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Health: Hospital-acquired Infections

I thank my noble friend Lord Patel for this short but important debate. He chairs the National Patient Safety Agency, which campaigns to improve patient safety. What can be more important? One of its projects was cleanyourhands, a national campaign to promote better hand hygiene in hospitals that began in 2005. In 2007, the programme was extended to other providers such as care homes and community clinics. If the campaign does not exist in schools, it should. Children should grow up realising how dangerous it is not to wash their hands, especially when handling food after going to the lavatory. People from eastern Europe whom I employ at home seem to wash their hands much more than British people. Washing one’s hands with soap and water is the best way of protecting patients, as the gel does not work on the highly infectious Clostridium difficile. I have heard of nurses who have gone from patient to patient while not washing their gloved hands. They think that washing is not necessary if they wear gloves. The wife of a severely disabled man in Yorkshire who had had MRSA and is fed by a peg in his stomach asked a nurse whether her husband had had a check to see whether he still had MRSA. The nurse said, ““Well, if he does have a check and it is positive, it will give us a lot more trouble as he will have to be barrier nursed””. I wonder how many such cases there are across hospital trusts. Infection control nurses should be able to take responsibility and have great support in stopping such dangerous attitudes among such lazy nurses. Much has been done in the past few years and the Government have tried hard to reduce hospital-acquired infections, but there is much more to be done. One still hears of sloppy practices such as that described to me by the wife of a high-lesion tetraplegic man. Her husband had a chest infection and had gone into hospital. On the Friday, when he went home for the weekend, his sputum jar was sitting on a shelf by his bed, but when he returned on Monday morning it was still there and had not been emptied. In the old days, a sister on the ward would have seen that such things were done and jars not left unclean. The grandson of one of my friends was admitted to the Freeman Hospital in Newcastle for a serious heart condition, aged one. The operation took many hours and was a success, but unfortunately he contracted MRSA. The family cannot praise the hospital team enough and, after many critical days, little George pulled through. Hospital infections put extra strain on everybody. In this case, a dedicated skilful hospital team and the family had much more anxiety due to MRSA. Does the Minister agree that prevention of hospital-acquired infection should be at the top of the agenda? It is said that patients should be screened when they come into hospitals or care homes, but should not the medical and nursing staff be screened as well? If they are working with vulnerable patients, how many might become carriers and put patients at risk? One often hears of bad practice such as clean laundry being brought in and left beside dirty laundry. Surely it is possible with such a large staff to put in a manager who could take responsibility for seeing that good practice takes place. I am pleased to be associated with the National Concern for Healthcare Infections, which aims to raise awareness, and give support, on patient safety. It asked me to be its patron, and I accepted. Does the Minister agree with the guidelines to tackle hospital-acquired pneumonia? This is the most common hospital-acquired infection in intubated patients, increasing mortality by up to 75 per cent. When hospital-acquired pneumonia is caused by bacteria, treatment will always be with antibiotics. However, the increasing problem of antimicrobial resistance, largely due to inappropriate use of antibiotics, has made its management more complicated and has led to a rise in hospital-acquired infections as a whole. A key driver in developing the guidelines was to minimise the number of preventable deaths from HAP due to any cause. The new guidelines set out the importance of prevention, diagnosis and early treatment and ensuring the right antibiotic is used at the right time. There should be fast-track testing and results, otherwise wide-spectrum antibiotics will continue to be used. What chance is there of this action happening? Consideration needs to be given not only to acute NHS trusts which provide general facilities for the public, but to specialist hospitals which treat patients who are susceptible to many other infections, including campylobacter—with almost 50,000 patients affected in 2006. Many impaired people are susceptible to the development of pressure sores. This presents another avenue for bacteria, such as MRSA, to enter the bloodstream or infect the skin around the lesion. As president of the Spinal Injuries Association, I know the terrible problems pressure sores can have for vulnerable patients treated in hospitals which do not have the correct equipment, such as turning beds and pressure-relieving mattresses. I hope that the new Care Quality Commission will include precautions being taken by healthcare establishments to prevent pressure sores in its assessment and inspection regime. The terrible problems of the virulent strain of 027 Clostridium difficile have been highlighted by the Healthcare Commission’s reports on Stoke Mandeville Hospital, and Maidstone and Tunbridge Wells. Is C. difficile a notifiable condition? There is some confusion over whether notification is voluntary or statutory. Can the Minister make this clear? Many infections put patients at risk, such as E. coli, Klebsiella, wound infections other than MRSA and many others. If infection prevention and control measures in hospitals are to be successful, this area of the budget should be ring-fenced, in terms of staff employed in infection control, developing general staff awareness and training in good practice for all staff who directly or indirectly come into contact with vulnerable people. Without adequate finance to support measures identified as the result of professional research, these initiatives will flounder. Many projects need looking at. I have recently had correspondence with Dartex Coating about the product Silver 3, a coating for hospital mattresses for which it is claimed that tests have shown that it kills 99.9 per cent of MRSA within 24 hours. Dartex believes that Silver 3 can play a major role in combating hospital-acquired infections. I hope that more research will be done on these matters. MRSA does not like cold conditions. Should hospital floors be washed with iced water? The elimination of hospital-acquired infections would improve the dignity of life for vulnerable patients as well as their quality of life, which can be shattered if they get an infection such as Clostridium difficile. The Darzi report stresses the quality of care. If this is to be taken seriously, infection control must be the top priority.