The Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England. (2000) HC 230 1999/2000 | National Resource for Infection Control (NRIC)

Best practice, Review

Abstract:

The report investigates the strategic management of HAI, what is known about the extent and cost of HAI and how well HAI’s are controlled through prevention, detection and containment measures in acute NHS hospitals. The main focus of the audit was on the work carried out by infection control teams with primary responsibility for surveillance, prevention and control of infection and how they worked with and reported to the trust’s Chief Executive. It outlines in some detail the conclusions from the findings on strategic management of HAI, surveillance and the extent and cost of HAI, effectiveness of prevention, detection and control measures and makes recommendations to the Department of Health, Health Authorities and NHS Trusts for improvements in these areas. It also provides examples of best practice with respect to prevention, control and management of HAI Executive Summary http://www.nao.org.uk//idoc.ashx?docId=cc49926b-67d1-4da7-a771-c721bbe59850&version=-1

Authors:

National Audit Office

Link:

https://www.nao.org.uk/wp-content/uploads/2000/02/9900230.pdf

Category:

Control

Economic analysis

Epidemiology

Management

Prevention

Expert Review

Expert reviews are submitted by our readers. They help other professionals decide whether the research findings reported in this resource are robust and applicable to their daily patient/client care decisions and working environment. If you would like to help, visit our Contribute page.

Summary:

The report investigates the strategic management of HAI, what is known about the extent and cost of HAI and how well HAI’s are controlled through prevention, detection and containment measures in acute NHS hospitals.The main focus of the audit was on the work carried out by infection control teams with primary responsibility for surveillance, prevention and control of infection and how they worked with and reported to the trust’s Chief Executive. It outlines in some detail the conclusions from the findings on strategic management of HAI, surveillance and the extent and cost of HAI, effectiveness of prevention, detection and control measures and makes recommendations to the Department of Health, Health Authorities and NHS Trusts for improvements in these areas. It also provides examples of best practice with respect to prevention, control and management of HAI

Questions Addressed:

The report outlines good practice and also the avoidable adverse effects of HAI for patient’s standard of care and health outcomes. The recommendations outline what actions need to be improved in the management and control of HAI in the interest of better patient outcomes and better use of resources

Type of Study:

Independent report investigation

Methods Valid:

Yes

Methods Valid Detail:

A variety of techniques were used to address the study issues: - A key part of the methodology was a census of acute NHS hospital trusts in England with analyses of responses including multivariate analysis Audit visits to trusts Review of published literature Convening panels of experts and wide consultation

Results Reliability:

Extensive validation checks were carried out on data provided by trusts which were double entered to ensure a very high standard of accuracy High rate of response 216 full responses out of 219 Detailed audit visits carried out to test audit findings

Problems or Biases:

Multivariate analysis to determine clear relationships between HAI rates and measure designed to prevent and control infections were inconclusive due to comparable data across a sufficient number of NHS Trusts

Relevant Studies:

1. Meers PD, Ayliffe GA, Emmerson AM, Leigh DA, Mayon-White RT, Mackintosh CA, Stongs JL, (1981) Report on the National survey of infection in hospitals 1980. Journal of Hospital Infection 2 (Supplementary): 1-112. Haley RW, White JW, Culver DH, Meade Morgan W, Emori TG, Munn VP, Hooten TM (1985) The efficacy of infection surveillance and control programmes in preventing nosocomial infections in US hospitals (SENIC) American Journal of Epidemiology 121: 182-205)3. Glenister HM, Taylor LJ, Cooke EM, Bartlett CLR (1992). A study of surveillance methods for detecting hospital infection. Public Health Laboratory Service 4. Coella R, Glenister H, Fereres J, Bartlett C, Leigh D, Sedgwick J, Cooke EM, (1993) The cost of infection in surgical patients – a case control study. Journal Hospital infection 25: 239-2505. Wilcox MH, Cunniffee JG, Trundel, Redpath (1996). Financial burden of hospital acquired Clostridium Difficile infection. Journal of Hospital Infection 34: 23-306. Glynn A, Ward V, Wilson J, Charlett A, Cookson B, Taylor L, Cole N (1997). Hospital acquired infection surveillance policies and practice – a study of the control of hospital acquired infection in 19 hospitals in England and Wales. London: PHLS7. Emmerson AM, Enstone JE, Griffin M, Kelsey MC, Smyth ETM (1996) The second national prevalence survey of infection in hospitals – overview of results. Journal of Hospital Infection 32: 175-1908. Taylor K, Plowman R, Roberts JA, (2001) The challenge of Hospital Acquired Infection. The National Audit Office. London: Stationary Office9. NAO Report by the Comptroller and Auditor General – HC 876 Session 2003-2004:: Improving patient care by reducing the risk of hospital acquired infection: A progress report. Northern Ireland Healthcare-associated Infection Surveillance Centre (HISC), Scottish Surveillance of Healthcare Associated Infection Programme (SSHAIP), National Public Health Service for Wales (March 2004). Pan Celtic Collaborative Surveillance Report.

Keywords:

Hospital Acquired Infection (HAI) Infection Prevention and Control Surveillance

Reviewer Name:

Sue Wiseman

Reviewer Post:

Nurse Consultant –Infection Control, DH

Reviewer Affiliations:

Member Advisory Committee on Dangerous Pathogens Health Protection Adviser Royal College of Nursing P/T Member Infection Control Nurses Association