Minimising the Risk
At The Portland Hospital, minimising the risk of healthcare associated infection, including MRSA infection, for each patient is a matter of continuous vigilance, robust infection surveillance systems and ongoing training of staff at all levels in hospital hygiene. Our entire infection control procedures are supervised and reinforced by our experienced and dedicated Infection Control Nurses and Consultant Medical Advisers.
Highest Quality Standards
The Portland Hospital is committed to the highest quality standards.
Factors that contribute to our high quality record include:
- Individual rooms with private en-suite facilities for almost all patients before and after any treatment or operation, unless the specialist resources of high dependency or intensive care are necessary.
- High nurse to patient ratios, increasing the time available for individual attention and ensuring the highest quality of care and hygiene.
- On-site cleaning staff who work to high specifications of hygiene and cleanliness, available 24 hours every day to respond to any need that may arise.
- A rapid and comprehensive room cleaning regime between the discharge of one patient and the admission of the next.
What is MRSA?
Staphylococcus aureus is an organism commonly found on the skin and in the nose of healthy people. At any one time approximately 30% of us carry this bacterium and the population affected is continually changing. Methicillin Resistant Staphylococcus Aureus (MRSA) is a much less common variant which is resistant to penicillin and cephalosporin antibiotics commonly used to treat sensitive strains. There are many other antibiotics readily available to treat MRSA infection. These organisms may also be transiently present on the skin without causing infection. However, like sensitive Staphylococcus aureus, on occasion, these organisms can cause infection and, rarely, blood infection or septicaemia.
MRSA Rates at the Portland Hospital
All patients admitted to the Portland Hospital will be screened for MRSA as part of their treatment by taking a swab from the anterior part of the nose (the commonest site of staphylococcal carriage, including MRSA). Should the patient be an MRSA carrier, the procedure may be deferred pending eradication treatment, or if clinically necessary to proceed, will be nursed in strict isolation ("barrier nursing") to reduce the possibility of transmission to healthcare staff or other patients.
Most antibiotics can cause diarrhoea and Clostridium difficile was discovered to be the cause of some of the diarrhoea that patients developed after taking antibiotics. It is a bacterium that is present in the gut of up to 3% of healthy adults and 66% of infants. However, C. difficile rarely causes problems in children or healthy adults, as it is kept in check by the normal bacterial population of the intestine. When antibiotics disturb the balance of bacteria in the gut, Clostridium difficile can multiply rapidly and some strains produce toxins which cause inflammation of the bowel.
Acquiring C. difficile may result in asymptomatic carriage, loose stools or profuse diarrhoea which can result in life-threatening inflammation of the bowel wall (pseudomembranous colitis). C. difficile infections are most common in people over the age of 65 years but any age group may be susceptible.
Large outbreaks of C. difficile with significant mortality have been documented in healthcare facilities. The organism is present in the environment particularly around those who have diarrhoea and can contaminate the hands of patients and their carers. The organism forms spores which are resistant to drying and some disinfectants. Cross infection occurs if the organism has been able to contaminate the food or water that patients consume. Very simple rules can prevent this happening.
We look for the bacterium by examining the faeces of patients in the laboratory for the toxins which are carried by the bacterium. If our laboratory identifies a case of C. difficile, the Infection Control Team are immediately alerted and specific robust policies are initiated. These policies are fully in keeping with national guidelines and data is submitted quarterly to the Healthcare Commission.
Within HCA we are pleased to assure you that C. difficile infections are uncommon.
Factors contributing to this low incidence include:
- Ongoing staff education and updates
- Monitoring of antibiotic prescribing practices
- Patients are generally nursed in private rooms with private facilities. The exceptions include intensive care and ambulatory surgery areas
- High nurse to patient ratios ensuring compliance with hygiene policies reduces risk
- On-site housekeeping staff work to high standards of hygiene and cleanliness.
Infection Control Service (ICS)
The microbiology service is through Infection Medical Chambers (IMC) who offer a 24 hour service. The 2 dedicated microbiologists are:
Dr Julie Andrews
Dr Sophie Collier