NI survey: 1 in 20 with infections in long term care settings

The Public Health Agency (PHA) has today published the results of a 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