Survey aims to improve infection prevention and control practices and antibiotic use in nursing and residential homes

Survey aims to improve infection prevention and control practices and antibiotic use in nursing and residential homes

The Public Health Agency (PHA) is today publishing the results of a point-prevalence survey of healthcare-associated infections (HCAIs) and antimicrobial (antibiotic) use in long-term care facilities in Northern Ireland. The survey, known as HALT 2013, is part of a larger, similar survey conducted across Europe in 2013.

HCAIs and the consequences of increasing rates of antimicrobial resistance are potentially serious health threats for elderly people, including those living in long-term care facilities. Patients in nursing homes have complicated underlying medical conditions and are from older age groups which have made them susceptible to infection. Good infection prevention and control practices and antimicrobial stewardship (which is the prudent use of antibiotics) is essential in all healthcare settings to prevent HCAIs and the emergence of antimicrobial resistance.

HALT 2013 was undertaken in Northern Ireland during May 2013 and included 1,503 residents in 42 long-term care facilities (nursing and residential homes). A total of 31 privately-owned nursing homes and 11 trust-managed residential homes participated in the survey.

The prevalence of HCAIs in nursing homes was 5.5% and in residential homes, 5.0%. This is equivalent to approximately 1 in 20 of residents in a nursing or residential home developing an infection in the home. The most common infections were urinary tract, respiratory tract and skin and soft tissue infections. At the time of the survey, 10.9% of nursing home residents were receiving antibiotics and 7.7% in residential homes.

Findings arising from the HALT 2013 survey in Northern Ireland have been shared with each of the facilities who participated in the survey. Homes will share their results with staff in their own facility and also with external staff providing care for their residents. Each facility is encouraged to use their results to document work they have progressed over recent years to prevent HCAIs and to promote antimicrobial stewardship. Each facility is also encouraged to use their survey findings to plan future improvements.

Welcoming the publication of the report, Health Minister, Edwin Poots said: “This is an important step in our efforts to further reduce healthcare-associated infections and to tackle the emergence of drug-resistant organisms. Antimicrobial resistance is one of the most serious threats to health worldwide. This report represents significant progress in developing the evidence base which will inform our decision-making in this field and enable us to take more effective action to prevent and control infections. In addition, the report helps us to address these serious issues across a wider range of care settings, not just in hospitals. Ultimately it will help us to prevent avoidable suffering and make care safer for the most vulnerable people.”

Dr Brenda Bradley, HSCB said “This is a very useful and informative study and we will be using the results to inform how we work with those involved in the prescribing, supply and administration of antimicrobials. Nursing home patients and people living in residential homes are both groups of patients for whom antimicrobial agents are very important. It is however essential that the right medicines are used in the right way to treat infections. Updated HSCB/PHA antimicrobial guidelines were produced in 2013 to provide guidance around the appropriate use of antimicrobials, and the Board and PHA will continue to promote use of these guidelines by all those involved in the management of this group of patients”.

Dr Lourda Geoghegan, Consultant in Health Protection at the PHA said: “This is an important survey providing us with information on the current picture of healthcare associated infections and antibiotic use in long-term care facilities. My sincere thanks go to staff in all the homes who worked with us on the survey. We are now concentrating on the survey findings and we are working with colleagues across health and social care to take the learning forward. We are moving to implement recommendations arising from the survey using a collaborative approach to ensure that care delivered in long-term care facilities continues to be of the highest standard.”

To view the publication click the following link - http://www.publichealth.hscni.net/publications/northern-ireland-prevalence-survey-healthcare-associated-infections-and-antimicrobial-u

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Notes to the editor

1. The full HALT 2013 NI Report and appendices can be found here: www.publichealth.hscni.net
2. This report presents key findings regarding prevalence of healthcare-associated infections and antimicrobial use in long-term care facilities in Northern Ireland.
3. The methodology for this survey was was developed by the European Centre for Disease Prevention and Control (ECDC) and the Scientific Institute of Public Health, Brussels, Belgium, for use in member states. The survey was conducted across Europe using standard protocols and pro formas.
4. The term ‘antibiotics’ used in this news release is used in preference to the term ‘antimicrobials’. Antimicrobials refer to antimicrobial agent with either antibacterial and/or antifungal properties which include antibiotics.
5. The fieldwork for the survey was carried out in Northern Ireland between May and June 2013.
6. All participating long-term care facilities (nursing and residential homes) have access to their own results.
7. The final survey included 1,503 residents in 42 long-term care facilities.
Definitions of terms used:
• Antimicrobial stewardship is an activity that promotes the appropriate and prudent use of antimicrobials (including antibiotics); improves patient outcomes; reduces microbial resistance; and decreases the spread of infections caused by multidrug-resistant organisms. The appropriate use of antimicrobials includes the appropriate selection, dosing schedule, route of administration and duration of antimicrobial therapy.
• Patients are residents of nursing and residential homes in Northern Ireland.
• Prevalence is the proportion of a population found to have a condition (in this survey the conditions were ‘healthcare-associated infections’ or ‘receiving antimicrobials’). Overall prevalence is arrived at by comparing the number of people found to have the condition with the total number of people studied, and is usually expressed as a percentage.
• Point prevalence is the proportion of a population that had the condition at a specific point in time.
• Prophylaxis is used to refer to an antimicrobial prescribed to prevent the occurrence of an infection (as distinct from an antimicrobial prescribed to treat an infection).