Patient Safety Indicator Reporting

The possibility of acquiring a health care-associated infection is a reality at any hospital. Ontario hospitals are working hard to reduce the risk factors that contribute to the spread of infections. They are focusing on minimizing infections and keeping patients safe.

Patient safety is about managing and reducing risk to ensure that the care patients receive is as safe as possible.

Improving patient safety is about creating an environment that is transparent and committed to change. This is the mandate of the government’s Patient Safety Initiative.

By visiting www.ontario.ca/patientsafety the public can access information on patient safety issues. It will evolve over time to report on a range of indicators with the goal of enhancing patient safety.

Taken from the MOH & LTC website.

 

 

 Wilson Memorial General Hospital

Indicator	Reporting Period	WMGH Totals
Clostridium Difficile Associated disease (CDAD)	August 1 - November 30, 2008	Rate per 100 patient days: 0 Case Count = 0
Methicilin Resistant Staphylococcus Aureus (MRSA)	September 1 - November 30, 2008	Rate per 100 patient days: 0 Case Count = 0
Vancomycin REsistant Enterococcus (VRE)	September 1 - November 30, 2008	Rate per 100 patient days: 0 Case Count = 0

  

C.difficile Rate:

Over the past few months, a great deal of public attention has been focused on the issue of Clostridium difficile (C. difficile) and C. difficile associated disease (CDAD) as a result of some widely publicized outbreaks in Ontario hospitals. Undoubtedly, public and media interest in this issue will intensify as Ontario hospitals will be required to publicly report their C.difficile rates through a public website beginning September 30, 2008.

Taken from the Ontario Hospital Association Website.

 

What is C.difficile?
C.difficile (Clostridium difficile) is a bacteria.  C.difficile can be part of the normal bacteria in the large intestine and is one of the many bacteria that can be found in stool ( a bowel movement ).

A C.difficile infection occurs when other good bacteria in the bowel are eliminated or decreased allowing the C.difficle bacteria to grow and produce toxin.  The toxin produced can damage the bowel and cause diarrhea.  C.difficile is one example of a hospital-acquired infection and is one of the most common infections found in hospitals and long-term care facilities.  C.difficile has been a known cause ofhealth care associated diarrhea for about 30 years.

Who is at risk for C.difficle?
Healthy people are not usually susceptible to C.difficile.  Seniors, and people who have other illnesses or conditions being treated with antibiotics and certain other stomach medications, are at greater risk of an infection from C.difficile.

What are the symptoms of C.difficile?
The usual symptoms are mild but can be severe.  Main symptoms are watery diarrhea, fever, abdominal pain/tenderness.  In some cases there may not be diarrhea.  Blood may or may not be present in the stools.

How does C. difficile spread?
When a person has C. difficile, the germs in the stool can soil surfaces such as toilets, handles, bedpans, or commode chairs.  When touching these items, your hands can become soiled.  If you then touch your mouth, you can swallow the germ.  Your soiled hands can spread germs that can survive for a long time on other surfaces if not properly cleaned.

The spread of C. difficile occurs due to inadequate hand hygiene and environmental cleaning; therefore, proper control is acheived through consistent hand hygiene and thorough cleaning of the patient environment.  Good hand hygiene, i.e. washing hands thoroughly and often, is the single-most effective way to prevent the spread of infectious diseases like C. difficile.

 

Blood Stream Infection (BSI)

Public reporting for blood infection rates for methicillin-resistant Staphylococcus aureus
(MRSA) and vancomycin-resistant enterococci (VRE) will enable hospitals to monitor MRSA and VRE in their facilities so that the most appropriate infection control measures and highest standards of practice can be put in place. Both MRSA and VRE are hospital-associated infections that are resistant to certain antibiotics. Primary bloodstream infection is a leading, infectious complication among critically ill patients. 

 

Methicilin Resistant

Staphylococcus Aureus (MRSA):

What is methicillin-resistant staphylococcus aureus (MRSA)?

Methicillin-resistant staphylococcus aureus is a bacterial infection resistant to antibiotic methicillin. Staphylococcus aureus, sometimes referred to simply as "staph," or "staph A" is a common bacterium found on the skin of healthy people. If staph gets into the body it can cause a minor infection such as boils or pimples or serious infections such as pneumonia or blood infections.

One antibiotic commonly used to treat staph infections is methicillin. While methicillin is very effective in treating most staph infections, some staph bacteria have developed a resistance to methicillin and can no longer be killed by this antibiotic. The resistant bacteria are called methicillin-resistant staphylococcus aureus or MRSA.

Who is susceptible to MRSA infection?

MRSA usually infects hospital patients who are elderly or very ill. You may be at more risk if you have had frequent, long-term, or intensive use of antibiotics. Intravenous drug users and persons with long-term illnesses or who are immuno-suppressed are also at increased risk.

The infection can develop in an open wound such as a bedsore or when there is a tube such as a urinary catheter that enters the body. MRSA rarely infects healthy people.

What are the symptoms of MRSA?

Methicillin-resistant staphylococcus aureus produces symptoms no different from any other type of Staphylococcus aureus bacteria. The skin will appear red and inflamed around wound sites. Symptoms in serious cases may include fever, lethargy, and headache. MRSA can cause urinary tract infections, pneumonia, toxic shock syndrome, and even death.

Can MRSA be treated?

Yes. While MRSA is resistant to many antibiotics and can be difficult to treat there are a few antibiotics that can cure MRSA infections. Patients that are only colonized with MRSA usually do not require treatment.

 

Vancomycin REsistant Enterococcus (VRE):

 

What is VRE?  

VRE stands for Vancomycin Resistant Enterococci. VRE is a type of Enterococci that 

are naturally found in the bowels of humans. Sometimes bacteria can cause 

infections. To treat these infections, antibiotics are used. Vancomycin is one type of 

antibiotic used to treat infections. VRE bacteria are not killed by common antibiotics 

like Vancomycin since it has become resistant to that antibiotic. 

VRE found in the bowel but not causing infection is called the carrier state. 

 

What are the symptoms of VRE? 

When an infection with VRE happens, the symptoms depend on where the infection is. 

Infections can occur in wounds, the bloodstream or the urinary tract. 

VRE in the carrier state does not cause any symptoms. 

 

How is it spread? 

It can be spread by touching people who have it or by handling things that they have 

used. Cleaning your hands is the most important thing you can do to stop the spread of 

VRE. VRE is not spread through the air or by coughing or sneezing. 

 

How do we stop the spread? 

Cleaning (hand washing) is the best way to stop the spread of VRE.