Almost a decade on, HCAI’s still cost NHS £1bn annually

Methicillin Resistant Staphylococcus Aureus (MRSA) first made the headlines in healthcare almost a decade ago now.

Back then, healthcare associated infection (HCAI) were believed to cost the NHS at least £1bn annually and cause at least 5000 deaths (NAO 2000; NAO 2004).

The British press ran articles almost daily about a healthcare system under pressure, patients scared to go into hospital and a Government needing to be seen to act.

In March 2004 the then Health Secretary, John Reid, set the target to halve the infection rates by April 2008. This made hospitals look at infection control more closely and the role of Director of Infection Prevention and Control (DIPC) was created in order to demonstrate that they took the threat seriously.

It was soon realised, however, that MRSA was not purely a hospital problem, it was a healthcare problem with patients entering hospital already colonised so MRSA was not going to be easily solved and was going to take a great deal of effort by all to control.

Infection control needed to be looked at as a big jigsaw; many measures were going to make the whole picture clearer with all areas needing to work together.

There was not going to be one solution. Cleaners, nurses, doctors, patients, visitors and industry all had a part to play.

In 2005, John Reid announced plans to tackle MRSA in hospital wards that included the Matron’s Charter.

The charter was a ten-point plan outlining matrons’ priorities for keeping hospitals clean. It stated that wards should be clean and safe and cleaning staff should be made to feel part of the team. Matrons would have the power to withhold payment for cleaning services that were considered substandard. Chris Beasley, the newly appointed Chief Nursing Officer, was to oversee the drive to improve ward cleanliness and tackle hospital acquired infections.

According to the National Audit Office Report ‘Trends in Rates of Healthcare Associated Infection in England 2004 to 2008’, the prevalence of HCAI between May 1993 and July 1994 in 157 hospitals was 9%.

In 2006, 270 hospitals in England, Wales, Northern Ireland and Republic of Ireland participated in a similar survey between February and May and identified an overall prevalence of HCAI of 7.6%.

The HCAI and Antimicrobial Point Prevalence Survey between September and November 2011 showed that there was an overall drop in HCAI prevalence to 6.4%.

So, nearly a decade later, and despite best efforts that promote good hand hygiene practices, isolation protocols and cleaning of healthcare surfaces, HCAIs acquired during hospital stays are still the most common complication of hospital care, and one of the most serious patient safety concerns.

In March 2012, the National Institute for Health and Care Excellence (NICE) estimated that 300,000 patients a year in England alone acquired an HCAI as a direct result of receiving care within the NHS. These infections are often difficult to treat and they can complicate illnesses, cause distress to patients and their family and in some cases may even lead to death.

It is estimated that HCAI’s still cost the NHS around £1 billion a year. That’s because infected patients not only cost three times more to treat than uninfected patients but the infections are becoming difficult to treat because of an increase in antimicrobial resistance. This has a knock-on effect on the availability of beds because infected patients have to spend, on average, an extra 11 days in hospital.

The primary control is and always will be an effective cleaning protocol. Disinfectants remove both good and bad bacteria to leave a sterile surface. However, the residual effect can last as little as an hour so any bacteria subsequently landing on the clean surface will flourish unchallenged.

Only surfaces that are both cleaned regularly and have built-in 24/7 antimicrobial protection will provide the maximum protection against the build-up of harmful bacteria and the threat of cross contamination.

Rooms can only be properly cleaned when the patient leaves so having antimicrobial surfaces working to reduce the threat of cross-contamination while the patient is there can only be beneficial.

In 2011 a study was conducted into uniforms worn by hospital nurses and doctors. Despite the fact that 58% claimed to change their uniform every day, the research concluded that up to 60% of the uniforms were colonised with potentially pathogenic bacteria – including drug-resistant organisms.

Further research 2012 amongst registered nurses, patient care technicians, therapists and doctors in specialist intensive care units showed that over 20% of healthcare/worker interactions resulted in contamination of the healthcare workers gloves or gowns.

Studies by The Hospital Infection Society showed that bacteria such as MRSA can survive on paper sterile goods packaging for up to 38 weeks and The Journal of Hospital Infection published research that confirmed patient files were contaminated with dangerous bacteria helping to explain why contamination appears to spread so easily on hospital wards.

Biomaster pioneered the use of silver based antimicrobial additives and can provide an antimicrobial solution for any healthcare environment to reduce the risk of cross contamination.

The antimicrobial action of Biomaster is silver ion technology. Silver is a natural antimicrobial that has been used for centuries to prevent the growth of bacteria.

When bacteria come into contact with a Biomaster protected surface, silver ion technology prevents them from growing, producing energy and replicating; so they die.

Tested in thousands of applications, Biomaster has been proven to reduce the growth of harmful bacteria such as MRSA, VRE, E.coli Legionella, Pseudomonas and Listeria by up to 99.99%.

Easily incorporated into any plastic, textile, paper, paint and coating during manufacture, Biomaster becomes an integral part of the finished product making it more hygienic, whilst providing effective, lasting antimicrobial protection. It can’t leach out or be washed off and being inorganic, bacteria cannot develop resistance.

Worldwide regulations require the registration of biocides, correct labeling of products and allowed marketing claims. All of which need the correct data and support to back them up. Addmaster offer its partners full technical and regulatory support guiding them through the regulatory process giving them the peace of mind they can be compliant globally.

Infection Control has a part to play in all aspects of healthcare services and as users of the system we should be grateful for its development.  The same should be said for the development of antimicrobial surfaces. The key to the growth of this sector is the professional development of antimicrobial products, with quality active ingredients and approved, dependable regulations, giving customers products they are confident in.

In the last 10 years, the importance of infection control has come to the forefront and if healthcare infection is going to be reduced, an effective and motivated infection control team is key.

Looking to the future their enthusiasm and desire needs to be harnessed along with a two-way conversation with industry highlighting technological developments and how they can be effectively implemented into infection control protocol. Antimicrobial plastics, textiles, paper, paint and coatings alone won’t stop the spread of infectious diseases within hospitals, but can certainly be a hugely important ally in the fight.

*Please note that Addmaster was acquired by the Polygiene Group AB in January 2021, so all news articles prior to that date will still be branded as Addmaster.