5/25/10

Compass and hospital acquired infections

Infection-control experts with the Vancouver Island Health Authority (VIHA) have largely blamed inadequate housekeeping practices for the deadly 2008 outbreak of Clostridium difficile at Nanaimo Regional General Hospital (NRGH).  Housekeeping servies at the hospital had been privatized by the giant corporation Compass.

Documents previously withheld by VIHA but obtained by the Nanaimo Daily News show health officials knew by July 2008 that the virus rapidly spread to five different hospital floors because of inadequate cleaning. Personal contact and overcrowding were also issues, but "housekeeping was really the biggest problem".


Compass and its subsidiaries held the Island cleaning contracts for six years, during which time hospitals had regular infection outbreaks, failed housekeeping audits and damaging WorkSafe B.C. inspections. Compass employees lacked proper training to use toxic chemicals that caused hair loss, nose inflammation, respiratory problems, and skin irritation, according to two failed WorkSafe B.C. inspections issued in 2008 and 2009. The reports showed that employees lacked access to protective equipment, such as respirators, goggles, chemical gloves and boots. Ineffective cleaning products were also used.

Ninety-four patients were infected.  The news story is below.– Doug







Deadly hospital outbreak linked to poor cleaning

Suppressed documents reveal criticism of work by Island health authority's private contractor

Derek Spalding, Nanaimo Daily News

Published: Thursday, May 20, 2010

Infection-control experts with the Vancouver Island Health Authority largely blamed inadequate housekeeping practices for the deadly 2008 outbreak of Clostridium difficile at Nanaimo Regional General Hospital.

Documents previously withheld by VIHA and obtained this week by the Nanaimo Daily News through the Freedom of Information Act show health officials knew by July 2008 that the virus, which first appeared at NRGH in April of that year, rapidly spread to five different hospital floors because of inadequate cleaning. Personal contact was an issue, but "housekeeping is really the biggest problem," the documents reveal.

Some members of the public questioned the effectiveness of the private housekeeping contractor, Compass Group Canada, but VIHA signed a second five-year contract in 2009. This time, however, the health authority created an escape clause that allowed health officials to retender the contract at any time. VIHA announced this week that it is looking for another private company to take over the housekeeping and food services for Island hospitals and residential care facilities.

Compass and its subsidiaries have held the Island contracts for six years, during which time hospitals had regular infection outbreaks, failed housekeeping audits and damaging WorkSafe B.C. inspections. This led VIHA to explore other options, according to Joe Murphy, vice-president of operations and support services.

"We need to find a provider to consistently hit quality standards that are written into the contract and that we would expect everywhere in the province," he said.

Other factors led to the spread of C. difficile in 2008, including overcrowding, but improper cleaning methods and insufficient cleaner strength had a significant effect in the 11-month outbreak that began in 2008 and infected 94 people.

Compass employees lacked proper training to use toxic chemicals that caused hair loss, nose inflammation, respiratory problems, and skin irritation, according to two failed WorkSafe B.C. inspections issued in 2008 and 2009. The reports showed that employees lacked access to protective equipment, such as respirators, goggles, chemical gloves and boots.

Workers also used ineffective cleaners, according to internal documents obtained by the Nanaimo Daily News. Staff over-diluted bleach cleaner and later needed to switch to a soil-lifting detergent that would remove the virus from surfaces.

"I am now convinced that our procedure differs from that recommended for the rest of North America," wrote Dr. Larry Frisch in e-mail in August 2008, during the height of the outbreak.

"The whole auditing process needs to be revamped to include more objective measures of performance -- again, not a new position from (infection protection and control)."

The former executive medical director for quality research and safety added: "If we aren't using some soil-removing cleaning agent (like detergent) as our first step that must change and quickly."

A VIHA spokeswoman said the retendering of the housekeeping and food services contract has nothing to do with a string of outbreaks at several Island hospitals in the past two years.

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