Bacteraemia: delivering zero tolerance

The Heart of England NHS Foundation Trust treats more than 1.2 million people each year – providing general and specialist hospital care across Heartlands Hospital, Solihull Hospitals, Good Hope Hospital and Birmingham Chest Clinic. The Trust has previously won recognition for excellence in infection prevention and control – including an award for the introduction of innovations which culminated in a 52% reduction in MRSA bacteraemia and 27% in Clostridium difficile infections in 2008.1 In recent years, the infection control team has continued to reduce infection rates annually and has strived to meet increasingly tougher, lower targets. In 2011/12 the number of cases of MRSA bacteraemia and C. difficile cases (post 48 hours) were lower than in 2010/11, and the targeted reduction for C. difficile cases was achieved. However, in January 2013, the Trust overshot its MRSA bacteraemia target and the infection prevention and control team, backed by the Trust Board, took decisive action to intensify its campaign to deliver ‘zero tolerance’ on avoidable bacteraemia. As part of this campaign, it launched a Trust-wide initiative of decolonisation of patients – prior to admission and during hospital stay.

Antimicrobial washing

Gill Abbott, deputy lead infection, prevention and control nurse, Heart of England Foundation Trust, was given the task of spearheading the zero tolerance policy for avoidable bacteraemia. She explained that all adult inpatient shower and bath rooms have now been stocked with octenisan – an antimicrobial wash lotion that helps prevent hospital-acquired infections and reduce the risk of carriage of MRSA on the skin. Patients are being asked to use the antimicrobial wash provided and not bring their own shower products. The octenidine-based antimicrobial wash lotion, suitable for hair and whole body washing, has a broad antimicrobial efficacy and has shown to be effective against bacteria in just 60 seconds. It also contains allantoin for gentle skin cleansing, which means it is well tolerated for blanket decolonisation. As such, it received the approval of the Trust’s consultant dermatologists.