Hospital pharmacists to be at centre of HCAI checks
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Hygiene control practices will be scrutinised |
Hospital pharmacists in England will find themselves at the centre of spot checks on the quality of infection control practices in acute trusts, it was announced by the Healthcare Commission last week.
The healthcare watchdog plans to inspect all 172 acute trusts in England — the
first 25 in the next two months — as part of a national programme
to try to reduce the number of healthcare-associated infections (HCAIs)
such as meticillin-resistant Staphylococcus aureus and Clostridium
difficile.
As the announcement was made, Jonathan Cooke, a member of the Government’s
independent Specialist Advisory Committee on Antimicrobial Resistance
and director of pharmacy and director of research and development at
South Manchester University Hospitals NHS trust, advised pharmacists
to scrutinise two commission publications to help them understand what
will be expected of them (see Panel below).
Reports outline pharmacists’ responsibilities
Pharmacists are advised to examine two reports: “The
management of medicines in acute and specialist trusts” (PDF 940K),
published in January 2007, and “Healthcare associated
infection: what else can the NHS do” (PDF 1MB), published
July 2007.
Both documents spell out what responsibilities pharmacists have
towards helping reduce HCAIs in general and provide advice about
how trusts
can meet the 11 mandatory duties of the Department of Health’s
hygiene guide which governs HCAIs and which will be the main focus
of the commission inspector’s scrutiny.
The documents advise that clinical pharmacy staff are expected
to provide antimicrobial prescribing advice routinely. Outcomes
following
the advice, including financial consequences, should also be monitored.
An audit trail of antimicrobial prescribing should also be in place
in trusts and all prescribers should be trained — during working
hours — in appropriate prescribing protocols.
Trusts should also make sure that any responsibility for prevention
and control of infection is written into staff job descriptions
and personal development plans as well as being raised during staff
appraisals. |
Ahead of the spot checks — which can take up to two days — trusts
will be asked to provide the commission with details of its hygiene code
action plan, risk registers and a list of all its infection control policies.
It also expects to be given minutes of the meetings of the trust’s
infection control committee and the trust board. The spot checks will
focus on any aspect of the trust’s infection control procedures
that the commission believes falls short of the 11 mandatory duties outlined
in the statutory code for hospital hygiene.
During the visits, inspectors will check the hospital’s physical
environment, observe whether hygiene control practices are implemented
properly and take the opportunity to interview staff, including cleaners,
clinicians and managers.
Andy Alldred, chairman of the Guild of Healthcare Pharmacists’ practice
committee, said the inspection programme created some really important
challenges for pharmacists as well as significant opportunities.
“This raises the profile of HCAIs and makes it of corporate importance
for the organisation. Its status has changed,” he said. “There
is a variation of practice up and down the country; some trusts still
don’t have dedicated antibiotic pharmacist time and these [trusts]
are going to find some real challenges. The crucial element in this is
ensuring that antibiotic prescribing is rational and there are two strings
to that — one is about reducing resistance and the other is about
reducing the cases of MRSA and Clostridium difficile and the financial
impact of that.”
Announcing details of the inspections, the commission’s chief executive
Anna Walker said: “The hygiene code has been in place for 18 months
now. Trusts know what they’ve got to do and previous inspections
have shown that most trusts are working hard to ensure that they are
meeting all the requirements.
“However, if we find any trust falling short of its obligation
to protect patients from infection, we will use our powers to ensure
improvements
are made.”
Last year similar spot checks at 120 acute trusts found that three were
breaching the statutory hygiene code. They were served with improvement
notices, which indicate the improvements trusts have a duty to introduce. |
The
Pharmaceutical Journal
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