Infection Prevention and Control 2019-Sharing Knowledge Improving Care
In 2016 Health Secretary Jeremy Hunt launched new plans to reduce infections in the NHS. He announced government plans to halve the number of gram-negative bloodstream infections by 2020. The programme of actions included the Serious Infection CQUIN 2017-2019.
In London in February, 2019 together with 500 colleagues from across the ?whole health economy? we will review the CQUIN results and look forward to see what progress is still required to achieve the 2020 targets. We will review the latest NHSE/PHE/NHSI reporting trends and share local best practice on subjects including Sepsis, E. coli, UTIs and SSIs. We will also showcase the latest industry innovations and technologies in our networking area.
E. coli infections ? which represent 65% of what are called gram-negative infections ? killed more than 5,500 NHS patients last year and are set to cost the NHS £2.3 billion in 2018. There is also large variation in hospital infection rates, with the worst performers having more than 5 times the number of cases than the best performing hospitals.
With so much of the government?s focus on hospital infection it has been welcoming to see NHSI?s plans on tackling infection rates take a ?whole health economy? approach to support the fact that over 70% of e coli infection is acquired in a community setting.
Infection rates can be cut with better hygiene and improved patient care in hospitals, surgeries and care homes, such as ensuring staff, patients and visitors regularly wash their hands. People using insertion devices such as catheters, which are often used following surgery, can develop infections like E. coli if they are not inserted properly, left in too long or if patients are not properly hydrated and going to the toilet regularly.
These plans build on the progress made in infection control since 2010 ? the number of MRSA cases has been reduced by 57%and C. difficile by 45%.
Health Secretary Jeremy Hunt said,
?The NHS can rightly be proud that in the years 2010-16, we?ve reduced the number of MRSA cases by 57% and C. difficile by 45%. These aren?t abstract numbers ? they show that we have prevented the needless suffering ? sometimes fatal suffering ? of over 60,000 people in that period. Because every avoidable infection also has a financial cost, we know that progress has also saved the NHS over half a billion pounds.?
Dr Ruth May, New National Infection and Prevention Lead who spoke at our 2018 conference, said:
?This is a clear plan to achieve real change across the NHS focusing on a combination of strict oversight from the CQC and the collection, publication and intelligent use of data which will ensure organisations improve infection control and help us to make sure poor performers get the support they need to improve quickly.?
Health Secretary Jeremy Hunt said:
?Taken together, these measures are intended to achieve a dramatic reduction in hospital infections, reducing enormous human pain and suffering in the process. They will make us better at knowing when to use antibiotics and better at knowing when not to use them. They will save doctors and nurses time, and save the NHS money. But most of all they will be another vital step in making NHS care something we can all be proud of as the safest and highest quality anywhere on the planet.?
These plans are also part of the government?s commitment to tackle antimicrobial resistance, which includes resistance to antibiotics.
E. coli infections have increased by a fifth in the last 5 years. Targeting preventable infections like E. coli helps to make surgeries and care homes safer for patients and reduce the need for antibiotics, therefore reducing the opportunity for infections to develop a resistance to them.
We will also review progress against the latest 2018 indicators.
March 2018 ? The following indicator has been added to the antimicrobial stewardship domain
- Antibiotic Guardians per 100,000 population per calendar year by CCG
February 2018 ? The following indicators have been added to the Healthcare-associated Infection domain
- Completion of risk factor information, coli by CCG and NHS Acute Trust
- Known risk factor information, coli by CCG and NHS Acute Trust
- Completion of antibiotic information, coli by CCG and NHS Acute Trust
- Known antibiotic information, coli by CCG and NHS Acute Trust
January 2018 ? Trust-type (as per ERIC) breakdown function added. The following indicators have been added to the Antibiotic Resistance domain:
- Rolling quarterly average proportion of gentamicin non-susceptible coli blood specimens; by quarter
- Rolling quarterly average proportion of ciprofloxacin non-susceptible coli blood specimens; by quarter
- Rolling quarterly average proportion of piperacillin/tazobactam non-susceptible coli blood specimens; by quarter
- Rolling quarterly average proportion of 3rd generation cephalosporin non-susceptible coli blood specimens; by quarter
As we know all infection preventionists are committed to eradicating all infection and to protect our patients first and foremost. It is however worth considering the financial case too.
Norovirus accounts for at least 50%of all viral gastroenteritis outbreaks worldwide and can be detected throughout the year. An estimated 600,000 to one million people contract Norovirus annually in the UK, mainly in their own homes. Approximately 3000 people a year are admitted to hospital with Norovirus in England. The Hospital Norovirus Outbreak Reporting System (HNORS) in England estimate that, on average, reported outbreaks are associated with 13,000 patients and 3,400 staff becoming ill, 8,900 days of ward closure and the loss of over 15500 bed-days, annually with a cost to the NHS in excess of £100 million per annum in years of high incidence. Obviously more serious or severe the infection and these numbers would escalate.
Further information on the costs of infection can be requested from ?Our Reports? in the toolbar on the Knowlex home page.