MRSA Screening and Testing Plan RIA Jun 2009 - draft by keralaguest

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									                        Rapid Impact Assessment summary report

                 Each of the numbered sections below must be completed

    1. Title of plan, policy or strategy being assessed.

MRSA screening and testing SMT plan

    2. What will change as a result of this proposal?

In May 2009 the Cabinet Secretary decided that a national MRSA screening
programme should be rolled out across NHS Scotland over 2009/10 so that the
majority of elective admissions to acute hospitals (excluding paediatrics, obstetrics
and psychiatric specialities which were excluded from the interim report and the
HTA) and all emergency admissions to the four specialities (renal/nephrology, care
of the elderly, dermatology and vascular surgery) identified above as having the
highest incidence of MRSA colonisation are routinely screened

It was announced that there would be a Scotland-wide MRSA screening
programme that would come on-line from January 2010. This follows on from the
work of the MRSA screening Pilot Sites in Grampian and Ayrshire and the
publication of the interim MRSA screening programme report1. Currently NHS
Lothian examines 55,000 MRSA swabs and this first wave of the screening
programme will add 24,000 patients. There is every expectation that the screening
programme will expand further over time.

The National MRSA Screening Steering Group met mid-May and will meet monthly
until the project is completed. Fiona Cameron (Head of Service for Infection
Control) and Mike Gray (Clinical Manager for Microbiology) are NHS Lothian’s
representatives on this group. Each Board has been asked to establish this
programme ready for January 2010.


    3. Date of RIA

Friday, 12 June 2009

    4. Who was present at the RIA?




1
 MRSA screening programme interim report – Accessed June 2009 -
http://www.documents.hps.scot.nhs.uk/hai/mrsa-screening/mrsa-screening-interim-summary.pdf
Name            Job Title          Date of RIA               Email
                                   training
Mike Gray       Clinical           NOV 2007 (at              Mike.gray@luht.nhs.uk
                Manager            East Lancs NHS
AP Gibb         Speciality         Trust)
                Head -
                microbiology

Fiona           Head of
Cameron         Infection
                control

    5. Populations groups considered
   minority ethnic people (incl. gypsy/travellers, refugees & asylum seekers)
   women, men and transgender people
   people in religious/faith groups
   disabled people
   older people, children and young people
   lesbian, gay and bisexual people
   people of low income
   people with mental health problems
   homeless people
   people involved in criminal justice system
   staff
   carers
   All patient groups in most elective admissions to acute specialties (excluding
    paediatrics, obstetrics and psychiatric specialties) and for both elective and
    emergency admissions to the four specialties of nephrology, vascular surgery,
    dermatology and care of the elderly

    6. What positive impacts were identified and which groups will they
       affect?

Impacts                                                  Affected populations
Positive impacts – reduction of risk of the acquisition of
                                                         All patient groups in most elective
MRSA – less morbidity and mortality                      admissions to acute specialties
                                                         (excluding paediatrics, obstetrics
Positive impact through reduction of the stress of MRSA and psychiatric specialties) and for
infection and morbidity and mortality                    both elective and emergency
                                                         admissions to the four specialties
Positive impact in that all patients in the target group of nephrology, vascular surgery,
will have access to treatment and screening              dermatology and care of the elderly
Positive impact on the transmission of infectious
disease as screening will increase and transmission risk
decrease

Positive impact on quality of service with reduction in
MRSA transmission and morbidity and mortality



   7. What negative impacts were identified and which groups will they
      affect?

Impacts                                                    Affected populations
Negative impact – delay in treatment potential             All patient groups in most elective
                                                           admissions to acute specialties
Negative impact in that MRSA positive patients may         (excluding paediatrics, obstetrics
have treatment delayed                                     and psychiatric specialties) and for
                                                           both elective and emergency
Negative impact - potential for patients to be become      admissions to the four specialties
“branded” as MRSA carrier                                  of nephrology, vascular surgery,
                                                           dermatology and care of the elderly
Negative impact on access to services possibly as a
result of delayed start to treatment

Negative impact on working conditions since more work
and more tests will need to be taken



   8. Additional Information and Evidence Required

Evidence is required via this project to track the effects of the negative impacts


   9. What communications needs were identified? How will they be
      addressed?

Communication to board and bed management teams on any potential delays –this
should be handled via the MRSA project team



   10.        Recommendations
Specific action is required around the communication and handling of positive
patients and preventing 2 key effects

   1. Preventing a delay in the start of high risk treatment
   2. Following up and eradication and education of patients and staff to create
      clear guidelines within which the project is driven


   11.      As a result of the RIA what actions have been, or will be,
       undertaken and by when? Please complete:
  Specific actions (as a result Who will take     Deadline     Review date
  of the RIA)                   them forward      for
                                (name and contact progressing
                                details)

  Use as rapid a method as       Lab team within       Jan 2010      Feb 2010
  is possible to prevent delay   MRSA screening
  of transmission of result      project team
  and intervention               Mike Gray

  Communication to patients      Infection control     Jan 2010      Feb 2010
  – to prevent branding as       team
  “MRSA carriers”                Fiona Cameron

  Communication with bed                               Jan 2010      Feb 2010
  flow management and            Infection control
  booking to prevent any         team
  delay in treatment             Fiona Cameron



   12.      Has a full EQIA process been recommended? If not, why not?

More detailed analysis of potential impacts not relevant for this policy.

Manager’s Name: Mike Gray
Date
         Please send a completed copy of the summary report to:
                James Glover, Head of Equality and Diversity
                   James.Glover@nhslothian.scot.nhs.uk

								
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