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Patient Safety Congress: Maidstone turns corner on C. diff

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Significant improvements in infection control practices have dramatically reduced cases of Clostridium difficile at Maidstone and Tunbridge Wells NHS Trust in Kent.

The trust has attracted intense scrutiny over its record on healthcare-associated infections following a highly critical report from the Healthcare Commission, published last October.

Between April 2004 and September 2006, the trust recorded 1,176 cases of the infection, and 90 patient deaths were linked with it, the commission said.

The report resulted in a ‘root and branch’ reorganisation and a 130-point action plan, including a review of antibiotic policy and cleaning regimens.

‘No one had a handle on the number of cases going on,’ said Sara Mumford, the trust’s director of infection prevention and control, who took up her role in late 2007. ‘We had to have a really big push to bring infection rates under control.’

An extra £1m was spent on cleaning – including a 24-hour rapid response team. A commode replacement programme was also implemented and the trust has made improvements to bed spacings and decreased general clutter on wards, she told conference delegates.

Additionally, more nursing staff were employed, link nurse networks were strengthened and ward mangers were encouraged to use risk assessment tools to identify high-risk patients.

Ms Mumford also said she does spot checks of all wards and high-risk patients with diarrhoea are moved to a dedicated isolation ward.

‘Over 90% of the action plan had been implemented by March 2008, and the change within the trust was palpable,’ she said. ‘There has been a repeated decrease year-on-year of cases of C. difficile. We now have less than 10 cases per month. ‘We are not completely there yet but we are definitely getting there,’ she added.

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