Grampian

Strategic Content

Healthcare associated infection, hand hygiene and cleaning data are routinely collected and monitored by the Infection Control Committee. All Boards are required to produce the attached report for discussion at Board meetings and subsequent publication on their websites.

Discussion

  • There were zero cases of Multi-resistant Staphylococcus aureus (MRSA) bacteraemia in NHS Grampian in November 2010
  • The incidence of Methicillin Sensitive Staphylococcus aureus (MSSA) bacteraemia rose in October and November but fell to the lowest level (7 cases) for the whole year in December 2010.
  • There were no cases of Staphylococcus aureus bacteraemia (MRSA or MSSA) or CDI in Dr Gray’s Hospital in November or December 2010.
  • There have been no cases of MRSA bacteraemia in WoodendHospital throughout 2010 and only 2 cases of MSSA bacteraemia since May 2010.
  • There was also a dramatic drop in MSSA bacteraemias identified by General Practitioners or within 48 hours of admission to hospital (Out of Hospital) from 11 cases in November to 2 in December 2010, the average number of cases per month in 2010 being 8.
  • The number of cases of Clostridium difficile infection (CDI) across NHS Grampian fell to 8 in December 2010, the lowest number of cases for any month in 2010.
  • The number of cases of CDI identified by General Practitioners or within 48 hours of admission (Out of Hospital) showed the most dramatic decrease from 17 in November to 3 in December 2010, the average number of cases per month in 2010 being 14.
  • Hand Hygiene compliance across NHS Grampian reached an all time high of 99% in December 2010.
  • Hand hygiene compliance hit 100% in Dr Gray’s Hospital in November 2010.
  • It would appear that the considerable amount of effort that has gone into producing and publicising the antibiotic guidelines has been hugely beneficial in reducing CDI rates with this reduction being sustained for well over a year.

Key Risks

One very high risk remains on the Infection Control Risk Register relating to a single system for identifying cleaned equipment. The Infection Control Committee reviewed this risk at the last meeting and concluded that the level should remain very high, although it is monitoring the work ongoing to address this issue. We have recently sought support from Health Protection Scotland (HPS) whorecognised that implementation in this area was a real issue for many Boards. HPS agreed to contact the NHSQuality Improvement Scotland Quality Hub to ask for their support in this regard.

Conclusion

The Board will continue be kept fully informed of the ongoing improvement work around healthcare associated infection via this regular report.

Recommendation

The Board is requested to note the content of this report.

Executive Lead:

Medical Director

Pamela Harrison

Infection Control Manager

January 2011

1