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Infection control standards in A&E have ‘worsened’, new report warns
Infection control standards in A&E departments – vital for containing the spread of infectious diseases – have fallen significantly since the pandemic, according to new research published by the Royal College of Emergency Medicine (RCEM). The findings are contained in the final report
of RCEM’s three-year Quality Improvement Programme (QIP) recently published on Infection Control and Prevention (IPC). The QIP collated and analysed data and captured patient experiences from 127 Emergency Departments (EDs) across all four nations.
It found that the number of EDs achieving the
standards seen in 2020 at the height of the pandemic had fallen, but concluded that the increasing pressure and crowding in EDs will have impacted clinicians’ ability to attain the previous levels. The infection control and prevention measures
included things such as screening patients on arrival for COVID-19, isolating vulnerable patients in side rooms and moving those with infections to isolation areas. The report also highlighted the drop in the number of staff obtaining and maintaining their own vaccinations. The QIP team, led by Dr. Fiona Burton, EM Consultant, IPC topic team lead and co-chair of the RCEM Quality Assurance and Improvement (QA&I) committee, made the following recommendations: l Awareness that COVID-19 is a present and real risk to patients and staff should be maintained.
l Screening and documentation of IPC measures by healthcare staff must be routinely completed.
l Staff vaccinations must be promoted and actively encouraged.
The report adds that IPC teams must use their
local intelligence to work with each ED to guide PPE and departmental configuration to try and ensure appropriate areas are available to maximise staff and patient safety. Dr. Burton commented: “The drop in the
standards we observed is worrying but it has to considered in the highly unusual context of a global pandemic, combined with the escalating demands being heaped on our overstretched Emergency Departments. As COVID emerged, there was naturally strong messaging about the importance of escalating infection control measures including the focus on identifying the people who were most vulnerable. “However, with the successful vaccination
programme, the messaging has lessened and assessing people’s vulnerability, as soon as they enter the ED, is perhaps no longer as prominent a consideration as it was – especially as other system pressures mount. “But we have to remember that COVID has
not gone away and, along with other infectious diseases, it still poses a serious threat to patients and to staff. Not being able to provide adequate IPC measures can put people’s lives at risk. It must remain a priority. “We will now be sharing this important piece of work with healthcare leaders in the four nations and also their governments to ensure the lessons and good practice that were commonplace during the pandemic do not slip as time passes.” The President of the Royal College of Emergency
Medicine, Dr. Adrian Boyle, said: “I’m grateful to Dr. Burton and the Quality Improvement team for doing this important work. It is unconscionable that directly after a terrible pandemic that the system is not providing the standards that staff and patients need. We must ensure that an environment where staff and patients are protected properly against infectious diseases is the norm. Everyone has a part to play in this.” Responding to the report, RCN General Secretary and Chief Executive, Professor Pat Cullen, said: “Emergency departments are crowded, undignified and dangerous. Nursing staff are doing everything possible to keep their patients safe but mounting pressures make everything a relentless battle. “When beds are lining the corridors and patients
are sitting on chairs and treated in cupboards, safety is compromised. Infection prevention and control should be paramount but high standards become harder to maintain in these circumstances and the staff of emergency departments, including nursing, feel set up to fail. The health and care system needs to be brought back from this perilous position.”
PACE collaborates with UKHSA to tackle antimicrobial resistance
PACE (Pathways to Antimicrobial Clinical Efficacy) has announced a partnership with the UK Health Security Agency (UKHSA) to support innovators developing new antimicrobials. PACE was founded in 2023 by LifeArc, Medicines Discovery Catapult, and Innovate UK, with a £30 million programme of funding and support to be deployed over five years. PACE is focused on removing barriers and connecting the antimicrobial resistance (AMR) research and development (R&D) ecosystem to accelerate and strengthen the pre-clinical pipeline. Its first funding call was launched in October 2023 with up to £10 million available to support innovators developing new treatments for the most threatening microbes and resistance mechanisms. Leveraging the UKHSA’s Open Innovation in AMR
platform, the strategic collaboration will support the evaluation of new antimicrobial candidates from PACE-funded projects to help generate new scientific breakthroughs. Successful projects will have access to UKHSA facilities to test panels of clinical strains of bacteria with the support of world-renowned expertise. These panels will be expanded to provide additional bacterial strains which represent the problems faced by clinicians in the UK and internationally. The UKHSA partnership will deliver a unique experience for PACE innovators to address the gap in supporting R&D in the early preclinical space, helping to strengthen the UK’s position as a global leader in life sciences in the effort to tackle AMR. AMR is one of the top ten global health threats. By 2050, as many as ten million people could
die each year as a result of AMR, more than the population of London. Bacteria and other microbes are evolving to become resistant to treatment, driven in large part by the overuse and misuse of antibiotics. There is an urgent need to grow a pipeline of new tests and treatments to combat the complexity of the global public health threat. In 2019, the UK government published a five-year national action plan, which supports the UK 20-year vision for antimicrobial resistance – aligning to the combined strategic priorities of PACE and UKHSA, with commitments to supporting the scientific research community to develop new therapeutic approaches. Through its partnership with the UKHSA, PACE will help create and advance a diverse pipeline of preclinical projects, aiming to treat bacterial infections with high unmet needs.
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