Superbugs

Every year more than 250,000 Canadians pick up deadly superbugs at hospitals resulting in more than 8,000 deaths. The patient killers include skin and blood infections such as methicillin-resistant Staphylococcus aureus (MRSA) and bloody diarrhea makers such as Clostridium difficile or “C diff.”

Given that one MRSA infection can cost $15,000 to treat, hospital acquired infections have become an annual multi-billion horror-show. Yet most of these debilitating infections and deaths can be prevented.

Hospitals that employ rigorous and consistent cleaning, eliminate patient over crowding and screen patients for superbugs as well as enforce hand washing regimes, have dramatically reduced infections rates by as much as 80 percent.¹

In fact good housekeeping remains a hospital’s best form of security against superbugs. Given that MRSA or C diff spores can be found on ordinary hospital surfaces such as countertops, cabinets, and bed rails, careful and regular cleaning is essential for patient safety. One hospital in Dorchester England reduced the spread of MRSA by 90 percent simply by doubling staff cleaning hours.²

But penny-pinching hospital administrators in Canada, England and the United States routinely reduce nursing staff, squeeze cleaning budgets or contract out housekeeping services to the lowest bidder in order to meet financial targets. Yet these administrative decisions can result in dirty hospitals that sustain superbug outbreaks and kill lots of patients.

The Vancouver Island Health Authority cut staff and contracted out cleaning services to a private company several years ago to save $10-million. The result: failed housekeeping audits, diluted cleaning solutions and three outbreaks of C diff including one that killed five people and infected another 94 patients.³

In England the Mid Staffordshire NHS Foundation Trust cut staff and cleaning activities in an effort to save $10-million pounds. The result: 400 additional patient fatalities from a nasty C diff outbreak. An investigation found that routine cut-backs on cleaning played a major role in the debacle.⁴

A head-line making wave of MRSA outbreaks hit England’s hospitals a decade ago after administrators cut the number of cleaning staff by 50 percent and farmed out nearly 40 percent of hospital cleaning services to private sector providers.⁵

In Scotland where deaths related to C diff infections soared from 170 to 417 between 2001 and 2006, authorities stopped the privatization of cleaning services altogether. Explained Christine Grahame, a long-time member of the Scottish parliament in a 2009 health debate on infections: “There is no doubt when cleaners, porters, nurses and others feel that they are part of a team in a hospital, they work together and take pride in what they do. People who come through on contract work do not have the same engagement with the hospital.”⁶

To date such stories suggest that properly funded in inhouse cleaning service can provide more accountability for infection control than contract cleaners. In house staff not only know all members of the hospital team but care more about what is familiar, effective and achievable.

Even though Alberta hospitals have been routinely hit by superbug epidemics, the province does not publicly disclose the rates of infections at its 105 acute care hospitals or nursing homes. Nor is there much transparency about the state of hospital cleaning. Yet in both Ontario and Quebec individual hospitals must now post their infection rates. Ontario, Quebec, Manitoba, Labrador and Newfoundland all report hospital infections caused by C diff.⁷

Although Alberta promised better infection control practices in 2007, the province’s auditor general found, two years later, that the government has made little progress: “Without effective, timely and robust compliance monitoring processes to support other infection prevention and control initiatives, there is a continual risk that unsafe practices will continue or develop, resulting in potentially severe public health issues for Albertans,” warned the auditor general.⁸