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Infection control

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The issue of infection control has dominated media headlines in recent years and become a common source of scare stories about the NHS and its staff.

First indications of a problem began when the mandatory surveillance scheme for monitoring Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) was introduced by the Department of Health in April 2001, so it is difficult to be accurate about the scale of the problem before then.

Rates did increase at the start of the decade but are dropping after concerted efforts to tackle the issue.

From mandatory reporting of MRSA infections in the bloodstream, cases rose to a high of 7,684 in 2003-2004. The following year saw a fall to a record low of 7,212 infections. The latest figures show there were 3,517 infections between October 2005 and March of this year - a 2.5% drop.

The National Audit Office estimates that healthcare-associated infections (HAIs) contribute to some 5,000 deaths annually.

Other types of HAIs have also been a problem and figures from the Health Protection Agency published in July this year showed the number of older patients infected with Clostridium difficile rose by around 17% in England in 2005 to 51,690 cases.

Nurses have said for some time that the problem arose because of high bed occupancy rates, low staffing levels and A&E targets, which all prevented proper infection control. The Department of Health has made various efforts in this area including launching the the Matron’s Charter in 2004, which said nurses and infection control teams should be involved in drawing up cleaning contracts and could withhold payment for poor cleaning services.

A new target to halve MRSA infection rates in the bloodstream by 2008 was announced in 2004 by then health secretary John Reid.

A survey of 2,140 nurses carried out by NT in March 2005 found many nurses felt they were scapegoats for the problem and were unsupported when it came to tackling it.

On the back of the survey, NT launched its Keep it Clean: back nurses to fight infection campaign. Since then, there are now good hand hygiene and clinical procedures in the NHS and the government passed The Health Act in July that gives powers for a hygiene code and a tougher inspection regime to improve standards of hygiene and infection control.

The code is due to be published in the autumn, although trusts will start to make declarations of compliance with the code from April of next year. The Healthcare Commission will be responsible for monitoring the code.

Updated: September 2006

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