NEWS
C. difficile report prompts review of infection control in Scotland’s NHS By Sally Gillen
@Sally_Gillen
Health boards in Scotland have been ordered to review the way they care for patients with clostridium difficile, following the publication of a report into patient deaths from the infection. Health secretary Shona Robison has given boards eight weeks to review their services, in particular infection control procedures, after a report found clostridium difficile (c.difficile) was a factor in the death of 34 patients at the Vale of Leven Hospital between 2007 and 2008. The report into the worst outbreak of the infection in the country, based on the public inquiry chaired by Lord MacLean and the analysis of patient records by seven nursing experts, uncovered ‘a catalogue of failures in fundamentals of nursing care’. Many nurses were not aware that c.difficile is a serious infection, describing it as a ‘wee bug,’ according to relatives who gave evidence. ‘It is clear to the inquiry that nurses were not fully aware at the time of the potential seriousness of c.difficile as an illness, particularly in older and
Three key recommendations Health boards should keep a proper record of a patient’s stools if he or she has or is suspected of having c.difficile diarrhoea. Nursing staff caring for a patient with c.difficile should keep accurate records of their observations including temperature, pulse and blood pressure. There should be a straightforward and timely escalation process for nurses to report concerns about staffing and skill mix. vulnerable people,’ says the report. ‘Ultimately this comes down to a lack of proper education, training and supervision. The lack of nursing knowledge compromised patient care.’ Lord MacLean said there had been ‘serious personal and systemic failures’ at the hospital. The report criticises some nursing staff for giving laxatives to patients with diarrohea – one of the symptoms of c. difficile. It makes 75 recommendations, of which 21 are specifically about nursing.
All of the recommendations have been accepted by the Scottish Government. Ms Robison said health boards will need to review their services against the recommendations of the report, adding that interim chief nursing officer Fiona McQueen will work with nursing directors to develop local quality assurance programmes. RCN Scotland director Theresa Fyffe said the c.difficile outbreak had had ‘devastating consequences’ for patients and their families. ‘It is right for Lord MacLean to say senior charge nurses are accountable for what happens on wards, but he also points out that governance and management failures at Vale of Leven meant nurses were seeking to do their best in an environment where patient care was compromised and infection control inadequate,’ said Ms Fyffe. NHS Greater Glasgow and Clyde chairman Andrew Robertson said: ‘This was a terrible failure and we profoundly regret it.’ The board’s nurse director Rosslyn Crocket said: ‘We have learned a huge amount about how to improve control infection rates since 2008.’
Nurses at Imperial College Healthcare NHS Trust promoted awareness of pressure ulcers among staff, patients and the public to mark this year’s Stop Pressure Ulcer Day. Staff handed out information and demonstrated how to use a chair with pressure relieving cushions at the trust’s St Mary’s, Charing Cross and Hammersmith hospitals. The trust also used the event to launch its new five-year pressure ulcer strategy. Sue Burgis, head of practice development and innovation, said: ‘We want to create a zero tolerance approach.’
NURSING STANDARD
BARNEY NEWMAN
Staff raise awareness of pressure ulcer prevention
december 3 :: vol 29 no 14 :: 2014 11
C. difficile report prompts review of infection control in Scotland’s NHS By Sally Gillen
@Sally_Gillen
Health boards in Scotland have been ordered to review the way they care for patients with clostridium difficile, following the publication of a report into patient deaths from the infection. Health secretary Shona Robison has given boards eight weeks to review their services, in particular infection control procedures, after a report found clostridium difficile (c.difficile) was a factor in the death of 34 patients at the Vale of Leven Hospital between 2007 and 2008. The report into the worst outbreak of the infection in the country, based on the public inquiry chaired by Lord MacLean and the analysis of patient records by seven nursing experts, uncovered ‘a catalogue of failures in fundamentals of nursing care’. Many nurses were not aware that c.difficile is a serious infection, describing it as a ‘wee bug,’ according to relatives who gave evidence. ‘It is clear to the inquiry that nurses were not fully aware at the time of the potential seriousness of c.difficile as an illness, particularly in older and
Three key recommendations Health boards should keep a proper record of a patient’s stools if he or she has or is suspected of having c.difficile diarrhoea. Nursing staff caring for a patient with c.difficile should keep accurate records of their observations including temperature, pulse and blood pressure. There should be a straightforward and timely escalation process for nurses to report concerns about staffing and skill mix. vulnerable people,’ says the report. ‘Ultimately this comes down to a lack of proper education, training and supervision. The lack of nursing knowledge compromised patient care.’ Lord MacLean said there had been ‘serious personal and systemic failures’ at the hospital. The report criticises some nursing staff for giving laxatives to patients with diarrohea – one of the symptoms of c. difficile. It makes 75 recommendations, of which 21 are specifically about nursing.
All of the recommendations have been accepted by the Scottish Government. Ms Robison said health boards will need to review their services against the recommendations of the report, adding that interim chief nursing officer Fiona McQueen will work with nursing directors to develop local quality assurance programmes. RCN Scotland director Theresa Fyffe said the c.difficile outbreak had had ‘devastating consequences’ for patients and their families. ‘It is right for Lord MacLean to say senior charge nurses are accountable for what happens on wards, but he also points out that governance and management failures at Vale of Leven meant nurses were seeking to do their best in an environment where patient care was compromised and infection control inadequate,’ said Ms Fyffe. NHS Greater Glasgow and Clyde chairman Andrew Robertson said: ‘This was a terrible failure and we profoundly regret it.’ The board’s nurse director Rosslyn Crocket said: ‘We have learned a huge amount about how to improve control infection rates since 2008.’
Nurses at Imperial College Healthcare NHS Trust promoted awareness of pressure ulcers among staff, patients and the public to mark this year’s Stop Pressure Ulcer Day. Staff handed out information and demonstrated how to use a chair with pressure relieving cushions at the trust’s St Mary’s, Charing Cross and Hammersmith hospitals. The trust also used the event to launch its new five-year pressure ulcer strategy. Sue Burgis, head of practice development and innovation, said: ‘We want to create a zero tolerance approach.’
NURSING STANDARD
BARNEY NEWMAN
Staff raise awareness of pressure ulcer prevention
december 3 :: vol 29 no 14 :: 2014 11
