NHS GRAMPIAN
Board Meeting
03 08 10
Open Session
Item 6.2.1
Healthcare Associated Infection Report (HAI)
July 2010
Introduction
The bi-monthly HAI Report has been reformatted to comply with the new mandatory
HAI Report Template (HAIRT).
Following the Clostridium difficile outbreak at the Vale of Leven in 2008, each NHS
Board has been required to publish, on a bi-monthly basis, numbers of
Staphylococcus aureus bacteraemias (SAB) and Clostridium difficile infections
broken down monthly by hospital, as well as information on hand hygiene and
cleaning compliance levels. A template was introduced in January 2009 for this
purpose, which required Boards to set out local data by hospital and provide an
appropriate routine analysis and commentary on HAI for Board meetings as a
standing agenda item. When the template was issued its key purpose was to:


ensure visibility of HAI data and issues for Board members, facilitating awareness
and action where indicated
assist in creating and populating a routine NHS Board HAI data set to facilitate
assurance, awareness and national reporting for various levels within the
organisation
Since introduction of the template, NHS Boards have modified both the format and
detail to meet local requirements. The consequence of this approach, however, has
been to create a lack of consistency across Scotland on how the HAIRT is being
used; and importantly how the minimum HAI data set is being reported into the public
domain.
Given the degree of Parliamentary and public interest in the reporting of HAI related
data, a short life working group was established to review the structure and
presentation of the HAIRT and to consider the changes necessary for making the
information, as presented, easier to understand.
Key changes



The final revised template has now been agreed by the Cabinet Secretary for
Health and Wellbeing, who has asked that it be introduced with immediate effect.
In doing so, all NHS Boards are asked to note that the use and completion of the
template format and data sets within it are a mandatory requirement, to ensure
consistency of reporting across NHSScotland
Individual NHS Boards may wish to provide additional information to meet local
reporting needs. This should be done either as an appendix to the template or as
a separate report.
The revised template makes explicit the requirement on Boards to provide details
of all outbreaks that have taken place since the last report. Where an outbreak
has occurred the HAIRT should, as a minimum, state when it was declared,
number of patients affected, number of deaths (if any), actions taken to bring the
outbreak under control and whether this was reported to the Scottish
Government. For outbreaks of norovirus, a more general outline will be asked for.
1
The HAIRT has being issued with a 6 month review date to allow for any issues
relating to their use to be identified early and addressed.
Aim
To assure the Board that infection rates and interventions are monitored and that
appropriate action is taken to reduce the number of healthcare associated infections
in NHS Grampian.
Discussion







NHS Grampian continues to see a significant drop in the number of MRSA
bacteraemias.
NHS Grampian continues to be off trajectory as regards the HEAT target around
Staphylococcus aureus bacteraemias, but a number of initiatives are being
implemented to address this
NHS Grampian continues to maintain a significantly reduced number of
Clostridium difficile infections.
Although individual hospital hand hygiene data is not available at this time,
unverified data suggests that the overall compliance figure for NHS Grampian
remains high at 95%.
Cleaning data for June are not yet available.
NHS Grampian continues to implement the action plans resulting from the
Healthcare Environment Inspectorate (HEI) inspections to Aberdeen Royal
Infirmary and Dr Gray’s Hospital.
There was one outbreak of Norovirus in Ward 7 in Dr Gary’s Hospital in June
2010 causing the ward to be closed. A problem assessment meeting took place
and identified that all appropriate infection control precautions were in place.
However, a number of potential areas for improvement were identified including
staffing over the weekend and variable hand hygiene compliance figures. Plans
are in place to address these issues.
Key Risks
One very high risk remains on the Infection Control Risk Register relating to a single
system for identifying cleaned equipment. In the short term, Vernacare tape is being
used across NHS Grampian which allows staff to record that a piece of equipment
has been cleaned and when. However, practice around how it is used is not
consistent and therefore two other systems are being trialled. A decision regarding
which system will be implemented is expected before the end of July 2010.
Conclusion
The Board will continue be kept fully informed of the ongoing improvement work
around healthcare associated infection via this regular report.
Recommendation
The Board is requested to note the content of this report.
Pamela Harrison
Infection Control Manager
July 2010
2
Healthcare Associated Infection Reporting Template (HAIRT)
Section 1 – Board Wide Issues
This section of the HAIRT covers Board wide infection prevention and control activity and
actions. For reports on individual hospitals, please refer to the ‘Healthcare Associated
Infection Report Cards’ in Section 2.
A report card summarising Board wide statistics can be found at the end of section 1
Key Healthcare Associated Infection Headlines for July 2010
This section should open with a few key headlines relating to HAI activity in the Board. These
can either highlight good progress or potential issues e.g.

NHS Grampian continues to see a significant drop in the number of MRSA
bacteraemias.

There were no outbreaks of Clostridium difficile in NHS Grampian in June 2010.

Although individual hospital hand hygiene data is not available at this time,
unverified data suggests that the overall compliance figure for NHS Grampian
remains high at 95%.
Staphylococcus aureus (including MRSA)
Staphylococcus aureus is an organism which is responsible for a large number of healthcare
associated infections, although it can also cause infections in people who have not had any
recent contact with the healthcare system. The most common form of this is Meticillin
Sensitive Staphylococcus Aureus (MSSA), but the more well known is MRSA (Meticillin
Resistant Staphylococcus Aureus), which is a specific type of the organism which is resistant
to certain antibiotics and is therefore more difficult to treat. More information on these
organisms can be found at:
Staphylococcus aureus : http://www.nhs24.com/content/default.asp?page=s5_4&articleID=346
MRSA: http://www.nhs24.com/content/default.asp?page=s5_4&articleID=252
NHS Boards carry out surveillance of Staphylococcus aureus blood stream infections, known
as bacteraemias. These are a serious form of infection and there is a national target to
reduce them. The number of patients with MSSA and MRSA bacteraemias for the Board
can be found at the end of section 1 and for each hospital in section 2. Information on the
national surveillance programme for Staphylococcus aureus bacteraemias can be found at:
http://www.hps.scot.nhs.uk/haiic/sshaip/publicationsdetail.aspx?id=30248
NHS Grampian continues to be off trajectory as regards the HEAT target around
Staphylococcus aureus bacteraemias but a number of initiatives are being implemented to
address this including:
1.
The introduction of Chloraprep for central venous catheter insertion.
2.
The spread of the implementation of care bundles for patients with central venous
and peripheral venous catheters.
3.
The development of a care bundle for patients with urinary catheters.
3
Clostridium difficile
Clostridium difficile is an organism which is responsible for a large number of healthcare
associated infections, although it can also cause infections in people who have not had any
recent contact with the healthcare system. More information can be found at:
http://www.nhs.uk/conditions/Clostridium-difficile/Pages/Introduction.aspx
NHS Boards carry out surveillance of Clostridium difficile infections (CDI), and there is a
national target to reduce these. The number of patients with CDI for the Board can be found
at the end of section 1 and for each hospital in section 2. Information on the national
surveillance programme for Clostridium difficile infections can be found at:
http://www.hps.scot.nhs.uk/haiic/sshaip/ssdetail.aspx?id=277
NHS Grampian continues to maintain a significantly reduced number of Clostridium difficile
infections. Antibiotic prescribing guidelines for primary care were reviewed and launched in
April this year and those for acute care (dated 2009) are currently under review. Recent
antibiotic prescribing data suggests that there has been a significant reduction in the
prescription of those antibiotics most associated with CDI alongside the reduction in the
number of Clostridium difficile infections.
Hand Hygiene
Good hand hygiene by staff, patients and visitors is a key way to prevent the spread of
infections. More information on the importance of good hand hygiene can be found at:
http://www.washyourhandsofthem.com/
NHS Boards monitor hand hygiene and ensure a zero tolerance approach to non
compliance. The hand hygiene compliance score for the Board can be found at the end of
section 1 and for each hospital in section 2. Information on national hand hygiene
monitoring can be found at:
http://www.hps.scot.nhs.uk/haiic/ic/nationalhandhygienecampaign.aspx
Latest unverified data suggests that NHS Grampian continues to maintain a hand hygiene
compliance figure of 95% or above.
There has been insufficient time to break down this figure into individual hospital data but
these will be available for the next report.
The decision was taken last month to increase the local target to 95% and therefore wards
who do not achieve this are now required to develop an action plan when their compliance
drops below this.
Cleaning and the Healthcare Environment
Keeping the healthcare environment clean is essential to prevent the spread of infections.
NHS Boards monitor the cleanliness of hospitals and there is a national target to maintain
compliance with standards above 90%. The cleaning compliance score for the Board can be
found at the end of section 1 and for each hospital in section 2. Information on national
cleanliness compliance monitoring can be found at:
http://www.hfs.scot.nhs.uk/online-services/publications/hai/
Healthcare environment standards are also independently inspected by the Healthcare
Environment Inspectorate. More details can be found at:
http://www.nhshealthquality.org/nhsqis/6710.140.1366.html
4
Cleaning data for June are not yet available.
NHS Grampian continues to implement the action plans resulting from the HEI inspections to
Aberdeen Royal Infirmary and Dr Gray’s Hospital. Key actions that have been completed
include:
1. A review of all available information for patients on healthcare associated infection.
2. Review and launch of the Decontamination of Patient Equipment policy.
3. More stringent monitoring of cleaning audits.
4. Review of the Communication Strategy.
5. Implementation of the HEI environmental audit tool.
6. Review and implementation of an overarching Infection Control Policy and removal of all
out of date policies from ward areas
7. The reinforcement of the role of the Senior Charge Nurse regarding responsibility for the
patient care environment.
8. Review and reinforcement of the processes for ward staff to report and record required
maintenance jobs.
Outbreaks
There was one outbreak of Norovirus in Ward 7 in Dr Gary’s Hospital in June 2010 causing
the ward to be closed. Ten patients and one member of staff developed diarrhoea and/or
vomiting, although not all of these cases were confirmed, as it is standard practice not to
continue laboratory testing once 2-3 positive samples have confirmed an outbreak to be due
to norovirus. A problem assessment meeting took place and identified that all appropriate
infection control precautions were in place. However, a number of potential areas for
improvement were identified including staffing over the weekend and variable hand hygiene
compliance figures. Plans are in place to address these issues.
Other HAI Related Activity
Antibiotic prescribing
Unfortunately, due to staff illness, no new antibiotic prescribing data is available for this
report.
5
NHS Grampian
Clostridium difficile Infection Cases (all ages)
NHS Grampian continues to maintain a significantly reduced number of
Clostridium difficile infections.
50
45
40
NHS Grampian continues to be off trajectory as regards the HEAT target around
Staphylococcus aureus bacteraemias but a number of initiatives are being
implemented to address this.
35
30
25
20
15
Latest unverified data suggests that NHS Grampian continues to maintain a hand
hygiene compliance figure of 95% or above.
10
5
0
Jan-10
NHS Grampian continues to implement the action plans resulting from the HEI
inspections to Aberdeen Royal Infirmary and Dr Gray’s Hospital.
Jan-10
45
Feb-10
Feb-10
28
Mar-10
Mar-10
35
Apr-10
Apr-10
21
MSSA Bacteraemia Cases
May-10
May-10
29
Jun-10
Jun-10
30
Jul-10
Jul-10
Aug-10
Sep-10
Aug-10
Oct-10
Sep-10
Nov-10
Oct-10
Dec-10
Nov-10
Dec-10
MRSA Bacteraemia Cases
25
7
6
20
5
15
4
10
3
2
5
1
0
0
Jan-10
Jan-10
14
Feb-10
Feb-10
10
Mar-10
Mar-10
11
Apr-10
Apr-10
23
May-10
May-10
20
Jun-10
Jul-10
Jun-10
9
Jul-10
Aug-10
Sep-10
Aug-10
Oct-10
Sep-10
Nov-10 Dec-10
Oct-10
Nov-10
Jan-10
Dec-10
Jan-10
6
Feb-10
Feb-10
0
Mar-10
Mar-10
1
Apr-10
Apr-10
1
Hand Hygiene Compliance
May-10
0
Jun-10
Jun-10
1
Jul-10
Jul-10
Aug-10
Aug-10
Sep-10
Oct-10
Sep-10
Nov-10
Oct-10
Dec-10
Nov-10
Dec-10
Cleaning Compliance
100
100
80
80
60
60
40
40
20
20
0
0
Dec-08
Dec-08
88
May-10
Mar-09
Mar-09
86
Jun-09
Jun-09
89
Sep-09
Sep-09
91
Dec-09
Dec-09
90
Mar-10
Mar-10
95
Jun-10
Jun-10
Sep-10
Sep-10
Dec-10
Dec-10
Mar-11
Mar-11
Jun-11
Sep-11
Jun-11
Sep-11
Jan-10
Jan-10
90
Feb-10
92
Feb-10
Mar-10
Mar-10
93
Apr-10
Apr-10
94
May-10 Jun-10
May-10
95
Jun-10
Jul-10
Jul-10
Aug-10 Sep-10
Aug-10
Oct-10
Sep-10
Nov-10 Dec-10
Oct-10
Nov-10
Dec-10
6
Quarterly rolling year Clostridium difficile Infection Cases in patients aged 65 and over per 1000 total occupied bed days for HEAT Target
2.5
2
1.5
Actual Performance
Target
1
0.5
0
Apr 07 Mar 08
Jul 07 Jun 08
Oct 07 Sept 08
Jan 08 Dec 08
Actual Performance
Target
Apr 08 Mar 09
Jul 08 Jun 09
Oct 08 Sept 09
Apr 07 Mar 08
Jul 07 Jun 08
Oct 07 Sept 08
Jan 08 Dec 08
1.27
1.47
1.66
1.97
Jan 09 Dec 09
Apr 08 Mar 09
Jul 08 Jun 09
1.90
Apr 09 Mar 10
Oct 08 Sept 09
1.83
1.43
Jul 09 Jun 10
Jan 09 Dec 09
1.69
1.35
Apr 09 Mar 10
1.25
1.27
Oct 09 Sept 10
Jul 09 Jun 10
1.19
Oct 09 Sept 10
1.11
Jan 10 Dec 10
Jan 10 Dec 10
1.03
Apr 10 Mar 11
Apr 10 Mar 11
0.96
0.89
Quarterly rolling year Staphylococcus aureus Bacteraemia Cases for HEAT Target
300
250
200
Actual Performance
150
Target
100
50
0
Apr 05 Mar 06
Jul 05 Jun 06
Actual Performance
Target
Oct 05 Sept 06
Jan 05 Dec06
Apr 06 Mar 07
Jul 06 Jun 07
Oct 06 Sept 07
Jan 07 Dec 07
Apr 07 Mar 08
Jul 07 Jun 08
Oct 07 Sept 08
Jan 08 Dec 08
Apr 08 Mar 09
Jul 08 Jun 09
Oct 08 Sept 09
Jan 09 Dec 09
Apr 09 Mar 10
Jul 09 Jun 10
Oct 09 Sept 10
Jan 10 Dec 10
Apr 10 Mar 11
Apr 05 Mar 06
Jul 05 Jun 06
Oct 05 Sept 06
Jan 05 Dec06
Apr 06 Mar 07
Jul 06 Jun 07
Oct 06 Sept 07
Jan 07 Dec 07
Apr 07 Mar 08
Jul 07 Jun 08
Oct 07 Sept 08
Jan 08 Dec 08
Apr 08 Mar 09
Jul 08 Jun 09
Oct 08 Sept 09
Jan 09 Dec 09
Apr 09 Mar 10
Jul 09 Jun 10
Oct 09 Sept 10
Jan 10 Dec 10
Apr 10 Mar 11
244
258
270
251
238
236
221
225
215
207
225
207
214
205
203
200
192
198
181
194
170
182
160
182
159
153
147
141
135
7
Healthcare Associated Infection Reporting Template (HAIRT)
Section 2 – Healthcare Associated Infection Report Cards
The following section is a series of ‘Report Cards’ that provide information, for each acute hospital [and key
community hospitals – delete if appropriate] in the Board, on the number of cases of Staphylococcus aureus
blood stream infections (also broken down into MSSA and MRSA) and Clostridium difficile infections, as well
as hand hygiene and cleaning compliance. In addition, there is a single report card which covers all
community hospitals [which do not have individual cards], and a report which covers infections identified as
having been contracted from outwith hospital. The information in the report cards is provisional local data,
and may differ from the national surveillance reports carried out by Health Protection Scotland and Health
Facilities Scotland. The national reports are official statistics which undergo rigorous validation, which
means final national figures may differ from those reported here. However, these reports aim to provide
more detailed and up to date information on HAI activities at local level than is possible to provide through
the national statistics.
Understanding the Report Cards – Infection Case Numbers
Clostridium difficile infections (CDI) and Staphylococcus aureus bacteraemia (SAB) cases are presented for
each hospital, broken down by month. Staphylococcus aureus bacteraemia (SAB) cases are further broken
down into Meticillin Sensitive Staphylococcus aureus (MSSA) and Meticillin Resistant Staphylococcus
aureus (MRSA). Data are presented as both a graph and a table giving case numbers. More information on
these organisms can be found on the NHS24 website:
Clostridium difficile : http://www.nhs24.com/content/default.asp?page=s5_4&articleID=2139&sectionID=1
Staphylococcus aureus : http://www.nhs24.com/content/default.asp?page=s5_4&articleID=346
MRSA: http://www.nhs24.com/content/default.asp?page=s5_4&articleID=252&sectionID=1
For each hospital the total number of cases for each month are those which have been reported as positive
from a laboratory report on samples taken more than 48 hours after admission. For the purposes of these
reports, positive samples taken from patients within 48 hours of admission will be considered to be
confirmation that the infection was contracted prior to hospital admission and will be shown in the “out of
hospital” report card.
Understanding the Report Cards – Hand Hygiene Compliance
Good hand hygiene is crucial for infection prevention and control. More information can be found from the
Health Protection Scotland’s national hand hygiene campaign website:
http://www.washyourhandsofthem.com/
Hospitals carry out regular audits of how well their staff are complying with hand hygiene. The first page of
each hospital report card presents the percentage of hand hygiene compliance for all staff in both graph and
table form.
Understanding the Report Cards – Cleaning Compliance
Hospitals strive to keep the care environment as clean as possible. This is monitored through cleaning
compliance audits. More information on how hospitals carry out these audits can be found on the Health
Facilities Scotland website:
http://www.hfs.scot.nhs.uk/online-services/publications/hai/
The first page of each hospital Report Card gives the hospitals cleaning compliance percentage in both
graph and table form.
Understanding the Report Cards – ‘Out of Hospital Infections’
Clostridium difficile infections and Staphylococcus aureus (including MRSA) bacteraemia cases are all
associated with being treated in hospitals. However, this is not the only place a patient may contract an
infection. This total will also include infection from community sources such as GP surgeries and care
homes and. The final Report Card report in this section covers ‘Out of Hospital Infections’ and reports on
SAB and CDI cases reported to a Health Board which are not attributable to a hospital. Given the complex
variety of sources for these infections it is not possible to break this data down in any more detail.
8
Aberdeen Royal Infirmary
Clostridium difficile Infection Cases (all ages)
14
12
10
8
There has been a sustained drop in the number of MRSA bacteraemias in
Aberdeen Royal Infirmary over the last 6 months and a recent drop in the number
of MSSA bacteraemias.
6
4
2
0
Jan-10
Jan-10
12
Feb-10
Feb-10
7
Mar-10
Mar-10
13
Apr-10
Apr-10
6
MSSA Bacteraemia Cases
May-10
May-10
7
Jun-10
Jun-10
8
Jul-10
Jul-10
Aug-10
Sep-10
Aug-10
Oct-10
Sep-10
Nov-10
Oct-10
Dec-10
Nov-10
Dec-10
MRSA Bacteraemia Cases
16
3.5
14
3
12
2.5
10
2
8
1.5
6
4
1
2
0.5
0
0
Jan-10
Jan-10
11
Feb-10
Feb-10
9
Mar-10
Mar-10
10
Apr-10
Apr-10
15
May-10
May-10
13
Jun-10
Jun-10
8
Jul-10
Jul-10
Aug-10
Sep-10
Aug-10
Oct-10
Sep-10
Nov-10
Oct-10
Dec-10
Nov-10
Jan-10
Dec-10
Jan-10
3
Feb-10
Feb-10
0
Mar-10
Mar-10
1
Apr-10
Apr-10
1
Hand Hygiene Compliance
May-10
0
Jun-10
Jun-10
1
Jul-10
Jul-10
Aug-10
Aug-10
Sep-10
Oct-10
Sep-10
Nov-10
Oct-10
Dec-10
Nov-10
Dec-10
Cleaning Compliance
100
100
80
80
60
60
40
40
20
20
0
0
Jul-09
Jul-09
May-10
Aug-09
Aug-09
Sep-09
Sep-09
Oct-09
Oct-09
Nov-09
Nov-09
Dec-09
Dec-09
Jan-10
Jan-10
Feb-10
Feb-10
Mar-10
Apr-10
Mar-10
May-10
Apr-10
Jun-10
May-10
Jan-10
Jun-10
Jan-10
87
Feb-10
89
Feb-10
Mar-10
Mar-10
91
Apr-10
Apr-10
94
May-10
May-10
95
Jun-10
Jun-10
Jul-10
Jul-10
Aug-10 Sep-10
Aug-10
Oct-10
Sep-10
Nov-10 Dec-10
Oct-10
Nov-10
Dec-10
9
Dr Gray's Hospital
Clostridium difficile Infection Cases (all ages)
3.5
3
Cleaning compliance audit data includes compliance figures for Leanchoil, Turner,
Seafield and Stephen Hospitals as these are not separated out in the monitoring
report. We will, however work to separate these data in time for the next report.
2.5
2
1.5
1
There have been no cases of MRSA bacteraemia in Dr Gray's Hospital since
January this year but no sustained improvement in the number of CDIs.
0.5
0
Jan-10
Jan-10
3
Feb-10
Feb-10
1
Mar-10
Mar-10
0
Apr-10
Apr-10
0
MSSA Bacteraemia Cases
May-10
May-10
2
Jun-10
Jun-10
2
Jul-10
Jul-10
Aug-10 Sep-10
Aug-10
Oct-10
Sep-10
Nov-10 Dec-10
Oct-10
Nov-10
Dec-10
MRSA Bacteraemia Cases
2.5
3.5
3
2
2.5
1.5
2
1.5
1
1
0.5
0.5
0
0
Jan-10
Jan-10
1
Feb-10
Feb-10
1
Mar-10
Mar-10
0
Apr-10
Apr-10
2
May-10
May-10
2
Jun-10
Jun-10
1
Jul-10
Jul-10
Aug-10
Sep-10
Aug-10
Oct-10
Sep-10
Nov-10
Oct-10
Dec-10
Nov-10
Jan-10
Dec-10
Jan-10
3
Feb-10
Feb-10
0
Mar-10
Mar-10
0
Apr-10
Apr-10
0
Hand Hygiene Compliance
May-10
May-10
0
Jun-10
Jun-10
0
Jul-10
Jul-10
Aug-10
Aug-10
Sep-10
Oct-10
Sep-10
Nov-10
Oct-10
Dec-10
Nov-10
Dec-10
Cleaning Compliance
100
100
80
80
60
60
40
40
20
20
0
0
Jul-09
Aug-09 Sep-09
Oct-09
Nov-09 Dec-09
Jan-10
Feb-10
Mar-10
Apr-10
May-10 Jun-10
Jan-10
Feb-10
Mar-10
Apr-10
May-10
Jun-10
Jul-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10
10
Jul-09
Aug-09
Sep-09
Oct-09
Nov-09
Dec-09
Jan-10
Feb-10
Mar-10
Apr-10
May-10
Jun-10
Jan-10
91
Feb-10
95
Mar-10
94
Apr-10
97
May-10
98
Jun-10
Jul-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10
Woodend Hospital
Clostridium difficile Infection Cases (all ages)
3.5
3
Data for Woodend Hospital is a collection of both hospital and community figures
that reflect the services that are currently provided on this site.
2.5
2
1.5
Woodend Hospital has seen a good month for HAIs in June with only one case of
CDI and no SABs.
1
0.5
0
Jan-10 Feb-10 Mar-10
Jan-10
3
Feb-10
2
Mar-10
3
Apr-10 May-10 Jun-10
Apr-10
2
MSSA Bacteraemia Cases
May-10
3
Jun-10
1
Jul-10
Jul-10
Aug-10 Sep-10 Oct-10 Nov-10 Dec-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10
MRSA Bacteraemia Cases
6
1
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
5
4
3
2
1
0
Jan-10
Jan-10
2
Feb-10 Mar-10
Feb-10
0
Mar-10
1
Apr-10 May-10 Jun-10
Apr-10
5
May-10
1
Jun-10
0
Jul-10
Jul-10
Aug-10 Sep-10
Aug-10
Oct-10
Sep-10
Nov-10 Dec-10
Oct-10
Nov-10
Jan-10 Feb-10 Mar-10
Dec-10
Jan-10
0
Feb-10
0
Mar-10
0
Apr-10 May-10 Jun-10
Apr-10
0
Hand Hygiene Compliance
Jun-10
0
Jul-10
Aug-10 Sep-10 Oct-10 Nov-10 Dec-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10
Cleaning Compliance
100
100
80
80
60
60
40
40
20
20
0
0
Jul-09
Jul-09
May-10
0
Jul-10
Aug-09
Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10
Sep-09
Oct-09
Nov-09
Dec-09
Jan-10
Feb-10
Mar-10
Apr-10
May-10
Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10
Jun-10
Jan-10
95
Feb-10
95
Mar-10
96
Apr-10
90
May-10
86
Jun-10
Jul-10
Jul-10
Aug-10 Sep-10 Oct-10 Nov-10 Dec-10
Aug-10
Sep-10
Oct-10
Nov-10
11
Dec-10
Community Hospitals
Clostridium difficile Infection Cases (all ages)
7
6
5
4
This section of the report includes data for all community hospitals in NHS
Grampian except Woodend Hospital.
3
Only 2 HAIs were reported in June - 2 cases of CDI.
2
1
0
Jan-10
Jan-10
6
Feb-10
Feb-10
0
Mar-10
Mar-10
3
Apr-10
Apr-10
2
MSSA Bacteraemia Cases
May-10
May-10
1
Jun-10
Jun-10
2
Jul-10
Jul-10
Aug-10
Sep-10
Aug-10
Oct-10
Sep-10
Nov-10
Oct-10
Dec-10
Nov-10
Dec-10
MRSA Bacteraemia Cases
4.5
1
4
0.9
0.8
3.5
0.7
3
0.6
2.5
0.5
2
0.4
1.5
0.3
1
0.2
0.5
0.1
0
0
Jan-10
Jan-10
1
Feb-10
Feb-10
0
Mar-10
Mar-10
0
Apr-10
Apr-10
1
May-10
May-10
4
Jun-10
Jun-10
0
Jul-10
Jul-10
Aug-10 Sep-10
Aug-10
Oct-10
Sep-10
Nov-10 Dec-10
Oct-10
Nov-10
Jan-10
Dec-10
Jan-10
0
Feb-10
Feb-10
0
Mar-10
Mar-10
0
Apr-10
Apr-10
0
May-10 Jun-10
May-10
0
Jun-10
0
Jul-10
Jul-10
Aug-10 Sep-10
Aug-10
Oct-10
Sep-10
Nov-10 Dec-10
Oct-10
Nov-10
Dec-10
12
Out of Hospital Infections
Clostridium difficile Infection Cases (all ages)
25
20
15
This section of the report includes HAIs identified by GPs or within 48 hours of a
patient beining admitted to hospital.
10
There has been a slight fall in the numbe of CDIs identified and no cases of
SAB.
5
0
Jan-10
Jan-10
22
Feb-10 M ar-10 Apr-10 M ay-10 Jun-10
Feb-10
19
M ar-10
17
Apr-10
11
MSSA Bacteraemia Cases
Jun-10
17
Jul-10
Aug-10 Sep-10 Oct-10 Nov-10 Dec-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10
MRSA Bacteraemia Cases
1
1
0.9
0.9
0.8
0.8
0.7
0.7
0.6
0.6
0.5
0.5
0.4
0.4
0.3
0.3
0.2
0.2
0.1
0.1
0
0
Jan-10 Feb-10 M ar-10 Apr-10 M ay-10 Jun-10
Jan-10
0
M ay-10
16
Jul-10
Feb-10
0
M ar-10
0
Apr-10
0
M ay-10
0
Jun-10
0
Jul-10
Jul-10
Aug-10 Sep-10 Oct-10 Nov-10 Dec-10
Aug-10
Sep-10
Oct-10
Nov-10
Jan-10 Feb-10 M ar-10 Apr-10 M ay-10 Jun-10
Dec-10
Jan-10
0
Feb-10
0
M ar-10
0
Apr-10
0
M ay-10
0
Jun-10
0
Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10
Jul-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10
13