1. Case for change – Why reduce healthcare associated infections?
There is a range of compelling reasons why staff should prevent and reduce healthcare associated infections (HCAIs). Reducing infections across the health economy will improve the patient experience and lessen the burden on NHS organisations.
It is important that all staff, from board to ward level, understand they have a role to play in infection prevention and control and provide patient and visitors with information about HCAIs. Achieving reductions in HCAIs will be of benefit to the patient, the staff member, the organisation and ultimately, the health economy. The key messages, tools and information provided in this section will be of benefit to:
- NHS staff, (especially those with patient contact)
- Chief Executives
- Directors of Infection Prevention and Control (DIPCs)
- Directors of Nursing
- Medical Directors
- Directors of Finance
- Directors of HR
- Communications staff
Below are the compelling reasons why staff and patients should strive to reduce HCAIs. These include:
- The reduction of HCAIs across the NHS has saved lives and reduced unnecessary pain and suffering caused to patients, their families and loved ones.
- The NHS has already significantly reduced MRSA and Clostridium difficile infections (CDI). However, there is still scope to drive these and other HCAIs, such as MSSA and E.coli, down further.
- The NHS should aim for a zero tolerance approach to all avoidable HCAIs.
- All NHS staff have a duty and responsibility for providing an environment and facilities within which clean safe care can be delivered. Reducing infection improves care and overall health outcomes for patients. The prevention and control of infections is a clinical and managerial responsibility.
- Increasing patients understanding of HCAIs help them gain a better understanding of infection issues and ensures a joint partnership in discussion of their care pathway.
- Providing patients and the public with information will help them understand the role they can play, as well as the role staff should play, in infection prevention and control.
- Patients should feel safe in a healthcare environment and be assured that clean, safe care is provided. Improving the cleanliness of an environment will instil more confidence in the public that our hospitals are clean. Patients should be presented with the facts so they can make their own decisions and choices.
- Only by increasing transparency and providing relevant information will we allow patients to hold hospitals to account over performance on HCAIs.
- MRSA and Clostridium difficile have, and continue to, severely affect patients, causing injury, disability and even death. HCAIs are responsible for 5,000 deaths per year in the UK (NAO report, 2000). At least 300,000 more patients acquire non-fatal HCAIs, extending the length of stay, slowing down recovery with associated pain, and loss of quality of life(1).
- HCAIs cost the NHS approximately £1 billion per year(2).
- The average cost per MRSA bloodstream infection has been calculated at costing £4,300, and the average cost per Clostridium difficile infection is £4,200, which is based on a Department of Health review of current evidence (savings calculated up to 2008/09, against baselines of 2003/04 (for MRSA) and 2006 (for Clostridium difficile infection) (1).
- It is estimated that reductions in MRSA and Clostridium difficile infection have saved the NHS at least £141 million in avoided treatment costs (3,4).
- All registered NHS providers and organisations that provide NHS care must comply by the Health and Social Care Act 2008(5). Organisations must audit compliance to key policies and procedures for infection prevention to ensure an appropriate and high quality of care is provided to all patients.
- NHS organisations are required to plan and deliver organisational MRSA objective to reduce infections. Organisations should screen all relevant admissions for MRSA – and all emergency admissions by April 2011.
- From April 2011, NHS organisations will be required to achieve the Clostridium difficile objective rate.
Why should we communicate about healthcare associated infections?
Communicating with patients and the public
Many patients are concerned about HCAIs. They want to know the facts and have access to the right information so they can make meaningful decisions and choices about their care. Patients look to their local NHS for information and to let them know what they can do to help prevent infection and protect themselves and their families.
The NHS has already significantly reduced infections like MRSA and Clostridium difficile, however there is still scope to further reduce these and other HCAIs. Organisations should aim for a zero tolerance approach to all HCAIs.
Research suggests that patients find conversations about infections with NHS staff the most reassuring source of information. Provision of information will help patients, and their visitors, understand what they can do to help tackle infections, as well as recognise what their local NHS is doing to reduce HCAIs. Face-to-face communication between patients and staff is very important. There is considerable local knowledge and expertise inside Trusts and NHS communication experts often know how to reach their target audiences more effectively.
Providing information and communicating about HCAIs
By providing information and communicating about HCAIs and infection prevention and control, it will:
- Educate patients and the public about HCAIs, origins of infection and the role they can play in infection prevention and control. Facts and information help patients make decisions and choices.
- Ensure staff understand their role in preventing and reducing infection, therefore providing patients with appropriate information about HCAIs.
- Raise the skills and confidence of staff in communicating effectively with patients.
- Help patients, the public and staff understand that success in tackling infections means taking a range of actions. Simple actions like cleaning hands and keeping floors and surfaces clean can make a big difference.
Communication resource materials
Communication resource materials have been co-designed and co-developed with staff, healthcare associations and patient groups, and in association with the NHS Institute for Innovation and Improvement. These resources will support organisations in their work to improve or extend communications, and provide information to staff, patients and visitors, other stakeholder groups and the media, to highlight the role everyone can play in infection prevention and control.
All elements of the resource materials are outlined below. To access these materials click here.
Objectives of the resource material
The communication resource material will:
- Support organisations in their work to improve and extend communications with staff, patients and visitors about HCAIs
- Help each organisation outline what they are doing to tackle infections
- Provide staff with information highlighting what they can do to help prevent infections
- Provide staff with information they can share with patients and visitors to emphasise what they can do to help prevent infections
- Allow organisations to develop positive relationships with key stakeholders and the media
- Provide hints and tips to help each organisation appropriately concentrate communication resources to more effectively prepare for and tackle any local HCAI issues
- Present ideas to aid the development of a communications strategy and activity plan by asking:
- How does your organisation communicate and provide information to users/ the public/ local media about HCAIs?
- How does your organisation communicate with stakeholders/ service providers on this issue?
- Does your organisation have a communications strategy and/or policies around reducing infection?
Who should use the resources?
Resource materials – all staff
The resources can be used by all staff within an organisation to foster more effective communication, and the sharing of information with each other, with patients and visitors about HCAIs and infection prevention and control. Each resource can be used at different points in the patient journey and provide varying degrees of information. By offering a menu of resource materials, staff can decide when and how they would like to provide information about reducing infections.
Resource materials – communications staff
In addition, some of the resources are targeted at communications staff. The ideas, hints and tips, and tools, can help shape communication strategies and policies to deliver key messages, inform and work with all stakeholders, both internal and external, including the local media. This should help ensure improvements across the organisation and local health economy are reported in a balanced and accurate manner.
To be successful, organisations need to join up their communication activities and be focused about the messages all parts of the organisation are delivering. A good communications team will make links with all the departments, internal and external stakeholders, as well as the local media, ensuring communications are consistent and coherent, useful, and able to make positive differences.
The resources provided for communications staff will demonstrate the following benefits of planned, strategically-led communications including:
- Greater engagement of frontline staff with their organisation
- Greater consistency and collaboration within, between and across organisations
- Clarity and consistency in the communication of the organisation’s strategy
- The ability to drive cultural change and embed values and the sustainability of HCAI reductions across the organisation
- Employees who are able to draw the link between their own role and the ‘bigger picture’, i.e. a zero tolerance approach to avoidable infections
- An engaging and open internal communications climate
- Improved skills and mindset of leaders as communicators
Key points conveyed in the resource materials
- Infection prevention and control is a key priority for the NHS.
- Everyone has a part to play in infection prevention and control.
- Success in tackling infections means taking a range of actions. Simple, visible actions like cleaning hands and keeping floors and surfaces clean can make a big difference.
The resource materials include the following documents:
i. Key communications messages
The messages are intended for four different audiences: NHS professionals with patient contact, inpatients and outpatients, hospital visitors, and the wider community. For each audience, this document sets out communication outcomes, points to convey and key messages that you can consider and use. Click here to read more.
ii. Key communication touchpoints
This document provides the materials you need to encourage conversations between patients and professionals on the subject of HCAIs. There are a range of individual communication solutions (10 in total). You will find PDF versions that you can use right away. You will also find PowerPoint versions of many of the solutions that are flexible and can be “localised” by adding inforation such as your Trust website address and a contact name and number. Click here to view and use the resources.
iii. Design style guide
This document provides an overview of the visual “look and feel” for the NHS HCAI communication resources. It contains an overview of the essential graphic elements of the resource and the rationale for the design. To read more, click here.
iv. Graphic assets
Contained within this section are the JPEG files that make up the “look and feel” of the communication materials. To access these files, click here.
v. PR ideas
This document contains ideas that PR and communications teams can use. They have been drawn from six NHS Trusts and are designed to show what some other Trusts have done to tackle HCAIs. To view these ideas, click here.
vi. Staff workbook
The Workbook and Team Facilitation Guide has been designed to help staff, individually or as a team, think about the conversations they have with patients and relatives, and the information provided, about HCAIs. To view and use this workbook, click here.
5. Hints and tips for communication staff
In this section, you will find resources aimed at the communication team. These resources can help shape communication strategies, inform all stakeholders groups, and provide the key messages about HCAIs and the role everyone can play in tackling infections.
These resources include:
- Communications Strategy Checklist (PDF, 24.2 KB)
- Employee engagement (PDF, 20.7 KB)
- Stakeholder engagement (PDF, 25.4 KB)
6. Other communication resources
These leaflets were produced collaboratively between the Department of Health and C-Diff support.
C. DIFFICILE - diarrhoea associated infection. This leaflet is for people in hospital who have been diagnosed as having a C. difficile infection.
C. DIFFICILE – now you are going home. This leaflet is intended for people who have had a C. difficile infection while in hospital and are now going home.