NATIONAL targets are not showing the full picture of infection control at hospitals, according to a Warrington nurse.

Lesley McKay, associate director of infection control, says that Warrington and Halton Hospitals NHS Foundation Trust should be praised for detecting more cases of clostridium difficile (c-diff), a bug that causes an infection in the gut.

The trust has missed its trajectory target for hospital acquired infections for the second year running, with 31 cases of c-diff, four more than the target of 27 and two of MRSA, two more than the zero tolerance threshold.

Lesley thinks that, especially when it comes to c-diff the targets are not reflecting the hard work that is going on behind the scenes.

She said: “The thresholds for the targets have actually increased for the last two years so in our ‘vintage year’ we were allowed 31 cases and we got 19 so we were significantly below the threshold that had been set.

“The following year the threshold was set really low and nationally lots of organisations failed them, even though there is a difference in sampling and testing between trusts, lots of them failed. So it went from 19 to 26 and then it has gone up again this year to 27.

“So the measurement that is being used isn’t quite right and actually I don’t think we should be penalised for missing that threshold, I think we should be praised for the amount of testing we are doing.

“We are really dedicated to making sure the patients who come into the trust are cared for appropriately and that they have the right tests for the presenting condition.”

About three per cent of the population will have c-diff in their gut but it can be dormant or a non-toxic strain. The bug tends to cause problems for people who have been prescribed antibiotics.

“Antibiotics can kill off bacteria in the gut which means that c-diff doesn’t have any competition and can thrive and start to release toxins that cause vomiting and diarrhoea,” said Lesley.

“We isolate anyone who comes in with diarrhoea until we establish what has caused it and if they text positive for c-diff we move them to a special ward which we opened in 2008 where they are completely isolated.”

The hospital uses a test kit that has a sensitivity of around 96 per and only takes 30 seconds to detect if C-diff is present and if it is a toxic strain.

The team gives every patient who tests positive for c-diff, if it is dormant with the potential to be toxic or if someone has recovered, a card for them to show their GP so they can be given the correct antibiotics to prevent it flaring up.

“We have really changed the way that we investigate so we have invited the CCG into our internal review and set up the c-difficile action group which is looking at prescribing antibiotics in the community as well as in the hospital,” Lesley continued.

“I referred to our vintage year when we just had nineteen cases and there was nothing particularly different that we did that year.

“We are fully compliant, we are following the department of health guidelines absolutely to the letter so where other people are perhaps not compliant with that we are because we see the value of making sure the patient has that test result to inform future prescribing.”