Addressing the issue of healthcare-associated infection in his annual report, Sir Liam Donaldson suggested that patients should be encouraged to ask healthcare staff if they have cleaned their hands and supply handrub if required.
Sir Liam recommended that patients and families should be educated in handrub use and be empowered to supply it to healthcare professionals.
The report suggests this could build on the NPSA’s well-established cleanyourhands campaign, which has been successfully implemented in hospitals in England.
According to the NPSA, 71% of patients want to be involved in improving hand hygiene but 75% would not ask healthcare staff to clean their hands.
Sir Liam suggested patients could be a second mechanism to improve hand hygiene, and added that hand hygiene no longer has the status that it once had.
He suggested that this may stem from poor hand hygiene practices established in childhood, which may help to explain why it is difficult to change hand hygiene behaviour among many healthcare professionals.
Adherence to good hand hygiene practice rarely exceeds 60% and is often much lower.
Compliance rates with alcohol-based handrubs is poor even in hospitals where they are widely available.
Small improvements in hand hygiene can have a major impact on the transmission of infection.
Up to three-quarters of patients did not feel able to ask a health professional if they had cleaned their hands.
Patients have an important part to play in improving hand hygiene.
New name and new members for ICNA
The Infection Control Nurses Association will be relaunched and become the Infection Prevention Society at its annual conference on 26 September.
IPS membership will be open to people in all areas of healthcare who are involved in or have an interest in infection control.
In an editorial in this issue, Judy Potter, lead nurse/director of infection control at Royal Devon and Exeter NHS Foundation Trust, writes: ‘This exciting development completes the transformation of the ICNA into an organisation that welcomes as full members all professionals working in the field of infection prevention and control.’
It is not only the name and the membership criteria that have changed. Two new categories of membership are now available. Student membership, with a lower subscription rate, will be open to pre-registration students, while institutional membership will be available to staff groups.
Information on joining the IPS can be found from 27 September at www.ips.uk.net.
Sexually transmitted infection rates continue to increase
The number of new sexually transmitted infections (STIs) diagnosed in GUM clinics in the UK rose by 2% from 368,341 in 2005 to 376,508 in 2006, according to the Health Protection Agency.
Cases of chlamydia increased by 4%, genital warts increased by 3% and genital herpes by 9%. However, syphilis and gonorrhoea decreased by 1%.
Gonorrhoea, like chlamydia, is most common in 20–24-year-olds, and more cases tend to be seen in urban areas. The number of cases diagnosed in men who have sex with men has risen by 3%, probably as a result of increasing unsafe sexual behaviour.
These figures predate the launch of the DH Condom: Essential Wear sexual health campaign.
Designating staff roles lowers HCAI rates
Trusts are more likely to have lower rates of disease associated with Clostridium difficile if they have designated link practitioners who can ensure that policies are put into practice on wards.
This is one finding of a national survey by the Healthcare Commission to identify how trusts were managing the prevention and control of infection.
The survey included 155 out of 173 acute trusts in England and was conducted in May last year, five months before the introduction of the government’s Hygiene Code.
The commission found trusts that had protected time for staff to focus on infection control had lower rates of healthcare-associated infection (HCAI).
Only 16% of trusts said that responsibility for compliance with policies and procedures on infection control was included in job descriptions for all staff working in clinical areas. Programmes to check that staff were adhering to policies for cleaning beds were in place in only 54% of hospitals.
Trusts with better cleanliness scores had lower infection rates. Over one-third – 36% – of trusts had found problems reconciling the management of HCAI and cleanliness with financial targets.
Hospitals with higher numbers of single rooms were more likely to reduce their rates of MRSA in line with national targets.
A core standard of the Hygiene Code is provision of information about HCAIs in languages and forms relevant to local populations. Only 58% of trusts provided information in this way.
The full report, Healthcare Associated Infection: What Else Can the NHS Do?, is at www.healthcarecommission.org.uk.