The MRSA Group, multidisciplinary advisory group including microbiologists, hospital pharmacists, and patient advocates with funding from Pfiizer, has published a report “Meticillin-Resistant Staphylococcus aureas (MRSA) in Ireland: Addressing the Issues” . Shockingly, the report finds that patients who acquire infections in Irish hospitals are 7.1 times more like than uninfected patients to die in hospitals.
The report estimates that patients who acquire an infection in hospital stayed in hospital 2.5 times longer than other patients and that the cost of healthcare associated infections (HCAI) totalled €233.75 million a year. This cost estimate does not include the cost of hospital negligence claims. The report states that approximately one third of HCAIs are preventable, therefore the potential savings from all HCAI is €77 million. Again, this illustrates the potential level of liability for medical negligence claims for infections that should never have happened if the hospitals were properly run.
European Antimicrobial Resistance Surveillance System data ranks Ireland fourth in Europe for MRSA bloodstream infection (BSI) rates at 33.1%. This infection rate is significantly higher than in many other EU countries.
There are some factors causing HCAI that are specific to individual patients such as age, surgical wounds, use of medical devices, illness severity, and length of stay in hospital. These factors are the same in all countries in Europe, so Ireland’s high rate of hospital infections is due to the way the hospitals are managed. The factors under the control and responsibility of the hospitals include poor hand-hygiene, overuse of antimicrobials, contaminated equipment, delays in patient isolation, low staff-patient ratios (which strongly influences quality of care), and the availability of isolation facilities (for patients at risk).
There is a lot of discussion about the degradation of hygiene in Irish hospitals. The cleaning staff are now heavily unionised and often blamed for a work-to-rule attitude. The nursing staff are now considerably better educated than previous generations and appear more focussed on medical issues less inclined to help with cleaning duties.
In fact, it was well known that while hospitals were run by religious orders, the hospital matron regularly terrorised nursing staff with meticulous inspections. The matrons famously used a handkerchief to search for any dirt or dust. The unholy wrath of the matrons was Ireland’s most effective defence against hospital infections!