Agenda item

To receive a presentation on the measures taken by the Betsi Cadwaladr University Health Board (BCUHB) to reduce hospital acquired infections.

10:35 – 11:05

The Committee received a presentation from the BCUHB's Assistant Director Nursing (Infection Prevention) outlining the measures taken  to date with a view to reducing hospital acquired infections. It was generally acknowledged that in 2013 Wales had a higher rate of Clostridium Difficile (C. diff) infection than England.

Steps had been taken to address this through changing cleaning routines including the use of chlorine based products and microfiber cloths. This had made a real impact on visual cleanliness. The Board acknowledged that some areas of Ysbyty Glan Clwyd looked grubby even though they were clean due to the failing fabric of the building.

The Board emphasised their commitment to infection control and addressing anti-microbial resistance which was a problem globally, not just in hospitals but primary care practices (GPs) too.  It had invested financial resources and recruited staff specifically to address infection control on the Board and the wards. 

Improvements to infection control had already been seen and progress made to date had been externally verified. The Board were committed to drive improvement through scrutiny of cause analysis. It was now focussing on further improvement to cleaning processes and reducing MRSA and other infections through partnership working with local authorities and other partners.  The Committee were informed that the Welsh Government produce statistics, publically available, showing the occurrence of C. diff outbreaks.

Members of the Committee expressed concern that nurses and other health care workers could be seen wearing their ward / work based uniforms outside of their clean working environment e.g. shopping in supermarkets etc. and questioned how this contributed to infection control and whether there were any policies relating to this matter?

Health officials confirmed that the Health Board had a clear policy on the wearing of uniforms outside of hospitals and whilst off-duty and that the wearing of an operational uniform in a non-health Board environment was a disciplinary offence.

In response to members' questions, Health officials confirmed that:

·        staff were regularly encouraged to challenge dress and hygiene non-compliance practices, as were patients and visitors;

·        aprons were regarded to be far more hygienic than the white coats with long sleeves for all hospital staff;

·        patients were encouraged to follow washing and dressing requirements when in hospital and pre-surgery. If a patient refused to conform to these request no action could be taken against them as staff had to respect individuals' right of choice. However any exposed for surgery purposes would be cleaned;

·        assigning cleaners their own individual wards had proved to be good practice. It was perceived cleaners took ownership of their allocated areas  and assumed greater pride in their work. Regular meetings with their ward leader resulted in better communication and improvement to the cleaned environment. 

·        there was a clear correlation between clean, modern buildings and hygiene, therefore further investment was being made in domestic staff;

·        all toilets in the vicinity of operating theatres contained washbasins as per building regulations;

·        it was identified that there were insufficient visitor chairs on wards, this led to visitors sitting on patients' bed while visiting.  This shortage was being redressed;

·        clinical governance visits were undertaken to GPs surgeries to undertake spot-checks;

·        in recent years leadership had been too far removed from patients and front-line staff, this situation was now being rectified;

·        dignity and respect were now being promoted at the 'front door' e.g. recently a system of triaging patients waiting in ambulances outside A&E had been introduced. This had achieved a positive outcome resulting in patients being referred to the appropriate treatment areas as soon as possible, thus releasing ambulances to their next call.  As a result ambulances queuing outside A&E were now an exception not a regular occurrence;

·        integrated working between medical and non-medical staff would eventually lead to the best possible experience for the patient at a very distressing time.