Sponsored: Launch of Mölnlycke’s clinical consensus statement: ‘Healthy skin, safe patients: the value of patient hygiene’
This sponsored article explores the launch of Mölnlycke’s clinical consensus statement 'Healthy skin, safe patients'
Author details: Global Medical Director-Antiseptics, Gloves, ORS at Mölnlycke, Dr Tod Brindle
The scale and impact of healthcare-associated infections (HCAIs) is a persistent and significant challenge for the NHS. It is estimated that 300,000 patients a year in England acquire HCAIs, costing the NHS £1 billion annually. 1,2 Infection control strategies, referred to as bundles, are a key line of defence against the proliferation of HCAIs. However, there is significant variation in approaches and outcomes in the UK, including the types of bundles and interventions used. This results in a greater risk profile for the spread of HCAIs, the consequences of which are potentially devastating for patients, their families and care teams. At a time of significant financial fragility for the UK, they are a threat to hospital trusts and the NHS.
Mölnlycke works in close collaboration with infection prevention professionals to understand how we can best support healthcare professionals (HCPs) to prevent HCAIs. We believe that a grass-roots approach, supported through constant dialogue with infection prevention experts, will alleviate the day-to-day pressures that HCPs face. Our new Clinical Consensus Statement, Healthy Skin, Safe Patients: The Value of Patient Hygiene' is the latest example of this work. The report was created following advisory panel, initiated and funded by Mölnlycke, which took place in May 2022. The panel was made up of leading infection prevention experts from across the UK.
The experts who joined the panel came to a consensus on five key statements on the importance of patient hygiene, skin integrity and the value of chlorhexidine (CHG) bathing as an efficacious preventative tool, one which can improve patient outcomes and deliver added value to the NHS. We believe that these five consensus statements demonstrate the value of safe and effective hygiene practices in preventing infections and aiding patients in their recovery.
Patient Hygiene: A fundamental element of patient care
The first point Mölnlycke’s panel came to consensus on was the importance of patient hygiene to be seen as more than a discretionary process. Instead, it is a fundamental element of basic care and must be seen as an essential, evidence-based infection prevention and control protocol. Our panel recognised that despite the widespread introduction of evidence-based guidelines for the prevention of HCAIs, limited compliance rates of care bundles across hospitals pose a significant barrier to improving patient hygiene outcomes. Hence, we believe there is a need to tackle HCAIs in an effective and systematic manner, through a bundled approach to healthcare that ensures high compliance rates.
HCAIs as a risk to healthy recovery
There was clear consensus from our panel that HCAI-associated pathogens on a patient's skin can pose a considerable risk to their healthy recovery. During a patient’s visit to a hospital, the risks of infectious pathogens entering the bloodstream of a patient are heightened, especially for patients with open wounds, following an invasive surgical procedure or patient injury. The panel acknowledged that ensuring reinforcement of basic hygiene practices, such as handwashing, plays a crucial role. 3 These basic practises paired with clinically supported tools, such as CHG whole body washing, ensure effective prevention of pathogens in hospital settings.
The value of skin integrity
The third consensus agreed upon by our panel was the need to promote skin integrity, as it carries importance in infection prevention and helps eliminate new portals of entry for pathogens.
An overstretched workforce, coupled with increases in hospital admission rates has resulted in greater risk of patients’ skin becoming susceptible to pathogenic flora. 4 Our panel highlighted growing evidence that shows surveillance methodologies have a considerable impact on surgical site infection (SSI) rates. They stressed the importance for hospitals to have risk assessments and surveillance exercises in place while adhering to consistent and high-quality SSI surveillance practices.5,6
The role of CHG in preventative bundles
The panel came to the consensus that a consistent approach to CHG bathing should be considered best practice for high-risk surgical procedures, as part of an SSI preventative bundle to reduce the risk of infection. The panel acknowledged that challenges existed, particularly due to the national and multi-regional guidance that often did not provide a strong steer in terms of the best types of hygiene practices that should be taken. They acknowledged the need for consistent, data driven advice for NHS Trusts. They believe that hospitals must take a consistent approach to patient hygiene, using SSI bundles which include CHG full body wash, to offer a robust and effective protection from patient infection.
Providing added value for the NHS
Finally, our panel came to the consensus that the consistent use of CHG bathing is effective in improving patient outcomes and provides added value for the NHS. SSIs can cause lengthy hospital stays due to significant physical or psychological disability. 7 The median length of stay for an SSI in the UK is 11 days, and the NHS is often burdened by litigation measures made by patients. 8 Our panellists agreed that by taking a holistic approach reduces hospital acquired infection rates most effectively. This includes a range of interventions in the form of standard precautions, environmental cleaning, hand hygiene and the use of CHG washes. They also emphasised the importance of developing a positive case for SSI bundles, illustrating the benefits of high-quality hygiene practices through best practise case studies.
With the heightened risk of HCAIs since the pandemic, we owe it to our patients to drive a change in hygiene practices that can ultimately protect them from preventable illnesses. The discussions which led to the development of this consensus statement demonstrate that across the UK, there is a need to standardise approaches to reduce the impact of surgical site infections as well as drive greater surveillance methods. We hope that the recommendations included in the Consensus Statement offer a valuable contribution to the national fight against HCAIs, helping to improve patient hygiene, patient care, and patient safety across the country.
- 1 Assets.publishing.service.gov.uk. 2022. [online] Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/212798/Sage-2-percent-Chlorhexidine-Gluconate-Cloth.pdf [Accessed 5 April 2022].
- 2 Nice.org.uk. 2022. Introduction | Healthcare-associated infections: prevention and control in primary and community care | Guidance | NICE. [online] Available at: https://www.nice.org.uk/guidance/cg139 [Accessed 4 May 2022].
- 3 Infection Prevention Control. 2022. Hand hygiene Policy for General Practice - Infection Prevention Control. [online] Available at: https://www.infectionpreventioncontrol.co.uk/resources/hand-hygiene-for-general-practice/#:~:text=Handwashing%20is%20the%20single%20most,which%20may%20cause%20them%20harm [Accessed 17 May 2022].
- 4 Iacobucci, G., 2022. Covid-19: NHS relaxes infection prevention and control measures. BMJ, p.o1029.]
- 5 Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Am J Infect Control 1992;20:271–4.
- 6 Tanner J, Padley W, Kiernan MA, Leaper DJ, Norrie P, Baggott R. A benchmark too far: findings from a national survey of surgical site infection surveillance. J Hosp Infect 2013;83:87–91
- 7 Adam-Howell P, Bhabra M, Enright M, et al. Taking a zero tolerance approach to preventable surgical site infections in UK hospitals; 2011. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8243999/
- 8 Totty, J., Moss, J., Barker, E., Mealing, S., Posnett, J., Chetter, I. and Smith, G., 2020. The impact of surgical site infection on hospitalisation, treatment costs, and health‐related quality of life after vascular surgery. International Wound Journal, 18(3), pp.261-268.