According to latest figures the Methicillin-resistant Staphylococcus aureus (MRSA) superbug cases are again above allowed levels at Leeds hospitals and the hospitals are now facing a fine of £500,000 over failure to tackle the bug. As reported by the Yorkshire Evening Post earlier this year, every month that the number of MRSA cases exceeds a target agreed by health bosses, a fine of £100,000 is levied. Between April last year and the end of January, the target was breached four times. Latest figures show it was breached again in February, with four cases reported, so another £100,000 fine has been added. In 2009 the Yorkshire Evening Post revealed that the hospitals trust faced a penalty of up to £20m as it had consistently failed to meet targets on MRSA and Clostridium difficile. That money would not be taken away from funding but would have to be spent on tackling the issue.
According to Leeds Teaching Hospitals director of informatics Alison Dailly, “The trust failed the target for the month, as the number of bacteraemias reported is significantly above the trajectory, which allows only one MRSA case per month between November 2010 and March 2011.” In the 11 months to February, there were 23 incidences of MRSA – less than the 37 reported the year before – but over the allowed number of 18. That means it will miss the target over cutting cases of the bug and, according to the rules set by health chiefs, won’t have the fines reimbursed. “As the local trajectory has now been exceeded for 2010/11, the trust will not achieve the target for the year,” Ms Dailly added. “The trust is therefore forecast to either underachieve or fail the indicator for 2010/11.”
Chief nurse Ruth Holt told a meeting of hospital directors, “We are taking the issue very seriously and we have increased our performance management arrangements. It’s particularly disappointing after having a good start to the year.” She added that there had been increased pressure on the hospital over the winter but they were focusing on improving performance. Analysis is done on every case of MRSA to find out where it has come from.
The Royal Gwent Hospital, as the area's biggest and busiest hospital, accounts for the highest proportion of cases of both MRSA and Clostridium difficile, but cases are down across the board, and particularly in Gwent's community hospitals. Among the plans drawn up by infection control chiefs at Aneurin Bevan Health Board, is one that focuses on staff education to highlight the board's zero tolerance policy toward infection.
As protective measures the hospitals are running pilot schemes using new methods of monitoring patients' tubes and catheters and these methods are being extended following encouraging early results, which have shown reductions in infections where such devices are inserted. Consideration is also being given to the use of a deep cleaning system using hydrogen peroxide vapor. This is recognized as an effective method, but involves wards being emptied of patients while the cleaning takes place, and this can be difficult to implement when the demand for beds is persistently high.
Nottingham's two main hospitals had fewer MRSA cases last year, but more of the bug Clostridium difficile, managers have revealed. Five cases of MRSA were reported at Queen's Medical Centre and Nottingham City Hospital in 2010 compared to 21 in the previous year. But the number of Clostridium difficile cases rose from 201 to 225. Nottingham University Hospitals NHS Trust said the hospitals had a stretch of 140 days without a new MRSA case.
“In the last year we have also expanded MRSA screening to all elective, emergency and day case patients. By the year-end we were screening over 95% of patients,” spokeswoman Linda Abolins said. She said the hospitals had “largely stopped infection between patients (cross-infection) and from the environment by good hand hygiene and isolation, and by on-going deep cleans and targeted cleaning…We must scrupulously maintain the very highest hygiene, learning and isolation practices.” She said the trust was aiming to have fewer than 158 Clostridium difficile cases in the next year.
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