Infection Control Monthly Report

Meeting
Trust Board - PART I
Date 26 th January 2012
Subject
Infection Prevention & Control (monthly update)
Reporting Officer
Purpose
Pippa Barber, Executive Director of Nursing and
Governance/DIPC
Monthly briefing on Infection Prevention & Control for December
2011
Please indicate as appropriate
Trust Objective
Achieve Excellence in Governance
Risks Identified
Impact on Equality
Norovirus Outbreaks during December. Ward closures to contain
the risk of transmission of infection.
Ensuring equal access to safe services
Legal Implications
Patients would have the right to take legal action if a hospital
acquired infection was diagnosed and appropriate diagnosis and
treatment not made.
Trust Board Meeting – 26.01.12
Monthly Infection Prevention and Control Report
Page 1 of 4

Summary
This monthly report covers the period since the last Board meeting. This report aims to keep the
Board fully apprised of issues, developments and risks of all infection prevention and control
issues.
Database Information
As agreed with the Board the following is a list of all reported infections since the last board
meeting. The database may contain personal information and cannot be included in the report.
Date Ward Infection Details Outcome/Learning
1/12/11 WKNRU MRSA in
groin and
Sacral sore
6/12/11
Emerald
Ward
14/12/11 Walmer
Ward TGU
Cellulitis of
leg and
colonised
with MRSA
MRSA skin
colonised
MRSA decolonisation
protocol implemented.
Patient had their own
room. Wound was
covered. Standard
precautions in place
used by all staff.
Patient treated with
systemic antibiotics.
Wound swabbed for
MRSA. Decolonisation
treatment prescribed.
Wound seen and advice
given by Tissue Viability
Nurse.
Patient has been non
compliant with decolonisation
treatment
despite staff attempts to
encourage compliance.
Wound was re-swabbed
as protocol. Still
infected with MRSA.
Silver dressings still
being used to reduce
bacterial load.
Wound re-swabbed
after completion of
decolonisation
treatment and provided
a negative result.
SICN visited the unit
and provided advice on
how to manage
situation. Advised
medical staff to contact
Consultant
Microbiologist for advice
Re: the suitability of
systemic antibiotics
when patient non
compliant with topical
treatments.
25/12/11 Cranmer
Ward
Confirmed
Norovirus
outbreak
10 patients and 5
members of staff
affected.
Deep clean performed
after all patients were
asymptomatic for 48
hrs. Ward now open -
See details below
30/12/11 Sevenscore Confirmed
Norovirus
outbreak
9 patients, 1 staff
member and 1 visitor
were affected.
All patients
asymptomatic and deep
clean being performed.
See details below
Trust Board Meeting – 26.01.12
Monthly Infection Prevention and Control Report
Page 2 of 4

NOROVIRUS OUTBREAK
CRAMNER WARD
Three cases of diarrhoea and vomiting were reported to the Infection Prevention and Control
Team, the duty doctor and on-call manager on the 25/12/11. Standard precautions were in place
with the patients being isolated. 2 further cases were identified on the 26/12/11. Stool
specimens obtained and sent to the lab confirmed Norovirus. The Kent Health Protection Unit
were informed and provided advice and support to the ward over the bank holiday period. The
ward was closed to admissions, transfers and discharges.
A total to 10 patients and 5 members of staff were affected.
The likely origin of the outbreak was a patient who three days earlier first became symptomatic
with vomiting. It had been documented that the patients daughter had been ‘unwell with a bug
causing vomiting and her mother may have caught it’. Other contributory causes included a
number of NHSP staff on duty over this period, but it is unknown if any were symptomatic.
Cranmer ward re-opened to admissions from the 5 th January 2012 following a deep clean.
SEVENSCORE WARD
Three cases of diarrhoea and vomiting were first reported to the Infection Prevention and
Control Team on the 30 th December. Stool samples sent to the laboratory confirmed diagnosis
of the norovirus. The team was able to support the Ward staff in managing this outbreak. The
ward was closed to admissions, transfers and discharges. The KHPU was notified. Patients
were isolated and standard precautions were in place. Enhanced cleaning was instigated.
A total of 9 patients, 2 staff members and 1 visitor were affected overall.
• The origin of this outbreak was not ascertained however contributory factors included
NHSP staff were used over the Christmas period to support the ward.
• First Patient affected had been admitted to acute general hospital on 2 occasions passing
through CDU which has a high thoroughfare. The hospital had norovirus circulating
during December however not on the occasions the patient was admitted.
Senior Infection Control Nurse visited the Sevenscore Ward on the 09 th of January. All patients
were asymptomatic and one member of staff remained off work and will return when clear of
symptoms for 48 hours. A deep clean was being performed and the ward will re-open once
completed.
During each outbreak, meetings were convened with the Senior Infection Control Nurse,
Matron/Service Manager, Domestic Supervisor and Deputy Ward Manager to plan the deep
clean and discuss learning from these events.
The SICN provided information on Staffzone to ensure staff are vigilant in recognising the
symptoms of Norovirus and reporting immediately to the Infection Prevention and Control Team.
Trust Board Meeting – 26.01.12
Monthly Infection Prevention and Control Report
Page 3 of 4

Training
Staff Trained in Infection, Prevention and Control Including % achieved against target as
at 31 December 2011
Course
Infection, Prevention and
Control Training
Advanced
95%
Basic
100%
1779 2675
Annual
Target
Advanced
2155
Annual
Target Basic
1532
% Achieved % Achieved
TOTAL 1779 2675 84% 100%
The targets set for the Infection Prevention control is 95% for all clinical staff and 100% for non
clinical staff. The figures for advanced IP & C training has decreased by 1% since November.
The Infection Prevention and Control Team continue to work hard to provide training to staff.
The Training Needs Analysis (TNA) will be reviewed shortly and will be changed to 2 yearly for
clinical staff as per other mental health Trusts.
Monthly Observational Hand Hygiene Audit results
The results of the monthly observational hand hygiene audit for December 2011 show a 95%
compliance rate, 1% decrease from last month. One ward had a 50% compliance and was
asked to repeat the audit which they duly did increasing their score to 80%. A feedback form
was completed and results reported to the ward team to raise hand hygiene profile. Four wards
did not submit their data. These were Emerald Ward (Acute), Anselm Ward (Acute), Hearts
Delight (Older Persons) and Birling Centre (Learning Difficulties).To address non compliance of
hand hygiene audit returns, the Infection Prevention and Control Team sent an e mail to the
Ward Manager, Service Manager, Associate Director and Directors for that service to ask why
their data has not been submitted. Hand Hygiene audits have become a standard item at the
Modern Matrons Meetings.
Staff flu vaccinations
The Infection Prevention and Control Team and the Lead Resuscitation Officer have been
providing flu ‘walkabouts’ within the Trust to encourage the increased uptake of flu vaccinations
for staff. Recent figures from the Kent Health Protection Unit (KHPU) show that the total
numbers of staff with patient contact are 610 who had received their flu vaccine which is an
increase of 25.5% from the previous year. Overall numbers of all staff vaccinated is 891 which is
an increase of 18% on last year. These figures will increase slightly as the vaccination
programme does not finish until the end of January 2012.
Recommendation
For this update report to be accepted as a briefing on the relevant issues since the last report to
the Board in December 2011.
Trust Board Meeting – 26.01.12
Monthly Infection Prevention and Control Report
Page 4 of 4