NHS © David Telford 2007 University Hospitals of Morecambe Bay National Reports of MRSA...

University Hospitalsof Morecambe BayNHS© David Telford 2007

0

2000

4000

6000

8000

10000

12000

14000

16000

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

*

Methicillin Sensitive

Methicillin Resistant

National Reports of MRSA Bacteraemias


EMBARGOED UNTIL THE MORNING OF 25 JULY

Table 5. Annual counts and rates of MRSA bacteraemia April 2001 to March 2007

These tables contain data received prior to the submission deadline for this publication. Data are provisional. Late submissions of data corrections will be incorporated in future publications.

Alphabetical order

April 2001 - March 2002

Trust

code

Trust category

Trust type

Region Name of NHS TrustMRSA

bacteraemia reports

Estimated MRSA

bacteraemia rate per 10,000

bed days

Total 7,291 1.70

RJE L - West Midlands University Hospital of North Staffordshire 83 2.14

RKB T - West Midlands University Hospitals Coventry and Warwickshire 74 1.92

RWE T - East Midlands University Hospitals of Leicester 163 2.24

RTX L - North West University Hospitals of Morecambe Bay 33 1.02

RM2 T FT North West University Hospitals of South Manchester 30 0.95

RBK M - West Midlands Walsall Hospitals 15 0.66

RET Sp - North West Walton Centre for Neurology and Neurosurgery 5 1.14


UHMB Bacteraemias

Year Total Rate

2001 - 2002 33 1.06

2002 – 2003 24 2.18

2003 – 2004 30 1.52

2004 – 2005 30 2.24

2005 - 2006 33 2.15

2006 – 2007 24 1.36

2007 – 2008

(projected)10/5*12

=24

Target is 60% reduction on 2004 level by March 2008 (12 cases)


MRSA Bacteraemia Rate vs Occupied Beds per Day

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

0 500 1000 1500 2000

Occupied Beds per Day

MR

SA

Bac

tera

emia

Rat

e

UHMB


National MRSA Bacteraemia Rates 2001-2007

0

1

2

3

4

5

6

0 1 2 3 4 5 6 7 82001- 02 2002- 03 2003- 04 2004- 05 2005- 06 2006- 07 0

1

2

3

4

5

6R

ate

per

10,

000

bed

day

s

All Trusts

Target Target

Average

UHMB



0

1

2

3

4

5

6

0 1 2 3 4 5 6 7

2001- 02 2002- 03 003- 04 2004- 05 2005- 06 2006- 07

3

0

1

2

4

5

6

Rat

e p

er 1

0,00

0 b

ed d

ays

Teaching Hospitals

Target Target

Average

UHMB


MRSA Bacteraemia Reduction vs Starting Point

0

10

20

30

40

50

60

70

80

90

100

-100% 0% 100% 200%

Percentage change

20

03

- 2

00

4 R

ep

ort

s

UHMB



0

1

2

3

4

5

6

0 1 2 3 4 5 6 7 8

Blackpool, Fylde and Wyre Hospitals East Lancashire Hospitals Lancashire Teaching Hospitals North Cumbria Acute Hospitals University Hospitals of Morecambe Bay National AverageNational Target

2001- 02 2002- 03 2003- 04 2004- 05 2005- 06 2006- 07

0

1

2

3

4

5

6

Rat

e p

er 1

0,00

0 b

ed d

ays

Critical Care Network


Date Ward Narrative Source Outcome Lesson

1 01/09/06 M58 R34 Septic Knee. Nursing home Comm

2 02/09/06 M85 W8 Admission sample. Chest infection. Non-contributory. No abx Comm

3 12/09/06 F45 W2 Admission sample. ALD Comm

4 03/10/06 M75 FONC Myeloma, Cytopenic Hosp IV care

5 16/10/06 M85 W11 Admission sample. Same patient as no 2 Comm ? Treat

6 26/12/06 M82 FICU Diabetic. Cancer. Complicated abdominal surgery. Wound, line, lung, Hosp Died Causative

7 26/12/06 M81 F6 Myeloma, Chest infection Hosp

8 13/01/07 M78 RITU Cholecystectomy Dec 06. Slow mobilisation & jaundice. Died 3 weeks post op. Hosp Died Irrelevant

9 23/01/07 M75 FICU Multiple problems. Very dependent. Longstanding positive. Multiple resistance Comm Died Marginal Catheter Care

10 12/02/07 M76 F5 Bladder Cancer. Cystectomy. Hosp

11 16/02/07 F85 W8 Residential Home. Diabetes, COPD, IHD OA. Admitted with C diff. Hosp Died Marginal

12 17/02/07 M81 F8 Diabetes. Leukaemia. Hosp Died Marginal

13 01/03/07 M80 F6 Diabetic foot ulcer. CVA. Catheter. Longstanding MRSA. Comm

14 13/03/07 F79 W3 Dementia, Diabetes, Anaemia. 2 hospitalisations. Bronchopneumonia. Hosp Died Causative

15 21/03/07 F68 F8 Diabetic. COPD. C diff. Longstanding MRSA Comm

16 01/04/07 F71 FITU Post arrest. Short stay Hosp Resp Care

17 08/04/07 F43 RMAU IVDU. Admission sample. Sensitive strain Comm

18 02/05/07 M91 FA&E Nursing home. Catheter infection Comm Catheter Care

19 08/05/07 M44 FHDU Varices. Short stay, Hosp

20 02/06/07 M65 F7 Alcoholic liver disease. Line infection. Hosp IV care

21 03/06/07 F57 RMAU Admission Sample. Diabetic foot ulcer. Poor compliance Comm

22 04/06/07 M71 R33 Trauma case. MRSA isolated after 4 days on ITU. Hosp IV care

23 02/07/07 M44 RMAU Admission Sample. Diabetic foot ulcer. Poor compliance Comm

24 27/07/07 M91 FA&E Indwelling catheter. MRSA in urine Comm Catheter Care

25 08/08/07 M86 R33 Arteriopathic. Multiple amputations. Prolonged hospital stay. Hosp Died Irrelevant Hand hygiene

UHMB MRSA Bacteraemias 2006-2007


“Community” cases 12

Total cases 24

Deaths 7

UHMB MRSA Bacteraemias 2006-2007

DependentMultiple interventionsHeavy antimicrobial use

“INEVITABLE”

13

“AVOIDABLE”

Short staySingle episodeLittle antimicrobial useAcute care

7 (No deaths)


Actions

Hand hygieneIntravenous accessWound care

SAVING LIVES

ANTIMICROBIALS PoliciesMedicines ManagementHigh profile microbiology

HOSPITAL HYGIENE Internal auditsExternal reviews

ISOLATION Need more

RESOURCES Trust investment - Nurse ConsultantCentral allocations - £500,000+


MRSA bacteraemi

a

Pre 48 hr

Post 48 hr

RCA within acute

setting

Acute Trust to telephone confidential patient details to PCT ICN; Email confirmation to all of above that details have been conveyedIf no-one available to speak to, Acute Trust to send urgent email alert to all of above to state that information is available; all of above to attempt to call Acute Trust to receive information and send email to each of above to confirm receipt of information; whoever receives information, pass information to PCT ICN for investigation

Acute Trust input into RCA tool PCT ICN to investigate

within non-acute setting

Acute Trust to input all individual cases into SHA reporting template, including any supporting evidence,

e.g. If unavoidable, state how

10th each month Acute Trust to forward Summary Sheet, with email confirmation of sign-off by Acute DIPC, to PCT

for sign off by PCT DIPC

Following formal sign off by PCT, on 15th each month PCT to forward Summary Sheet to SHA,

PCT ICN to liaise with Acute Trust; Acute

Trust to input into RCA tool

PCT ICN to inform PCT

DIPC

NHS © David Telford 2007 University Hospitals of Morecambe Bay National Reports of MRSA...

Documents

Transcript of NHS © David Telford 2007 University Hospitals of Morecambe Bay National Reports of MRSA...