Hospital infection prevention, control programs lacking, AG finds

Hospitals across New Brunswick have numerous infection prevention and control deficiencies that can have "severe consequences up to and including death," according to the province's auditor general.

• AG Kim MacPherson releases audits on health, silviculture

Hospital workers don't clean their hands as often as they should, they are removingprotective gear, such as gloves and gowns, improperly, increasing the risk of contamination, andbiomedical waste is improperly stored, according toKim MacPherson's latestreport, released in the legislature on Tuesday.

The report includes chapterson silviculture and private wood supply, as well as anaudit of infection prevention and controlto determine if the Department of Health and the two regional health authorities (RHAs) haveprograms to protect people from hospital-acquired infections.

"Based on the number and variety of deficiencies we observed, we believe there is inadequate monitoring of infection prevention and control policies and practices in hospitals," MacPherson said in a statement.

"We also conclude RHAs need to strengthen enforcement of policies and procedures."

Hospital-acquired infections, such as Clostridium difficile (C. difficile), methicillin resistant Staphylococcus aureus (MRSA) and bloodstream infections,are "common," said MacPherson.One out of every 10 patients admitted to hospital will get one and about 12,000 Canadians die from such infections each year.

They also increase healthcare systemcosts, dueto longer hospital stays andadditional procedures, at a time when the Department of Health is operating in an environment of fiscal restraint, said MacPherson.

About $1.5 billion was spent on hospital services in2012-13 more than 57 per cent of the department's budget.

"If there are cutbacks, it may mean the same amount of work is left to fewer staff. There is a risk these workers may not take the time to wash their hands or properly clean patient rooms and equipment."

As it stands, health care workers only clean their hands about 40 per cent of the time they are supposed to, said MacPherson, citing the Department of Health's online Patient Family Guide, which is based on a pamphlet prepared by the Canadian Patient Safety Institute.

"With the growing awareness of healthcare-associated infections this number is getting better, but it is still less than ideal," she said, noting hand hygiene isone of themost important ways to stop the spread of so-calledsuperbugsand other organisms.

Both Horizon and Vitalit's self-auditing results show compliance rates below their stated goals, according to the auditor general.

Some of her recommendations include:

• The Horizon and Vitalitnetworks address deficiencies within their respective programs.
• Regular "walk-arounds"byinfection prevention and control professionals and all managers to check for compliance with policies and standards.
• Developa provincial infection prevention and control program and strategy in consultation with the RHAs.
• Enhancepublic reporting on the effectiveness of infection prevention and control program.

The RHAshave agreed with the recommendations and have already started working to address the deficiences, said MacPherson.

Her findings were based on visits tofivehospitals within the Horizon Health Network between April and May last yearand three hospitals within the Vitalit Health Networkbetween Septemberand October last year.

Program deficiencies were found at each of the eight hospitals, she said.

"Many of the hospitals had similar deficienciesand we believe they may exist in a number of hospitals to some extent," she said.

The detailed findings for each hospital are not divulged inthe report.

"We believe the findings and the issues are more important than their location," she said.