Health care associated infections occurring in nursing homes should be monitored, audited and reported through a systematic surveillance programme, the Royal College of Physicians of Ireland (RCPI) said today.
It said while infections such as MRSA and Clostridium difficile occurring in acute hospital settings are monitored and reported, this is not the case in relation to infections occurring in long term care settings.
It wants this imbalance addressed in the interests of minimising infections and improving patient safety in long term care settings.
Prof Hilary Humphreys, chair of the RCPI's policy group on healthcare associated infections and a consultant microbiologist at Dublin's Beaumont Hospital, said while international surveys showed between 5 and 16 per cent of nursing home residents have a healthcare associated infection at any one time there was no accurate data in relation to the prevalence of such infections among nursing home residents in Ireland.
However a survey being conducted this year by the European Centre for Disease Prevention and Control, which will aim to collect data from long term care settings across Europe including Ireland, should provide some much needed data, he said.
A position paper on healthcare associated infections in nursing homes, published by the RCPI today, notes that residents of these facilities are frail and at higher risk of infections and colonisation with multi-resistant microorganisms, due to impaired defences.
It also says it is more difficult to recognise and diagnose infections in the elderly and access to diagnostic laboratory services for those treating them in nursing homes may not be adequate.
In addition it says the knowledge and training on infection prevention and control amongst the carers of residents may be sub-optimal.
Furthermore it notes some older facilities may find it difficult to isolate a resident when they do pick up an infection, to prevent it spreading.
"Preventing healthcare associated infections by establishing good practice and by the implementation of national standards are essential," it says.
"The publication earlier this year of the Hiqa national standards for the prevention and control of healthcare associated infections is a welcome advance in addressing these issues," it adds.
Along with monitoring of infections in nursing homes the RCPI wants to see healthcare associated infections in long term care settings included in undergraduate and postgraduate medical training programmes and in other educational activities for non-medical staff and it wants to see antibiotic stewardship in nursing homes enhanced.
It also points out that more research is required to evaluate the effectiveness of measures currently being advised to prevent healthcare associated infections in nursing homes.