MRSA Action UK: Patients at risk with inadequate facilities to decontaminate medical equipment
With MRSA, Clostridium difficile and other resistant microbes that are endemic in our hospitals; we are going to need to use every tool at our disposal if we are to reduce the incidents of patients contracting healthcare infections in hospital. This will mean introducing new methods of controlling infections with the ultimate aim of reducing to as low as is possible. However before we introduce new methods of working we must ensure that the basic methods of preventing and controlling infections are adhered to.
This applies to Doctors and Nurses who look after the patients; and just as importantly managers who have the responsibility to ensure that the proper policies and procedures are in place to ensure the patients are kept safe whilst in hospital. This includes ensuring that they comply with the Health and Social Care Act 2008
It is with great dismay as a Charity however that we have read the Royal College of Nursing survey that has highlighted very serious deficiencies in respect to decontaminating equipment in hospitals. Although this survey was completed by nurses in Welsh hospitals, we have to wonder how many hospitals within the United Kingdom have the same problem when it comes to decontaminating equipment that will be used again on patients.
The Hygiene Code introduced in October 2006 and superseded by the Health and Social care Act of January 2008 clearly lays down the responsibility of orgsanisations to decontaminate instruments and equipment in and on their premises.
The results of the survey performed by the RCN quite clearly shows that as many as four out of ten nurses did not have access to 24 hour cleaning services and almost one in four have not had any mandatory infection control training within the last year. Of great concern is the fact that one in five nurses do not have the appropriate storage rooms for equipment and that they are forced therefore to store and clean reusable equipment in bathrooms. One in three nurses have had no formal training on how to decontaminate equipment that will eventually be reused on patients in hospital.
The survey from the RCN has clearly shown that as many as possibly one in three hospitals are in breach of the Health and Social Care Act and its requirements for cleaning and decontaminating reusable instruments and equipment. Duty four of the Hygiene Code states quite clearly that organisations caring for patients should ensure that “decontamination of reusable medical devices takes place in appropriate dedicated facilities” also “appropriate procedures are followed for the acquisition and maintenance of decontamination equipment” and that “Effective decontamination of reusable medical devices is essential. There should be a system to protect patients and staff that minimises the risk of transmission of infection from medical devices and other equipment that comes into contact with patients or their body fluids. Decontamination is the combination of processes, including cleaning, disinfection and sterilisation, used to render a reusable item safe for further use on patients and handling by staff”.
The Hygiene Code stipulates that “the staff are trained in decontamination processes and hold appropriate competencies for their role; and a monitoring system is in place to ensure that decontamination processes are fit for purpose and meet the required standards”.
Clearly the survey performed by the RCN has very serious implications for the safety of patients in some hospitals, how many we do not know, however this survey we believe should be viewed very seriously by the Government, The Department of Health, by the NHS and the regulator and action should be taken to ensure that facilities, training and the required monies are put aside to ensure that staff in the hospitals have the ability to decontaminate instruments and equipment to the standards required.
Whilst the practice of decontaminating instruments and equipment in washrooms carries on, this is a clear breach of the Hygiene Code and a breach of law that puts the lives of patients at risk and is a totally unacceptable practice that should cease forthwith. In any other form of industry this kind of breach in the law would not be tolerated.
Any hospital that does not have the facilities to be able to decontaminate instruments and equipment as stipulated within the Hygiene Code should be dealt with harshly by the regulator. At MRSA Action UK it is our belief that unless failures in systems such as the one highlighted by this survey are addressed, we will fail to reduce infections to a level that is as low as possible, and that the consequences will inevitably lead to more patients suffering from and being lost to healthcare infections.
Derek Butler
Chair
MRSA Action UK
Registered Charity No 1115672
Tel No 07762741114
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