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Portsmouth trust almost eliminates norovirus outbreaks

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The number of norovirus outbreaks at a hospital trust was almost entirely eliminated over five years following the introduction of new technology that speeds up detection and improves surveillance of the infection, according to researchers.

A study, published in the journal BMJ Quality and Safety, showed the number of outbreaks at Portsmouth Hospitals NHS Trust fell by 91% – from 21 in 2009-10 to just one in 2013-14.

The number of reported outbreaks also fell across the Wessex region and across England as a whole, but by a far lower percentage – 15% in Wessex and 28% across the country.

“The combination of new technology and better training and organisation of our staff has contributed hugely to our successful results”

Caroline Mitchell

The trust’s reduction in outbreaks coincided with its use of new technology in 2010, which prompts nurses to note nausea, vomiting or diarrhoea when recording patients’ vital signs and then sends real-time alerts to staff if an emerging outbreak is suspected.

This new computer application extends an existing hospital-wide electronic vital signs system – called VitalPAC – that allows nurses to record observations at the bedside on handheld devices.

It meant the infection prevention and control team were able to react more quickly in implementing isolation measures and other interventions to prevent cross-infection of patients, staff and visitors.

However, the research authors noted this new technology was unlikely to have worked without the trust having also improved staff and patient education around the causes and prevention of norovirus.

Prior to the introduction of the initiative, other interventions had caused some reduction in norovirus outbreaks at the trust but cases typically involved several patients and were in progress for more than 24 hours.

“If every hospital achieved the same result as Portsmouth Hospitals Trust the savings could be £38 million a year”

Peter Greengross

Use of the new technology was associated with an “abrupt and sustained reduction in norovirus outbreaks, affected patients, affected staff and days of disruption in the following four years,” said the research paper.

The number of patients affected by norovirus-like symptoms fell by 92%, the number of affected staff reduced by 81% and the days of disruption in the hospital as a result of the virus was cut by 88%.

Dr Caroline Mitchell, the trust’s associate director for  infection and patient safety, and one of the study authors, said: “By application of simple measures we have significantly reduced the number of cases of norovirus and other gastrointestinal viruses, which can cause serious and unpleasant symptoms in patients and massively disrupt the operational capacity of the hospital.

“The combination of new technology and better training and organisation of our staff has contributed hugely to our successful results in this field,” she said.

Dr Peter Greengross, medical director of The Learning Clinic, which developed the VitalPAC system, added: “We believe norovirus outbreaks cost the NHS £41.5m a year.

“If every hospital achieved the same result as Portsmouth the savings could be £38m a year. That would have a massive impact,” he said.

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