Report reveals complete breakdown in infection control practices
- BC Nurses' Union/Hospital Employees' Union Joint News Release
Patients were put at serious risk because of restructuring forced on the Fraser Health Authority by the tight fiscal mandate imposed on health care by the Campbell government
Despite the careful language used in the report by BC Patient Safety Task Force chair Dr. D.D. Cochrane, the document is actually a searing indictment of Campbell government health care policies. Those policies forced the health authority to centralize infection control practices in a bureaucratic exercise that removed these key patient safety activities from front-line medical personnel and hospital staff.
Overlooked thus far in media stories on the report — which was in the government’s hands Dec. 20 but only released at a mid-afternoon news conference on Friday Jan. 7 — is what Dr. Cochrane said on page 6:
“Approximately two years ago, the infection control practitioners, previously institutionally based were centralized within the Fraser Health Authority ... As a result, of this realignment and the Fraser Health Authority response to SARS, the active infection surveillance process that had been functional at Surrey Memorial Hospital through ward rounds, chart review, microbiology review, physician and nursing notes, Emergency record review and surgeons reporting was not maintained at the same level as had been the case when the service was hospital based.
Without an infection control team being able to provide surveillance and quality monitoring, the Medical Infection Control Officer was not able to maintain an active role in hospital infection control. During this same period, the Infection Control Committee, a subcommittee of the Surrey Memorial Hospital Medical Advisory Committee, did not report regularly to the Medical Advisory Committee.
The changes in infection control practice were not communicated to clinical teams including the surgical and birthing services, nor were they reported to the Surrey Memorial Hospital Medical Advisory Committee through the Infection Control Committee, with the result that post-operative infection monitoring lapsed until concerns were expressed by the Family Birthing Unit care team late in the spring of 2004.”(emphasis ours)
BC Nurses’ Union president Debra McPherson says the report confirms what nurses have been saying for months. “The report completely validates the concerns that have been expressed by our members continuously about the lack of staffing and the decline in nursing resources for patients, including infection control and cleanliness.
“The government and health authority should increase front line staffing levels immediately, bring more resources into infection control and be more responsive to the views of front line nurses,” McPherson says.
HEU acting secretary-business manager Zorica Bosancic points out that at the same time that the infection control practices had lapsed, the health authority was busy privatizing its housekeeping staff who were a vital part of the hospital’s infection control team.
“Infection control involves a broad range of hospital staff including housekeepers who clean the emergency rooms, maternity wards, operating rooms and other high and very high risk areas,” says Bosancic. “Introducing privatized cleaning services when the internal infection control system was faltering was misguided and wasn’t putting patients first.”
The report also notes that because of hospital policies encouraging the discharge of patients as soon as possible after their operations, a community wound follow-up process should be developed involving community nurses, the BC Nurse Line or infection control practitioners to ensure “adequate recognition and tracking of surgical site infections.”
The report also documents considerable disarray in Surrey Memorial’s emergency ward revealed by the failure of staff to properly treat a patient suffering a head injury. Among the deficiencies, the report notes a serious and continuing shortage of hospital beds causing repeated backups in the emergency with 40 per cent of patients waiting more than six hours for a bed after a medical decision is made to admit them to the hospital.
“Despite the soothing assurances from the Health Minister last week that things are under control, this report gives no cause for comfort,” McPherson says.
“The review leaves many questions unresolved,” Bosancic says. “The patients who came forward and sparked this review need more and so does the public.”