Infections: The cost of hospital-acquired infections such as MRSA to the Irish health service is in the region of €150 million a year, a Cork-based study has estimated.
With 9 per cent of patients contracting hospital-acquired infections in Ireland and an additional average length of stay of 14 days, hospital-acquired infections are costing the health service at least €405,000 a day or €147,420,000 a year, according to a study carried out by Síle Creedon of the School of Nursing and Midwifery at University College Cork.
The State also faces the prospect of legal actions by patients who have contracted MRSA. This comes in the wake of the first case of its kind in Britain last week in which a hospital was forced to pay damages to a patient who had contracted MRSA .
Legal and clinical experts have warned that patients may need to be warned of the presence of the superbug in advance of admission to hospital. Lecturer in legal medicine at University College Dublin, Dr Asim Sheikh also says patients have a right to accurate figures on the prevalence of MRSA.
The burden of hospital-acquired infection was "significant", according to the Cork-based study. The effects on patient include pain, anxiety, disability, loss of earnings, extra travel, prescription charges and potentially death.
Costs to the health services include investigations, provision of antibiotics, additional surgery, extra length of stay and cancelled admissions, Ms Creedon said.
"Anything that contributes to keeping large amounts of people, between 9 and 10 per cent, in hospital longer is significant," she added.
Figures were based on an average daily cost of stay in an acute hospital of €300 and an average daily number of patients in hospital in the Irish health service of 15,000.
This estimate of the economic burden of hospital-acquired infections on the health service accompanies a study of hand hygiene practices among hospital staff, which was published in the Journal of Advanced Nursing last week.
The need for patients to be warned by healthcare providers if their institutions are not free of MRSA is raised by Dr Sheikhin in an editorial in the current issue of the Medico-Legal Journal of Ireland. He writes: "[There is] an exacting duty of care on healthcare providers to ensure a safe healthcare premises and, where it is not safe, to warn visitors/patients prior to entry of that fact." He adds that where this procedure is not followed, "the defence of [medico legal] claims will be difficult".
Given the prevalence of MRSA in the Republic, Dr Sheikh says litigation is inevitable. Last week, Kitty Cope (87), won "substantial damages" after the Princess of Wales Hospital in Bridgend, south Wales, accepted that it had not followed its own guidelines on infection control.
A number of solicitors in the State are known to be preparing claims on behalf of MRSA victims and their relatives.
Noting that MRSA has been recognised since the 1970s and preventive measures have been well documented, he says: "An Irish hospital which has failed in its attempts to introduce and/or enforce such measures, leading to a patient becoming infected and being caused harm, may find defending an action difficult."
Meanwhile, Prof Hilary Humphries, Professor of Clinical Microbiology at the Royal College of Surgeons in Ireland and consultant microbiologist at Beaumont Hospital, said he was in favour of patients being made aware of the risk of contracting hospital acquired infections before being admitted to a hospital for an elective procedure.
However, he warned that current figures on the prevalence of MRSA were raw and varied enormously. "They do not take account of the type and complexity of work being carried out at a particular hospital," he said, in reference to the catchment area characteristics and the number of tertiary referrals received by different institutions.
Prof Humphries said it might be possible to introduce more standardised data for MRSA "in the months ahead", but he warned that many hospitals might have difficulty adopting optimal guidelines because of a lack of personnel as well as resources. He identified information technology and the need for specialist microbiological epidemiologists as two key requirements.