Written answers
Thursday, 9 July 2009
Department of Health and Children
Infectious Diseases
12:00 pm
Denis Naughten (Roscommon-South Leitrim, Fine Gael)
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Question 226: To ask the Minister for Health and Children the steps being taken to address the issue of hospital acquired infection; the number of such cases in each hospital in the past 12 months of suspected or confirmed infection; and if she will make a statement on the matter. [29247/09]
James Reilly (Dublin North, Fine Gael)
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Question 370: To ask the Minister for Health and Children the number of claims lodged with the State Claims Agency per year for compensation as a result of patients acquiring hospital infections since 2001; the number of cases settled to date in 2009; the settlement in each case; the amount paid in legal fees; the duration between lodging the claim and the judgement or settlement; and if she will make a statement on the matter. [30006/09]
James Reilly (Dublin North, Fine Gael)
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Question 385: To ask the Minister for Health and Children the progress made on the programme for Government commitment to significantly reduce hospital acquired infections in our hospitals and the need to guard against infection in the refurbishment of existing hospitals and the construction of new hospitals; and if she will make a statement on the matter. [30022/09]
James Reilly (Dublin North, Fine Gael)
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Question 386: To ask the Minister for Health and Children the progress made on the programme for Government commitment to establish a specific financial incentive which will reward hospitals that achieve excellence in hygiene standards; and if she will make a statement on the matter. [30023/09]
James Reilly (Dublin North, Fine Gael)
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Question 387: To ask the Minister for Health and Children the progress made on the programme for Government commitment to continue to carry out regular hygiene audits without notice, at minimum annually, and publish the results; and if she will make a statement on the matter. [30024/09]
James Reilly (Dublin North, Fine Gael)
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Question 388: To ask the Minister for Health and Children the progress made on the programme for Government commitment to introduce measures to help reduce the prescribing of antibiotics; and if she will make a statement on the matter. [30025/09]
Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 226, 370 and 385 to 388, inclusive, together.
Health Care Associated Infections (HCAIs) continue to be a challenge for healthcare systems worldwide. Ireland is not unique in this regard and tackling HCAIs here continues to be a priority for the government and for the Health Service Executive (HSE). In March 2007, the HSE launched a National Infection Control Action Plan. An Infection Control Steering Group is responsible for overseeing the implementation of the plan. Over the period of the Plan the HSE aims to reduce HCAIs by 20%, MRSA infection by 30% and antibiotic consumption by 20%. The Steering Group is supported by eight Local Implementation Teams which will ensure that all local facilities are focused on achieving the national targets.
A National Surveillance system was established by the HSE to collect data and provide information to monitor HCAIs in our health system. The number of MRSA bloodstream infections for the past three years are - 588 cases in 2006, 536 cases in 2007 and 436 cases in 2008. This shows a significant decrease of over 25% between 2006 and 2008. Below is a table showing the number of MRSA cases by acute public hospital for 2008 which is the most recent information of this detail available. Most of the variation between hospitals can be explained by differences in hospital size, activity and patient population. It should be noted that if a patient is diagnosed with a bloodstream infection at a given hospital it does not indicate that the infection was acquired at that hospital. Many bloodstream infections are acquired in the community, but only diagnosed upon admission to hospital.
In order to introduce measures to aid in the reduction of antibiotic prescribing, education campaigns for healthcare staff and the general public around the prudent use of antibiotics commenced last year. The HSE launched a three week awareness campaign in November 2008 to highlight the importance of using antibiotics properly. This coincided with the first European Antibiotic Awareness Day. The awareness campaign included radio ads and distribution of leaflets on the prudent use of antibiotics.
Earlier this year, new environmental guidelines to inform infection control policy in all new builds and refurbishments were published by the HSE. HIQA, since its establishment in 2007, has also taken significant steps in this area. A core function of the Authority is to set standards on safety and quality of health services and to monitor enforcement of those standards in an open and transparent way. In 2007, HIQA developed National Hygiene Standards and commenced a programme of audit against these Standards. The Authority undertook a comprehensive inspection and review of hygiene in our acute public hospitals in 2007 and again in 2008. This included unannounced visits by inspection teams. The reports, which were published, represent a thorough assessment of how hygiene services are provided and managed in HSE-funded acute care hospitals. HIQA noted that the standard of front line services which was already very high in 2007 had been maintained in 2008 and that corporate governance was significantly improved.
In May 2009, HIQA published its National Standards for the Prevention and Control of Healthcare Associated Infections to provide an overall framework for health and social care providers to prevent or minimise the occurrence of HCAIs. These Standards include all key areas of importance in the control of HCAIs namely governance, hygiene, microbiological services, antimicrobial resistance and surveillance systems as well as relevant aspects of the design of facilities. Six months will now be allowed for the development by the HSE of a self-assessment tool, gap analysis and implementation plan before HIQA commences its initial review against those Standards.
In relation to financial incentives for achieving excellence in hygiene standards, while it is a matter for the HSE to decide on funding priorities, I favour, of course, the allocation by the Executive of resources to best ensure the delivery of high quality services.
The State Claims Agency handles all HCAI claims against individual hospitals in the public sector, the HSE and/or the Minister for Health and Children. The Agency indicates that there were 114 HCAI claims lodged with them since inception of this scheme in 2004 and to date one case has been settled. The duration between lodging the claim and settlement was just over two years. It will be appreciated that each case has its own complexities and there are issues involved beyond HCAI. It is policy not to divulge either the details or amounts concerned in individual cases. I am satisfied that significant steps are being taken to reduce the rates of HCAIs generally and to treat them promptly when they occur. Data on Meticillin Resistant Staphylococcus Aureus (MRSA) bloodstream isolates by acute public hospital for 2008
Acute Public Hospital | Total number of isolates of MRSA 2008 |
Adelaide, Meath and National Children's Hospital, Tallaght, Dublin | 27 |
Bantry General Hospital | 1 |
Beaumont Hospital (including St. Joseph's Hospital, Raheny), Dublin | 45 |
Cappagh National Orthopaedic Hospital, Dublin | 0 |
Cavan General Hospital | 3 |
Children's University Hospital, Temple Street, Dublin | 2 |
Connolly Hospital, Blanchardstown, Dublin | 8 |
Coombe Women's Hospital, Dublin | 1 |
Cork University Hospital (inc Maternity) | 25 |
Galway University Hospitals (inc UCHG and Merlin Park) | 47 |
Kerry General Hospital, Tralee | 13 |
Letterkenny General Hospital, Donegal | 19 |
Lourdes Orthopaedic Hospital, Kilcreene | 0 |
Louth County Hospital, Dundalk | 4 |
Mallow General Hospital, Co. Cork | 6 |
Mater Misericordiae University Hospital, Dublin | 34 |
Mayo General Hospital, Castlebar | 8 |
Mercy University Hospital, Cork | 12 |
Midland Regional Hospital, Mullingar | 6 |
Midland Regional Hospital, Portlaoise | 1 |
Midland Regional Hospital, Tullamore* | 1 |
Mid-western Regional Hospital, Ennis | 2 |
Mid-western Regional Hospital, Nenagh | 1 |
Mid-western Regional Hospital, Dooradoyle, Limerick | 19 |
Mid-western Regional Maternity Hospital, Limerick | 0 |
Mid-western Regional Orthopaedic Hospital, Limerick | 0 |
Monaghan General Hospital | 1 |
Naas General Hospital | 6 |
National Maternity Hospital, Holles St., Dublin | 0 |
Our Lady of Lourdes Hospital, Drogheda | 2 |
Our Lady's Hospital for Sick Children, Crumlin, | 6 |
Our Lady's Hospital, Navan | 1 |
Portiuncula Hospital, Ballinasloe | 7 |
Roscommon County Hospital | 4 |
Rotunda Hospital, Dublin | 0 |
Royal Victoria Eye and Ear Hospital, Dublin | 0 |
Sligo General Hospital | 10 |
South Infirmary – Victoria University Hospital, Cork | 4 |
South Tipperary General Hospital, Clonmel | 5 |
St. Colmcille's Hospital, Loughlinstown** | |
St. James's Hospital, Dublin | 31 |
St. John's Hospital, Limerick | 0 |
St. Luke's General Hospital, Kilkenny | 4 |
St. Luke's Hospital, Dublin | 2 |
St. Mary's Orthopaedic Hospital, Gurranebraher, Cork | 0 |
St. Michael's Hospital, Dun Laoghaire | 0 |
St. Vincent's University Hospital, Dublin | 28 |
Waterford Regional Hospital | 19 |
Wexford General Hospital | 5 |
It should be noted that 2008 data is provisional
*No data for quarters 3 and 4 of 2008;
**No data for 2008
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