Controlling infection in British nursing homes
BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7285.506 (Published 03 March 2001) Cite this as: BMJ 2001;322:506All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Dear Editor
In their editorial on infection control in nursing homes (1) Sheldon
Stone and colleagues provide an incomplete picture of the current
situation by ignoring the contribution over many years of Consultants in
Communicable Disease Control and their Clinincal Specialist Nurse
colleagues, largely based in Health Authorities.
For example, here in North Wales we have run educational initiatives
for nursing home staff since 1997, alongside an infection control manual
developed in partnership with the homes and other key players. We have
also operated a system of link nurses in each home, but in our experience
this has been difficult to sustain due to staff turnover and lack of
incentive. We have more recently piloted a self-audit tool, which will be
subject to routine checks by the Nursing Home Inspectorate. We agree with
the authors that if such interventions are to be effective they must be
underpinned by the routine inspection of homes, better still by the
regulations which determine the duties of both homes and inspectorate.
We believe the implied exclusion of residential homes is unfortunate,
given that the editorial highlights the risk of infective diarrhoea. A
small audit of residential homes in our area suggested practice in two
thirds of homes represented a significant risk of faecal oral cross
infection (2). In contrast to nursing homes, infection control
infrastructure is already poorer in residential homes. For example, there
is no nationally recognised minimum standard for sluice facilities in
residential homes, and many do not possess adequate facilities to empty
commodes. Their exclusion from any new initiatives to raise standards
will only accentuate existing inequalities.
Yours sincerely
R J Roberts
C A Roberts
D Casey
1 Stone SP, Kibbler CC, Bowman C, Stott D. Controlling infection in
British nursing homes. BMJ 2001;322:506.
2 Roberts RJ, Roberts CA, Casey D. Is Infection Control in Residential
Homes neglected? Comm Dis Pub Hlth 2000;3:64-5
No competing interests
Competing interests: No competing interests
Scottish Borders nursing home audit programme
With reference to the article on Controlling Infection in British
Nursing Homes in the 3 March 01 issue of BMJ,I am pleased to inform your
readers of a 7 year old initiative in the Scottish Borders.
We have completed the audit with regards to Infection Control
standards in Nursing Homes with a very satisfactory outcome of 88%
compliance with 15 standards. This audit is one element of a series
including nutritional standards, pressure sore prevention and dental care.
The clinical standards though more detailed were similar to those
identified in the article. This was a joint initiative with the NHS
Trusts, the Independent Sector and the Health Board. The Infection Control
Nurse,the Registration and Inspection Officer and the Audit Facilitator
took the lead roles.
Regards the comment that Nursing Homes may be a reservoir for MRSA, I
must advise that our findings from a complementary review do not concur.
Prevalence of MRSA at the time of the audit was 1.5% and compliance with
the MRSA standards was 92% on average.
Competing interests: No competing interests