CUPE recently hosted U.K. expert Steve Davies on a cross-Canada tour to raise awareness about health care associated infections (HAIs), and what Canadian health care facilities can do to contain them.
Davies is a senior research fellow at the School of Social Sciences at Cardiff University in Wales. Specifically, Davies’ research has focused on the importance of cleaning and other support services in combating HAIs such as MRSA, VRE and C. difficile.
Health care associated infections are now the fourth-leading cause of death in Canada, and infection rates are rising quickly. Currently, one in nine Canadian hospital patients will contract an HAI.
In an interview, Davies talks about the various responses to HAIs he encountered during his eight-city tour.
Q: How seriously do you feel Canadians are taking the issue of HAIs compared to in the UK?
A: There seems to be some general concerns among Canadians about HAIs – particularly among CUPE health care members who are more aware of the issues. The key point however, is whether Canadian governments are taking it seriously. As long as some provincial governments cling to the idea that contracting out cleaning is a good idea, there will remain problems in dealing with HAIs.
Resources are a key element in controlling HAIs - even in those provinces or hospitals that have retained in-house cleaning. A great deal of additional money has been ploughed into cleaning in recent years in the UK (together with other measures) and the results are beginning to be felt in terms of improvements. Scotland and Wales have gone further than England, having rejected contracting out of cleaning. These are litmus tests of how seriously the issue is taken.
Q: In what provinces did you notice the most interest in HAIs?
A: Judged on the responses of CUPE members, the general public and the media, I would say that the regions that showed the most interest were Saskatchewan, Manitoba and PEI. However, even in the provinces that had smaller public meetings, there was a very lively discussion and considerable interest in the implications of HAIs on several fronts
Q: Did you notice any recurring questions or concerns during the public meetings?
A: The most commonly expressed concern was for adequate resources in order for cleaners to be able to do the high quality job that is needed. There was a desire to return to the high standards (in cleaning, measurement of cleanliness and bed occupancy rates) that previously existed but which have been undermined by budget cuts. Many people called for mandatory reporting of incidents and deaths attributable to HAIs across the country. There were also demands that infection control in long-term care homes be improved and not allowed to be forgotten while the public’s attention was on the hospital sector.
Q: What do you see as the next steps for Canadian health care facilities in fighting HAIs?
A: To recognise that contracting out cleaning is part of the problem, not part of the solution. Canadian governments need to focus on saving lives, not on saving money. It is also important to locate cleaners as a valued and integrated part of the clinical team who should work closely with other healthcare staff in a coherent infection control programme.
Another step is to see the business case for high quality cleaning. Penny pinching in this area contributes to the enormous human and financial costs associated with infection outbreaks. Therefore it’s necessary to rebalance the way healthcare budgeting takes place. Good quality cleaning is value for money.
Finally, Canada must introduce high quality mandatory standards, monitoring and public reporting across the country. In order to deal with the problem it is vital to have reliable data.