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Next Steps on Patient Safety in the EU Better
PRACTICE, better COMMUNICATION 17 March 2009
Julian Hartley Chief Executive, Blackpool, Fylde
Wyre Hospitals NHS Trust
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Next Steps on Patient Safety in the EU Better
PRACTICE, better COMMUNICATION 17 March 2009
Dr Achyut Guleri MD, FRCPath. Consultant Clinical
Microbiologist, Blackpool Victoria Hospital
Hon. Senior Clinical Lecturer, UCLAN
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HCAI Containment Strategy in the 21st Century

• The Blackpool Success Story
• Julian Hartley
• Chief Executive
• Dr Achyut Guleri
• Consultant Microbiologist

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MRSA The Problem (UK)

• 4,500 MRSA Bacteraemia in UK (April 2007 to March
  2008)
• Approximately 100,000 total MRSA infections in UK
  
• Cost to the NHS approximately 100M each year

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MRSA The Problem (Europe)
The cost to Europe - Billions!!
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About our Trust

• Large Acute Hospital Trust in the North West of
  England
• Foundation Trust
• Local population of 330,000 plus 12 million
  visitors
• 800 beds across five sites
• Tertiary centre for cardiac and haematology
• 92,000 AE attendances
• 4,500 staff

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MRSA Bacteraemia in Blackpool April 2007- March
2008
40 cases of MRSA bacteraemia against target of 26
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Objectives

• Reduce total MRSA infections and MRSA bacteraemia
• Enhance Patient Safety
• Deliver our vision of providing Best in NHS
  Care
• Greater staff and public awareness of HCAI
• Strengthen infection management team

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Actions

• Six month pilot of Polymerase Chain Reaction
  (PCR) test for MRSA
• Launch of Ban the Bugs Campaign
• Mandatory infection prevention training for staff
• Hand Hygiene Champions and audits
• MRSA counter
• New uniform policy - Bare Below the Elbow

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Actions

• Appointment of new Director of Infection
  Prevention and Control (DIPC)
• Expansion of Infection Prevention team
• Improved infection management programme
• Root Cause Analysis for all MRSA bacteraemia
• Reduce and rationalise the use of antibiotics

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Introduction of PCR

• Rapid diagnostic test based on MRSA DNA
• Six month pilot (March to September 2008) funded
  through the Hospitals Charitable Funds
• Screening of all emergency patients admitted
  through AE, Critical Care, Clinical Decisions
  Unit
• 7 days a week 8am-midnight

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Advantages

• Rapid Results (within two hours)
• Sensitive and specific
• Reliable and Reproducible

Disadvantages

• Expensive

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PCR Video Clip
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Results following the trial
63 reduction in MRSA bacteraemia infections
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Results to date MRSA bacteraemia
8 cases of MRSA bacteraemia in 2008/2009 compared
to 40 in 2007/2008 reduction of 80
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Key Achievements

• 80 reduction in MRSA bacteraemia
• Lowest MRSA infection rates in the North West of
  England
• Significant reduction in mortality
• Greater staff and public awareness
• Sharing best practice nationally and
  internationally

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Key Achievements
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MRSA counter 109 days since last MRSA
bacteraemia
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Key Achievements
Expansion of the Infection Prevention team
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Key Achievements
Ban the Bugs Greater public and staff
awareness
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Key Achievements
Winner of Department of Health and NHS Purchasing
and Supply Agency HCAI Technology Innovation
Award 2009
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So how have we achieved it?

• Combination of the use of cutting edge
  technology and deep staff engagement
• The Blackpool Way

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• Questions?