Traffic lights system cuts cross-infection
A simple risk assessment tool could optimise the use of hospital isolation facilities, infection control nurses have said.
Using a ‘traffic light’ system, nurses can categorise patients based on their infection status.
‘Red’ patients need continued isolation, ‘amber’ patients need isolating but can be moved if necessary, and ‘green’ patients pose no infection risk.
This data is recorded on a spreadsheet on the hospital intranet, explained Bridget Lees, infection prevention and control nurse at Southport and Ormskirk NHS Trust, which has been using the tool for three years.
The spreadsheet can be accessed 24 hours a day but only by senior infection control nurses and bed managers, and only a senior infection control nurse can change the status of a patient, Ms Lees told delegates last week at the Infection Prevention Society (IPS) conference in Harrogate, North Yorkshire.
Isolated patients are reviewed by an infection control nurse twice a day, and information relating to infection status, such as MRSA screening results, is recorded on the spreadsheet.
‘The tool shows the infection control team who can and cannot be moved from side rooms at a glance,’ said Ms Lees. ‘It enables us to prioritise quickly and act fast, and also shows us which patients we can cohort.’
She added: ‘As well as improving efficiency, it has improved the relationship between the infection control team and the bed managers, as it removes the need for unnecessary communication.’
IPS vice-president Martin Kiernan, senior infection prevention and control nurse at the trust, said: ‘To maximise the benefits of isolation, it is vital that patients are nursed in a manner that reduces the risk of cross-infection.
‘This is a simple, cheap and easily accessible tool which acts as a reference and a measurable method of ensuring that valuable resources are not wasted.’
The Infection Prevention Society is to set up a special interest group for infection control nurses working in mental health settings.
Judy Potter, president of the IPS, acknowledged that infection control in mental health settings could be particularly challenging and nurses working there needed specialist support.
‘Applying the practices used in acute or primary care settings can be very difficult because of the types of patients mental health nurses see,’ she said.
The group plans to hold its first meeting before the end of the year.
Contact Bryony Robertson, infection control nurse at Surrey and Borders Partnership NHS Trust, at email@example.com.
Big change from small measures
Introducing a range of small, practical improvements to elderly care wards can significantly reduce Clostridium difficile rates, data suggests.
Putting stickers on commodes after cleaning, so staff can see which ones are dirty, and introducing a movement-activated voice box reminding people to wash their hands have seen infection rates plummet at a Manchester trust.
Salford Royal NHS Foundation Trust had over 400 recorded cases of the infection in 2006–2007, 30% of which came from five elderly care wards alone, conference delegates heard
With the aim of reducing this figure by 50% in 12 months, a multidisciplinary team – including nurses, pharmacists and domestic staff from each of the five wards – met to ‘brainstorm’ ideas for improving infection control practices, which were then taken back to wards to see how they worked in practice.
Since the initiative began, there has been a 68% reduction in the rates of C. difficile on the five wards – from 122 recorded cases in April 2007 to just 38 cases in April 2008.
Maxine Power, associate director of quality improvement at the trust, said: ‘This shows that adopting different ways of thinking, and making small, practical changes that are robust and reliable, can have a significant impact on infection rates.’
News in brief
An educationalprogramme to improve peripheral IV cannulation has helped reduce the MRSA rate at Portsmouth Hospitals NHS Trust. There were 80 cases between April 2006 and March 2007 but 44 cases in the following 12 months. The programme was introduced in January 2007.
Shorter hospital stays mean up to 50% of surgical site infections (SSI) are not being detected until after discharge, delegates heard. Hospitals need a ‘standard approach’ to post-discharge surveillance, said Jennie Wilson, a nurse consultant at the Health Protection Agency.
A high Waterlow pressure ulcer risk assessment score is a significant risk factor for Clostridium difficile, according to nurse researchers from De Montfort University, Leicester. Of the 6% of 1,468 patients with a score of 20 or above, 17% contracted the infection.
Nursesoverwhelmingly support continuing the RCN’s Wipe it Out campaign. A survey of almost 300 Infection Prevention Society and RCN members found that 98% said the drive to encourage good infection control practice should continue.
UK nursesshould be congratulated for their ‘tremendous efforts’ in more than halving the rate of MRSA bacteraemia over the past four years, Professor Stephan Harbarth, associate epidemiologist at Geneva University Hospitals in Switzerland, told delegates.