Hospital infection prevention, control programs lacking, AG finds

Auditor General Kim MacPherson says department, 2 health authorities have agreed with recommendations

Media | Auditor Infection

Caption: New Brunswick's forestry plan is losing the province millions of dollars. And the province's hospitals aren't doing enough to prevent infection. Those are two of the key areas Auditor General Kim MacPherson focused on, in her latest report released today.

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Hospitals across New Brunswick have numerous infection prevention and control deficiencies that can have "severe consequences up to and including death," according to the province's auditor general.
Hospital workers don't clean their hands as often as they should, they are removing protective gear, such as gloves and gowns, improperly, increasing the risk of contamination, and biomedical waste is improperly stored, according to Kim MacPherson's latest report, released in the legislature on Tuesday.

Image | Auditor General Kim MacPherson

Caption: Auditor General Kim MacPherson released her audits on health and silviculture in Fredericton on Thursday. (CBC)

The report includes chapters on silviculture and private wood supply, as well as an audit of infection prevention and control to determine if the Department of Health and the two regional health authorities (RHAs) have programs to protect people from hospital-acquired infections.
"Based on the number and variety of deficiencies we observed, we believe there is inadequate monitoring of infection prevention and control policies and practices in hospitals," MacPherson said in a statement.
"We also conclude RHAs need to strengthen enforcement of policies and procedures."
Hospital-acquired infections, such as Clostridium difficile (C. difficile), methicillin resistant Staphylococcus aureus (MRSA) and bloodstream infections, are "common," said MacPherson. One out of every 10 patients admitted to hospital will get one and about 12,000 Canadians die from such infections each year.
They also increase healthcare system costs, due to longer hospital stays and additional procedures, at a time when the Department of Health is operating in an environment of fiscal restraint, said MacPherson.

Image | Biomedical waste in hospital hallway

Caption: The auditor general's audit of eight hospitals found biomedical waste being left unattended in a public corridor, and next to a dedicated hand-washing sink and coffee cups in a nursing unit. Biomedical waste includes human tissues, blood products, drugs used in cancer treatment and sharp objects, such as needles. (Report of the Auditor General)

About $1.5 billion was spent on hospital services in 2012-13 — more than 57 per cent of the department's budget.
"If there are cutbacks, it may mean the same amount of work is left to fewer staff. There is a risk these workers may not take the time to wash their hands or properly clean patient rooms and equipment."
As it stands, health care workers only clean their hands about 40 per cent of the time they are supposed to, said MacPherson, citing the Department of Health's online Patient Family Guide, which is based on a pamphlet prepared by the Canadian Patient Safety Institute.
"With the growing awareness of healthcare-associated infections this number is getting better, but it is still less than ideal," she said, noting hand hygiene is one of the most important ways to stop the spread of so-called superbugs and other organisms.
Both Horizon and Vitalité's self-auditing results show compliance rates below their stated goals, according to the auditor general.
Some of her recommendations include:
  • The Horizon and Vitalité networks address deficiencies within their respective programs.
  • Regular "walk-arounds" by infection prevention and control professionals and all managers to check for compliance with policies and standards.
  • Develop a provincial infection prevention and control program and strategy in consultation with the RHAs.
  • Enhance public reporting on the effectiveness of infection prevention and control program.
The RHAs have agreed with the recommendations and have already started working to address the deficiences, said MacPherson.
Her findings were based on visits to five hospitals within the Horizon Health Network between April and May last year and three hospitals within the Vitalité Health Network between September and October last year.
Program deficiencies were found at each of the eight hospitals, she said.
"Many of the hospitals had similar deficiencies and we believe they may exist in a number of hospitals to some extent," she said.
The detailed findings for each hospital are not divulged in the report.
"We believe the findings and the issues are more important than their location," she said.