Trust denies massaging MRSA data

http://news.bbc.co.uk/go/rss/-/1/hi/health/7227818.stm

Version 0 of 1.

An NHS hospital trust has denied ordering a cut in blood tests as a way to reduce its reported MRSA rates.

The comments, from London's Kingston hospital come after a senior member of staff leaked an email which was circulated to all clinical staff.

The source said that staff were being encouraged to question whether blood samples should be taken.

Kingston Hospitals NHS Trust said the aim was to cut test numbers to those carried out at comparable hospitals.

In a statement, the trust said it currently carried out more blood tests than other hospitals of a similar size, and denied the intention was to reduce the number of MRSA cases being reported.

Drop in numbers

Kingston Hospital Trust has recently reported a 36% drop in the reported cases of MRSA.

Really I think it's rather more driven by government guidelines than actually by patient care Kingston hospital staff member

The source acknowledges that the level of hygiene at the hospital has changed for the better.

"There have been improvements in cleaning, hand washing, and all these other things which everyone's very familiar with to reduce the spread of MRSA," he said.

However, he feels that the hospital is encouraging staff to carry out fewer of the blood tests required to detect an MRSA infection.

"Certainly there will be a sort of significant reduction simply by doing fewer blood tests," he said.

"If you are not looking for something you wont pick it up."

Several factors

The leaked email draws attention to cases of MRSA recently discovered in the hospital.

The aim is to ensure patient safety and to try and prevent contamination of blood culture samples Helen DirilenDirector of Nursing & Quality, Kingston Hospital NHS Trust

It highlights the negative implications of this discovery both on the patients, and on the hospitals' Foundation Trust application.

It goes on to state that while the Trust carries out a proportionally large number of blood cultures per week, a number of "factors" should be questioned.

One such factor is whether the samples are being taken by competent individuals, but another relates to whether some of the samples should be taken at all.

"The rationale for obtaining a number of the samples in terms of whether they contribute to achieving a positive clinical outcome for some of patients, ie the terminally ill," it reads.

"Whilst we understand the complexities of clinical decision making, we need to have confidence that decisions to take blood culture specimens are appropriate."

Surprise

The source, who requested that his name be withheld, was surprised at the contents of the memo.

"I thought we were all meant to be trying to reduce the risk of MRSA genuinely, rather than simply massaging figures to reduce the number of tests," he said.

He questioned the motivation of the Trust in the suggestions put forward.

"Really I think it's rather more driven by government guidelines than actually by patient care," he said.

"I think the paragraph in which they suggest that it may affect our application for foundation trust status says it all."

Correct procedures

Helen Dirilen, director of Nursing & Quality for Kingston Hospital NHS Trust, said: "As part of good practice, a memo was sent to all clinical staff last week (originally circulated in September 2006) to remind them of the correct procedures and indications for the collection of blood culture samples from patients.

"The aim is to ensure patient safety and to try and prevent contamination of blood culture samples.

"Reducing MRSA and all hospital acquired infections is one of our key priorities."