Board Meeting Agenda July 2012 - Birmingham Children's Hospital

Ref. Item Action
12.088 Infection Control Annual Report
MM and DJG presented the report to the Board with the following highlights:
• Last year was the start of a new era for infection control. We had previously
put a lot of time and resource into getting the basics right. Last year we felt
ready to set some challenging objectives, particularly around reducing central
line infections, which is one of the most common types of healthcare
associated infections we see, and reducing antibiotic usage.
• These stretch objectives have been met with room to spare. We aimed to
achieve 25% reduction in line infections and we achieved 33%; we aimed to
achieve 10% reduction in antibiotics and achieved 14%.
• There is a lot more we can do and we have set a further objective that no
child will experience an avoidable infection at BCH. First we have to define
what is ‘avoidable’.
• There is also more we can do on antibiotic usage, ensuring there is no delay
in getting antibiotics and discontinuing them as soon as appropriate.
• The DoH mandatory surveillance changed focus last year from MRSA which
has a low prevalence in paediatrics, to MSSA, which is in the top three
causes of bacteraemia within BCH and most other children’s hospitals. The
target concerned us but by working with parenteral nutrition and
gastroenterology we were able to meet it. Learning from this work will be
applied to Haematology/Oncology.
The Board discussed the following points:
• How we compare to other hospitals and is there anything we can learn from
them.
We have been consistently the best performing of the paediatric hospitals in
relation to the DoH measures. It is difficult to compare ourselves on MSSA
with other hospitals because the figures in the public domain are unclear.
• The need to continue to embed the message that infection control is
everyone’s responsibility and that by taking simple measures we can meet
our targets.
• Whether further improvements can be made in relation to blood culture
contamination.
Unnecessary laboratory investigations are bad for the patient and for the
hospital. This is a cultural issue and DJG’s team is working with clinicians to
make use of labs more appropriate.
• Whether there is any cause for concern about infection control compliance
connected with our capacity pressures.
There are no concerns. We have a larger population of infected patients than
most organisations and have a cultural appreciation of infection as a risk. All
infections are monitored weekly and any hospital acquired investigations are
investigated through root cause analysis.
The Board congratulated DJG and MM on the successes; approved the report
and confirmed support of the plans to develop infection prevention and control
in line with the Trust’s strategic objectives.
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