Number of cases of MRSA at Dartford's Darent Valley Hospital increases
12:00, 04 April 2016
The number of cases of MRSA has shot up as a result of staff shortages, nurses not washing their hands and wash bowls not being properly cleaned.
A list of problems were found at Darent Valley Hospital after an inspection last month by the Trust Development Authority.
During a Dartford And Gravesham NHS Trust board meeting last week it was conceded that "February has been a very poor month for infection prevention and control".
On three consecutive days MRSA outbreaks were reported to Public Health England which has brought the total for the trust to 14 since April last year.
While cases earlier in the year were rare, less than one a month, the levels of MRSA cases have shot up recently.
There were four in December, another in January and three in February.
There was an MRSA outbreak during the inspection in March too, and various practices were found to be unacceptable.
The Clinical Quality Visit Report states: "Compliance with hand hygiene was poor, staff were spotted going from patient to patient without decontaminating their hands.
"Many rooms on all wards had patients nursed in isolation due to infections. However, the vast majority of single rooms had doors open and these were held open by clinical waste bins.
"There were instances of poor compliance with the wearing of PPE [Personal protective equipment] and not removing this appropriately. In addition, staff who should have been wearing PPE were not. For example, when handling used linen and waste products."
In addition, the Infection Prevention and Control (IP&C) nursing team have been short staffed for many months due to long term sickness.
This has impacted the team’s ability to be pro-active and the team "feel overwhelmed by the situation... they appeared fatigued and frustrated".
While all staff demonstrated that they were aware of the MRSA position and appeared very concerned, they lacked strategic direction in how to improve.
A spokesman for the hospital said: "The increased number of MRSA infections is a great concern and we know we need to improve. We saw an increase in MRSA cases at the end of the year which prompted us to contact the NHS Trust Development Authority (now NHS Improvement) for support and to review our practices and procedures.
"We have already put in place a range of measures to reduce the risk of an MRSA infection such as reintroducing universal screening of all patients and body washes with antimicrobial shower gel for all inpatients as well as an increased emphasis on hand hygiene.
"We are continuing to closely monitor MRSA and no new cases have been identified during March. We are confident the measures we are implementing to address the increase are working and that the number of MRSA cases will be back down to normal levels this year."
Improvement action taken by the trust includes:
• A MRSA taskforce has been set up and met already four times.
• A new, temporary infection prevention and control team has been put in place
• All staff have been reminded of the need for good hand hygiene and personal protection
The main culprit at Darent Valley for outbreaks is Rowan Ward. According to the report, it is now getting more support from two senior matrons; Tara Laybourne and Suki Gill.
The report states: “Rowan ward has a particularly heavy work load as all the surgical complicated cases with parenteral nutrition and fistulae are cohorted there.”
Spruce ward, which has also had a couple of cases, is also getting senior matron support.
MRSA is a bacteria that can cause mild skin infections, which can lead to life-threatening infections including blood poisoning.
It can be spread through skin-to-skin contact, or contact with contaminated objects such as towels, sheets, clothing and surfaces.
People staying in hospital are most at risk of becoming infected with MRSA.
The increase seems to have been affected by the decision to stop universal screening following new guidance from Public Health England.