Reducing infections in the NHS.
10 April 2017
By Hayley Carmichael
The NHS is tasked with reducing the number of infections. One way it can do that is by supporting patients to lead a healthier lifestyle and therefore reduce the need for antibiotics.
SCFT’s Infection Control team tell us more…
An NHS wide push
The Secretary of State recently announced plans to try to reduce infections in the NHS. We have made great progress since 2010 achieving targets in the fight against infection; in particular the number of MRSA bloodstream infection cases has fallen by 57% and C. difficile infections by 45%.
As from 1 April 2017, our aim is to halve healthcare associated Gram-negative blood stream infections (GNBSI), and improve antibiotic prescribing by March 2021.
Over the next year, Clinical Commissioning Groups (CCGs) need to reduce E.coli bloodstream infections (BSIs) by 10% and focus on inappropriate prescribing of antibiotics to patients with Urinary Tract Infections (UTI).
The good news is that for areas that achieve their goals they will be rewarded; however those not meeting the targets will be penalised.
What are Gram negative bacteria?
Gram negative bacteria are found in the gut and are usually harmless. However problems can occur if they enter the bloodstream and can lead to a significant health risk. One of the most common Gram negative infections is caused by the bacteria Escherichia coli (E.coli). In the UK we have had to report E.coli bloodstream infections (BSI) to Public Health England since June 2011 which has provided some useful background information.
Why is there a problem?
E.coli BSI has increased by a fifth in the last 5 years and mostly affects those aged 75 years and over. Urine infections appear to be one of the most common causes. One reason for this could be that patients are being given antibiotics when they don’t need them which later results in them developing the infection again.
You may have heard that it is getting harder to treat infections and this means that we could be close to reaching a point where it is not possible to prevent or treat everyday infections or diseases. To help solve this problem healthcare professionals are targeting preventable infections like E. coli so we can help to keep our patients safe and reduce the need for antibiotics, therefore reducing the chance of an antibiotic resistant infection. By doing this we can also help to reduce C.diff infections which are often caused by antibiotic treatment even further.
How will SCFT meet the challenge?
SCFT Infection Prevention & Control team attended a roundtable event, hosted by the Secretary of State for Health, looking at ways to improve infection prevention and control and helping to develop a tool kit to address the issue. The tool kit includes educational material, risk assessments and a review tool for looking at cases. SCFT will be working with other healthcare professionals outside of the trust to meet the challenge.
Staying hydrated is key
Work is already underway within SCFT to ensure our patients reduce their chance of having a urine infection by drinking plenty of fluids. And staff are encouraged to stay hydrated too.
International Infection Prevention week takes place every October and this year healthcare professionals can take part in a hydration quiz with prizes up for grabs. The quiz reminds us why it is so important for everyone, patients and healthcare professionals, to drink plenty of water. SCFT also plans to promote the use of ‘Catheter Passports’ which is a record the patients keep to hold information on their urinary catheter care. Patients can then take this record with them and share it with whoever is looking after them. In addition our Antimicrobial Pharmacist continues to lead work in the trust to ensure antibiotics are prescribed correctly and works closely with the Infection Prevention and Control team.
Sharing our progress
Communicating our rates of E.coli BSI is important, so these will be displayed on poster boards within the wards visible to all, healthcare professionals, patients and visitors.
This work will also support other priority areas across England such as the UK 5 Year Antimicrobial Resistance Strategy (2013-2018), Sepsis agenda and Sustainability and Transformation Plans, providing opportunities to save on staff time and money as well as increasing patient safety.
NHS Improvement 2017 Ambition to halve healthcare associated Gram-negative blood stream infections by March 2021:
NHS England 2017 Quality Premium 2017-19