Sunday 6 May 2012

MRSA and C. difficile infections in hospitals fell


Hospital hygiene drive 'saved 10,000 lives'

'CleanYourHands' campaign has led to significant fall in MRSA and other superbug infections, says BMJ report
  • Press Association
  • guardian.co.uk, 
  • Article history
A doctor scrubbing up in hospital
MRSA rates in hospitals fell by more than half between July 2004 and June 2008, according to the BMJ study. Photograph: Getty Images
The government-funded campaign to improve hand hygiene at hospitals across England and Wales led to a significant fall in the rates of superbug infections, a report has revealed.
After the "CleanYourHands" campaign was rolled out in 2004, the amount of soap and alcoholic hand rub bought by NHS trusts almost tripled, according to a study published in the British Medical Journal (BMJ).
Over the same period, MRSA rates in hospitals were slashed by more than half, while there was a significant drop in the number of Clostridium difficile infections.
The campaign, backed by the Department of Health, was introduced across the 187 acute NHS trusts in England and Wales between December 2004 and June 2005.
It encouraged hospital visitors, patients and staff to wash their hands with soap or an alcohol gel when entering or leaving wards. People were also encouraged to clean their hands before touching patients or eating food and after going to the toilet.
As part of the drive, alcohol gels were put by bedsides, posters reminded staff to wash their hands and regular checks were made to ensure hands were kept clean.
The BMJ study, which analysed statistics between July 2004 and June 2008, found that the number of patients infected with MRSA fell from 1.88 cases per 10,000 bed days to 0.91 over the four-year period.
Rates of C difficile infection dropped from 16.75 to 9.49 cases, while the number of cases of MSSA – a bacterium found on the skin – did not fall.
The study also found that hospital trust procurement of soap and alcohol hand rub rose from a combined 21.8ml to 59.8ml per patient bed day over the period.
The increased use of soap in hospitals was linked to reduced rates of C difficile infection, while rising use of alcohol hand rub was associated with a reduction in MRSA cases.
The report concludes: "The CleanYourHands campaign was associated with sustained increases in hospital procurement of alcohol rub and soap, which the results suggest has an important role in reducing rates of some healthcare associated infections.
"National interventions for infection control undertaken in the context of a high profile political drive can reduce selected healthcare associated infections."
Sheldon Paul Stone, senior lecturer at UCL medical school, who led the study, estimated that around 10,000 lives were saved because of the campaign, which ended in 2010.
He told the Independent: "Without a doubt, lives were saved by the campaign. I would say 10,000 lives over the four-year period of the study was a reasonable estimate.
"If hand hygiene were a new drug, pharmaceutical companies would be out selling it for all they were worth."
Stone added: "It is obvious the campaign should be continued. Independent groups have suggested it should. It needs a new focus on staff who use gloves. They deal with the most infectious patients but they are much less likely to use soap."
A spokesman from the Department of Health was quoted as saying: "The CleanYourHands campaign was successful in its aim to highlight the importance of good hand hygiene practice across the NHS. We know this has been successful.
"The challenge now is to ensure the NHS embeds the good practice highlighted in the campaign to achieve our ambition to wipe out avoidable healthcare-associated infection."

Hand hygiene campaign 'cut superbug infections'the campaign to improve hand 


hygiene in hospitals in England and Wales contributed to a significant fall in the rates of superbug infections, according to a report.

The study published on the BMJ website showed the amount of soap and hand gel being used tripled during the campaign.
At the same time, levels of MRSA and C. difficile infections in hospitals fell.
The government has since dropped the campaign, but said its ambition was to "wipe out" such infections.
Hospital superbugs were once a real fear for many patients. In response the Clean Your Hands campaign, funded by the Department of Health, was introduced in all hospitals by June 2005.
Alcohol gels were put by bedsides, posters reminded staff to wash their hands and there were regular checks to ensure hands were kept clean.
By 2008, the total amount of soap and alcohol gel being purchased by hospitals trebled, going from 22ml per patient per day to 60ml per patient per day.
Rates of MRSA more than halved in the same time period and C. diff infections fell by more than 40%.
'Success story'
One of the report's authors, Dr Sheldon Stone from the Royal Free University College London Medical School, estimated that around 10,000 lives were saved because of the campaign.
He told the BBC: "It's been a real British success story, we've gone from being the dirty man of Europe to being world leaders.
"What we need to do is keep up the momentum and stay at the forefront of world hand hygiene."
A spokesman from the Department of Health said: "The Clean Your Hands campaign was successful in its aim to highlight the importance of good hand hygiene practice across the NHS. We know this has been successful.
"The challenge now is to ensure the NHS embeds the good practice highlighted in the campaign to achieve our ambition to wipe out avoidable healthcare-associated infection.
"We know real progress has been made in this area as MRSA bloodstream infections have dropped by 41% and C. difficile by 30% across the NHS in England since 2009/10.
at
Labels: , ,

Saturday 5 May 2012

ritual slaughter


Leading vet criticises ritual slaughter of animals

Halal abattoir in Oudeschoot, NetherlandsProf Reilly says if there is no alternative to non-stun slaughter, then it ought to be kept to a minimum

Related Stories

A leading vet has criticised the "unacceptable" rise in the number of animals killed in ritual slaughter.
Ritual slaughter is lawful in the UK and the EU to satisfy the dietary requirements of Jews and Muslims.
Prof Bill Reilly, former president of the British Veterinary Association, said estimates suggested more animals were slaughtered than was necessary.
The Food Standards Agency (FSA) said its own figures showed most animals were stunned before being killed.
The FSA conducted a survey into animal welfare in slaughterhouses in September.
A spokesman said: "The results indicate that the number of animals not stunned prior to slaughter is relatively low, accounting for 3% of cattle, 10% of sheep and goats, and 4% of poultry.
"They also show that the majority of animals destined for the halal trade in both the red and white meat sectors are stunned before slaughter."
The FSA said full details of the survey would be published ahead of a discussion at a board meeting on 22 May.
'Not acceptable'
But Prof Reilly, writing in the Veterinary Record, said: "In my view, the current situation is not acceptable and, if we cannot eliminate non-stunning, we need to keep it to the minimum.
"This means restricting the use of halal and kosher meat to those communities that require it for their religious beliefs and, where possible, convincing them of the acceptability of the stunned alternatives."
He suggested some abattoirs might be refusing to stun animals simply to cut costs.
UK legislation allows halal (Muslim) or schecita (Jewish) "non-stun" slaughter as long as it does not cause "unnecessary suffering".
But Prof Reilly said he witnessed schecita slaughter in the 1970s and he wrote: "The distress, fear and pain were there for all to see in the abattoir."
Prof Reilly said his own estimates suggested around two million animals, mostly poultry, were killed in the UK each year without stunning for the orthodox Jewish community.
Halal meat now accounted for 25% of the entire UK meat market, Prof Reilly added. Anecdotal evidence suggested that almost half of lambs destined for slaughter were killed without prior stunning.
Joyce D'Silva, from the charity Compassion in World Farming (CWF), said: "Judaism and Islam believe that animals are creatures of God; science tells us that they are sentient beings, who can suffer.
"If you hold either view, or both, then your principle concern must be to ensure the least possible suffering for the animal concerned.
"Therefore animals should be handled with care and stunned effectively before their throats are cut in order to minimise their distress and pain.
"Consumers should be able to tell how the animals they eat are reared, transported and slaughtered," he added.

More on This Story

Related Stories

at
Labels:

Saturday 28 April 2012

Care Quality Commission


Home inspector in bribery arrest


A former care home inspector has been arrested over allegations that she pressured homes into giving money in exchange for "favourable" reports.
The woman, who used to work for the Care Quality Commission (CQC), was arrested on suspicion of bribery and money laundering.
The CQC said it sacked her after an investigation and had informed the police.
It said the woman had failed the organisation and people in care.
The unnamed 43-year-old was arrested on Thursday morning at her home in Northamptonshire.
City of London Police said care homes were "pressurised into paying fees for favourable inspection report".
Detective Inspector James Clancey said: "We are working closely with CQC to thoroughly investigate these allegations."
The CQC said it had a "zero tolerance policy" towards fraudulent or dishonest behaviour and that it expected "extremely high standards" from its inspectors.
Louise Guss, director of governance and legal services at the CQC, said: "This inspector has failed the organisation, failed the providers who rely on us to act fairly and impartially, and - most importantly - failed in their responsibility to protect people who use services through identification of poor care.
"Unfortunately, in any large workforce there is a risk that a tiny minority may act in a way that betrays the principles of their colleagues and of the organisation as a whole, which is what has happened here.
"Having investigated allegations made to us about this inspector and found these were substantiated, we terminated their employment with immediate effect and referred the matter to the police."
A care home: the former inspector was arrested following allegations that care home owners were offered 'favourable inspection reports' in return for cash. Photograph: Paula Solloway/Alamy
City of London police have confirmed the arrest of a former Care Quality Commission (CQC) inspector, on suspicion of bribery and money laundering, following allegations that care home owners were offered "favourable inspection reports" in return for cash.
The unnamed 42-year-old, arrested at home in Northamptonshire, is being questioned by police. Detective Inspector James Clancey, said: "We are working closely with CQC to thoroughly investigate these allegations. We are appealing to anyone who may have information linked to these allegations to come forward."
The force, which takes the lead in economic crime, said that anyone with information should contact the Care Quality Commission, which regulates the health and social care system, which had been alerted to this case because of a "whistleblower".
In a statement, the CQC said an "internal investigation revealed that the impartiality of regulatory judgments had been seriously compromised".
Confirming that an inspector had been dismissed for "gross misconduct", the director of governance and legal services at the CQC, Louise Guss, said: "Having investigated allegations made to us about this inspector [the CQC] terminated their employment with immediate effect and referred the matter to the police.
"CQC operates a zero tolerance policy in regard to fraudulent or dishonest behaviour … We take any credible allegations relating to this behaviour extremely seriously and, following a full investigation, will take the swiftest and most severe action possible against any member of staff found guilty."

at
Labels: , ,

Wednesday 25 April 2012

mengele: It is thought extensive use of sunscreen

mengele: It is thought extensive use of sunscreen
at

Saturday 21 April 2012

Louis Theroux on autism


Louis Theroux on autism: A very different sort of school

Louis Theroux with students from the DLC Warren

In today's Magazine

With autism diagnoses rising more and more parents are plunged into a battle to understand the condition and find their child the right treatment, writes Louis Theroux.
Joey Morales-Ward is a 13-year-old kid who lives in suburban New Jersey. He likes playing on his computer, making books that he illustrates himself, and drawing in coloured chalk on his parents' front drive.
Joey also has violent tantrums on a daily basis, which often involve him hitting himself, punching holes in the walls all through the house, and assaulting his mother, leaving her bruised and shaken.
Joey has been diagnosed with autism.
People with autism vary widely in terms of their symptoms. Some are above average intellectually, though many are below average and struggle in mainstream schools.
Commonly, people on the autistic spectrum have trouble with social interaction - using speech, recognising emotions (their own and other people's), body language. They also often have repetitive behaviours and routines and can appear locked in their own worlds.
    For reasons that aren't fully understood, diagnosis rates for autism have gone steadily upward in America in recent years. New Jersey is at the forefront of the trend. Latest figures put the autism rates among boys in New Jersey at one in 29 (rates for girls tend to be much lower).
    Despite its increasing levels of diagnosis, autism is still poorly understood. Indeed, it is not clear if the real rates of autism are climbing. Some say there are more cases due to improved detection, or, some believe, an overly expanded set of criteria.
    In the popular mind, the condition is forever linked to the Dustin Hoffman character in Rain Man, an autistic savant whose idiosyncratic behaviour - obsessive routines, strange vocal mannerisms - was offset by a host of "savant" abilities. He could memorise a phone book and beat the casinos in Las Vegas.
    In fact, savant abilities are rare among those with autism.
    For my part, my interest in the condition stemmed from an interest in the unique nature of the relationship between parents and their diagnosed kids.
    Louis Theroux with JoeyParents of autistic children can find it a struggle to cope
    Raising a child on the autistic spectrum presents a very demanding, though often rewarding, set of challenges.
    As a father of two young boys, who are in psychiatric parlance "neuro-typical", I know first-hand how hard it can be when your four-year-old refuses to eat his vegetables or goes through weird phases of waking every few hours; the tantrums over certain clothes and the squabbles over who was playing with what first.
    But raising a child with autism puts my stresses in the shade.
    Carol has a cot next to Joey's bed where she sleeps most nights, to stop him getting out of bed and wandering around.
    Children with autism sometimes sleep erratically into their teens. In terms of sleepless nights, many parents of diagnosed children remain in a kind of "newborn" mode for 10 or 15 years.
    Language can develop incredibly slowly, or barely at all. Even sometimes, when the communication skills are there, an autistic child may seem to have no interest in communicating.
    There can also be tantrums and outbursts.
    It's not always clear what is causing a tantrum. It might be that a kid's playtime has been refused or brought to an end, but it might be something more obscure - a thought or a memory.
    Nor is it always clear how best to handle a tantrum once it's started. When I first met them, Carol would lie on top of Joey to stop him from smashing up the place, sometimes in tandem with her husband Tadeo who would pin down his legs.
      A few weeks later, she implemented a new regime of giving him boxing gloves to soften his self-inflicted blows and keeping him in his room until the tantrum had blown over.
      As a TV presenter, the subject of autism also put me in a tricky position. I had to figure out how to get to know children, some of whom could only speak a handful of words, and whose way of interacting socially was very different to the ones I was used to.
      But this, in a way, was the point - that I should get a little glimpse of the strains, and the pleasures, of having a relationship with someone diagnosed with autism.
      On the positive side, kids on the spectrum can make massive strides in their progress, in rare cases losing the diagnosis entirely.
      With its high rates of autism, New Jersey is home to some of America's best services, including a remarkable school, the Developmental Learning Center in Warren, NJ. The DLC Warren lavishes resources on the 250 or so kids who go there, almost all of them diagnosed with autism. The teacher/student ratio is about 1/1.5.
      One of the children I met, Nicky Ingrassia, had been non-verbal until the age of six, and yet was now highly articulate, not to mention curious and humorous. Nicky had progressed to the point that he was being moved to a more mainstream school.
      But Nicky's level of progress is not the rule.
      Nicky Ingrassia turns the tables on Louis Theroux
      Just as typical was the story of the Englehard family.
      Josephine Englehard's son Brian was eight when he burned down the family house. As he grew older, he began assaulting Josephine, often when she refused him certain items of food. Sometimes he chased her around the house and pulled her hair out in clumps.
      After one particularly violent incident Josephine called the police. Brian was sent to a psychiatric hospital. From there, he moved to a group home where he still lives, aged 20.
      Brian spends Saturday and Sunday back in the family home. One Saturday I went with Josephine as she picked him up. Having heard so much about Brian's tantrums, I was a little nervous about meeting him.
      But over the course of the afternoon, using body language and a little bit of speech, Brian and I seemed to strike up a bit of a rapport. I found Brian outgoing, mischievous, and - especially after everything I'd heard about autism - surprisingly interested in me.
      Josephine told me that, although it had been a huge wrench moving Brian out of the house, he was now much calmer and seemingly much happier - a change she partly put down to the effect of the correct use of psychiatric medication.
        Sure enough, by the end of the visit, in the early evening, it was Brian who volunteered that he wanted to go back. In the car on the drive to the home, we listened to some merengue music on a Latin radio station, and the two of us grooved together sedately in the backseat.
        Joey's future remains uncertain.
        Carol says she is praying for a miracle for him, that he will somehow emerge from his autism.
        At the moment he is not on medication. Should his behaviour become even more disruptive as he gets bigger, Carol has resolved to try drugs as a first resort. If this doesn't help, a move to a group home like Brian's is not out of the question.
        In the end, I came away from my trip in New Jersey impressed, more than anything else, by the patience and love shown by the parents of the autistic children.
        The demands made of parents whose children are diagnosed with autism can be immense.
        Though Carol was praying for a miracle, in the course of spending time with her I felt she was performing a small miracle of her own simply by keeping going.
        An earlier version of this story incorrectly gave the ratio of teachers to students at DLC Warren as 1.5:1. The correct ratio is 1:1.5.
        Here is a selection of your comments.
        I feel for the parents, but especially I feel for the children. I have Asperger's Syndrome but was not diagnosed until I was well into my 50s. Growing up whilst rarely fitting in was hell. Increasing the awareness of the problems associated with autism needs to be handled carefully, many Aspies are not violent, just bewildered.
        Malcolm Midgley, Papamoa Beach, New Zealand
        So often autism is depicted as something where people are just a little strange but have huge abilities . In the majority of cases - and certainly amongst the parents of autistic children we know - it's more like having a 3-year-old in a 15-year-old's body . Life is difficult , sometimes violent and always stressful . Our son was an escapee - he would try and escape from the house and just run. Our house was like fort knox but he still got out. The last time he fell from the roof and broke his hip. Not exactly Rain Man is it ?
        Peter Little, Herne Bay
        My daughter was diagnosed at the age of two-and-a-half years old. Her speech came at the age of four, she could not pick up a pencil till the age of five. Presently she is studying at a normal school. She scores 80% to 90% marks in studies. She can understand everything. But her speech is not constructive. She cannot think in a different way. She is always withdrawn in nature.
        P P Pal, Uttarpara, West Bengal, India
        We are parents of three lovely, gorgeous boys. Our seven year-old is severely autistic and non-verbal but we all know that our efforts are worth it when we get a little bit of eye contact or a little smile or, on a really good day, a quick hug. The world can be a scary place for him, not knowing what to expect or what to do or how to act. But sometimes if you catch him really looking at something whether it's a flower or a ladybird or the leaves blowing in the wind - sometimes - it's good to look at things through his eyes. You realise that instead of rushing around just stop and really look at something and appreciate its beauty or its strangeness.
        Janis Cuthbert, Dunfermline
        As a perfectly verbal and expressive individual, I would like journalists to recognize that I AM on the spectrum. That the spectrum does not go from "genius, gifted, tragic, bit weird," to "sociopath, can't communicate,". It is a spectrum. We are as varied - and more so - than you could ever imagine. But no one wants to read stories of boring autistic people. I'm boring. I'm 22, I live at home with my family, I'm going to uni (again!) next year to do an arts subject, I have mates, I have hobbies, it's my fourth anniversary with my partner in June, and I don't hit people.
        Dee, Belfast
        My son was diagnosed with Aspergers Syndrome, but was badly misunderstood at school, with very distressing consequences. Anyway, he was so unhappy and home life was suffering to such an extent that we sent him to a private school. He loved it for a time and went to the top of his class until a teacher came along who wasn't so sympathetic. Again, we had the same problems so we took the monumental decision to take him out of school and have him home educated. Twelve years later, my son is at a top university studying physics with maths, two hundred miles away. He plays music in lots of groups and manages himself in the student accomodation without any support.
        at
        Labels: ,

        Friday 20 April 2012

        rickets death hospital inquiry


        Baby's parents demand rickets death hospital inquiry

        Rohan Wray and Channa Al-Alas said they felt like one doctor was accusing them of harming their child

        A young couple acquitted of murdering their four-month-old son have called for an inquiry into two London hospitals responsible for his care.
        Rohan Wray, 22, and Chana Al-Alas, 19, of London, were accused of abusing baby Jayden but his fractures were later found to have been caused by rickets.
        They told the BBC that the Great Ormond Street and University College hospitals should have diagnosed the disease.
        The hospitals have defended their care of Jayden before his death in 2009.
        A University College Hospital spokesman said its clinicians "acted with Jayden's interests at heart".
        "We regret that we were unable to reverse his deteriorating condition despite our intensive efforts in the short time he stayed with us. We would like to offer our sincere condolences to Jayden's parents," he said.

        Analysis

        Andrew Hosken BBC Today programme
        It is difficult to hear of a more astonishing ordeal than that endured by the parents of baby Jayden.
        Accused of murdering their first child who died of natural causes, the couple had to suffer the shock of seeing their second baby taken away in the delivery room and taken into care.
        They were acquitted of murder at the Old Bailey last December but have not been able to speak until now due to their family court battle to have their baby daughter Jayda returned to them.
        That fight ended successfully on Thursday. For almost three years, they were treated as murder suspects not only by police and medical experts but also strangers in the street who recognised them from newspaper reports.
        Both parents want their story told and an inquiry held to help other innocent parents in similar circumstances.
        Solicitors and other medical experts say there are many other parents also accused of abuse and murder of children where rickets is later found to be the cause.
        • What is rickets?
        Great Ormond Street said the rickets abnormalities had been less obvious to hospital radiologists than at the later autopsy and that it regretted the family's distressing time.
        Criminal charges against Jayden's parents were dropped in December 2011, after witnesses were unable to agree on the cause of the boy's death. But civil action was then taken by the local authority, Islington, which said Jayden had died from trauma inflicted on him by his parents.
        'Horrible two years' On Thursday, family court judge Mrs Justice Theis cleared Jayden's parents of responsibility for the death of their son and criticised the two hospitals for what she described as sub-optimal care.
        Jayden had a fractured skull and died from brain damage and swelling. He had been suffering from severe rickets, a disease caused by vitamin-D deficiency that causes bones to become soft.
        In their first broadcast interview, given to BBC Radio 4's Today programme, Jayden's mother and father voiced their anger at Great Ormond Street and University College hospitals.
        They described being asked at University College Hospital (UCH) if they knew how Jayden's injuries had occurred.
        "I said apart from him rolling over in his cot and hitting his head on the side of the bars I can't think of any other explanation because we haven't dropped him, nothing's dropped on him," Mr Wray said. "The look from them was that simply they didn't believe my explanation."
        Baby Jayden Four-month-old baby Jayden died three years ago
        The couple said they believed that Jayden would still be alive had his condition been correctly diagnosed at UCH and that they blamed both hospitals for his death.
        Ms Al-Alas said they were prevented from seeing Jayden after he was transferred to Great Ormond Street and later learned the hospital had spent four hours getting his injuries scanned.
        "He wasn't being treated then. They didn't know his brain readings - they wasn't checking that - they was just concentrating on getting the right pictures and he could've been treated then as well." Lessons needed to be learned, she said.
        Mr Wray said it had been a "horrible, horrible two years".
        "I really feel that they didn't really know what they were doing and they just pre-judged us way too early," he said. "You should actually be treated as innocent until proven guilty and not guilty until proven innocent."
        'Nightmare went on' In a statement, a Great Ormond Street Hospital spokesman said the decision to prosecute Jayden's parents was taken by the Crown Prosecution Service (CPS) after rickets had been diagnosed following Jayden's death.
        "It is therefore fair to say that GOSH's radiological opinion was not the determining factor in that decision. Nor would a diagnosis of rickets at GOSH have altered the clinical outcome," he said.
        "It is not for the trust to decide legal issues of criminal responsibility. We never took any position on whether any specific person caused these injuries."
        A CPS spokesman said: "In bringing this prosecution we considered all of the evidence in detail and our policy on non-accidental head injuries, and were satisfied that there was a realistic prospect of conviction. There was no criticism of the CPS by the judge for bringing this case."
        In her High Court ruling, Mrs Justice Theis said she could not be satisfied "on the balance of probabilities" that any of the fractures or the "traumatised fissure" were "as a result of inflicted deliberate harm caused to Jayden by either of these parents".
        Mrs Justice Theis concluded that more research was needed on the impact of vitamin D deficiency and rickets on babies aged under six months.
        The couple's daughter, who has been in the care of Islington since her birth in October 2010, has now been returned to them.
        at
        Labels:
        Subscribe to: Posts (Atom)

        Featured post

        More patients in Scotland given antidepressants

        More patients in Scotland given antidepressants 13 October 2015   From the section Scotland Image copyright Thinkstock Image ca...