Welsh Government
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Plans to extend Clostridium Difficile reporting

A plan to extend the mandatory surveillance scheme for Clostridium difficile has been unveiled by the Chief Medical Officer for Wales Dr Tony Jewell yesterday Tuesday, 22 July.

Currently only information on patients aged 65 and over is published, but this will now be extended to cover all confirmed cases of the infection in patients aged two and above.

The Welsh Assembly Government will also issue a new protocol for testing for C.difficile to ensure consistency across Wales.

The new measures follow expert advice from the Welsh Healthcare Associated Infection team at the National Public Health Service for Wales and Welsh Assembly Government health professionals.

The data will be published for the first time in September on the number of patients confirmed with C. difficile between January and the end of June 2008. Following an evaluation of the data, this will form part of the routine health associated infection publications in 2009.

Dr Jewell said:

Up to three per cent of healthy adults carry C. difficile and generally it causes them no harm. All patients over the age of two who are suspected of having antibiotic associated diarrhoea are routinely tested for C difficile and the laboratory results are recorded but not published.

This has been because the evidence clearly shows that C. difficile is a particular risk to older people who account for 80 per cent of cases. But due to concerns about the increased rate of C.difficile in the over two age group in England, the Assembly Government asked the Welsh Healthcare Associated Infection team to look at how data can be published in Wales for surveillance and benchmarking.

It is not easy to compare data between Trusts, because the incidence of infection depends on a range of factors, including the age of the patients being treated and the type of services provided.

To ensure consistent reporting of C. difficile, a new protocol is being developed for when and how to test for this infection. This will enable us to compare data more effectively. We will also be looking at publishing information on the severity of the infection for the patient.

Health Minister Edwina Hart added:

We must remember that the vast majority of patients receive safe and effective care, and the risk of developing any type of healthcare associated infection is low.

Our strategy for tackling all infections, which has been endorsed by the Wales Audit Office and Assembly’s Audit Committee, is paying off with lower infection rates in Wales. But we are not complacent and are working hard to drive them down even further.

While they will never be entirely preventable, there are measures in place to reduce the risk and spread of infection. Healthcare Inspectorate Wales, the independent organisation set up to inspect NHS settings, has appointed a number of peer reviewers to look at Trusts’ infection control procedures and the unannounced hospital cleanliness spot-checks will continue.

In addition, reducing infections is a key theme in the 1,000 Lives Campaign, which was launched in April. This aims to reduce avoidable risk to patient safety by implementing new ways of working and techniques developed by clinicians in Wales.

My recent announcement to give extra power to hospital ward sisters and charge nurses on ward cleanliness and hygiene and to restrict patient visiting hours will also help to reduce infections.

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