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Patient Safety

Patient Safety

Patient safety is a priority for the Almonte General Hospital (AGH), including efforts to prevent and control in-hospital infections. As part of its efforts to keep the public informed, AGH posts regular patient safety reports on its website.

AGH C. difficile Infection Rates

C. difficile (Clostridium difficile) is a bacteria. C. difficile-associated Disease is one of the most common infections found in hospitals. Each Ontario hospital is required to provide monthly updates of its C. difficile Infection Rate. A hospital's C. difficile Infection Rate is calculated as follows: The number of new hospital-acquired cases of C. difficile times 1,000, divided by the hospital's total number of patient days for one month*. The Almonte General Hospital began posting its C. difficile infection rates in September 2008.

September 2008 to March 2009
  • Number of new C. difficile cases - 0

April 2009 to March 2010

  • Number of new C. difficile cases - 0

April 2010 to March 2011

  • Number of new C. difficile cases - 0

April 2011 to March 2012

  • Number of new C. difficile cases - 0

April 2012 to March 2013

  • Number of new C. difficile cases - 0

April 2013 to March 2014

  • Number of new C. difficile cases - 0

April 2014 to July 2014

  • Number of new C. difficile cases - 0

* The total number of days that services were provided to all in-patients during that month, excluding patient days for those patients less than one year of age.


What are C. difficile and C. difficile-associated Disease?

C. difficile (Clostridium difficile) is one of many types of bacteria found in bowel movements. For most people C. difficile does not pose a health risk. However, when the bacteria grow in the bowel it produces toxins that can damage the bowel and cause diarrhea. This is known as C. difficile-associated Disease (CDAD). CDAD symptoms can range from mild to severe diarrhea, to high fever, abdominal cramping, abdominal pain and dehydration. Severe cases may require surgery and extreme cases may cause death.

What causes CDAD?

CDAD can sometimes occur when antibiotics are prescribed. Antibiotics work by killing both bad and good bacteria. In the absence of good bowel bacteria, C. difficile can start to grow and produce toxins that cause CDAD.

Who is at risk for CDAD?

Risk factors for CDAD include:

  • A history of antibiotic usage
  • Bowel surgery
  • Chemotherapy
  • Prolonged hospitalization
Additional risk factors that predispose some people to develop more severe CDAD include increased age and serious underlying illness or debilitation.

How is CDAD diagnosed?

CDAD is diagnosed by laboratory testing of a stool sample to see if C. difficile toxins are present.

How is CDAD treated?

Those with mild symptoms may not need treatment. Antibiotics are used to treat more severe cases.

How does CDAD spread?

When a person has CDAD the bacteria in the stool can contaminate surfaces such as toilets, handles, bedpans or commode chairs. If you touch these items your hands can become contaminated. If you touch your mouth without washing your hands, you can become infected. Soiled hands can also spread the bacteria to other surfaces. Hand-washing and good hygiene can greatly reduce your risk of picking up C. difficile or any other bacteria.

What happens if a patient gets CDAD while in hospital?

Special precautions are used when a patient has C. difficile and continue to apply until the patient has been free from diarrhea for at least two days. These precautions include restricting the patient's activities outside their room and ensuring that all health care staff entering the room wear gown and gloves. Everyone must clean their hands when leaving the room.

What is AGH doing to prevent the spread of C. difficile?

AGH staff are strongly encouraged to follow best practices in the areas of hospital cleaning and hand-washing. Special precautions (see previous answer) would be taken and the appropriate treatment would be administered to any AGH patient with, or suspected of having, CDAD.

How can I find out more?

To find out more about C. difficile, CDAD and efforts to improve patient safety in Ontario hospitals, visit www.health.gov.on.ca and click on "Patient Safety"



AGH MRSA Infection Rates

S. aureus is a germ that lives on the skin and mucous membranes of healthy people. Occasionally, S. aureus can cause an infection. When S. aureus develops resistance to certain antibiotics, it is called methicillin resistant staphylococcus aureus, or MRSA.

Each Ontario hospital is required to provide monthly updates of its MRSA Infection Rate. MRSA bacteraemia rates are determined by the number of patients newly diagnosed with hospital-acquired MRSA bacteraemia, divided by the number of patient days in that month, multiplied by 1,000. Patient days are the number of days spent in a hospital for all patients.

The Almonte General Hospital began posting its MRSA Infection Rates in September 2008.

AGH MRSA Infection Rates

September 2008 to March 2009

  • Number of new MRSA cases - 0

April 2009 to March 2010

  • Number of new cases where the infection was present on admission and the patient was not exposed to any health care facility in the last 72 hours - 1

April 2010 to March 2011

  • Number of new MRSA cases - 0

April 2011 to March 2012

  • Number of new cases where the infection was present on admission (i.e., onset of symptoms < 72 hours after admission) and the patient was exposed to another health care facility (including LTC) other than the reporting facility - 1

April 2012 to March 2013

  • Number of new cases of MRSA bacteraemia associated with a source other than a health care facility or unknown/indeterminate source - 1

April 2013 to March 2014

  • Number of new MRSA cases - 0

April 2014 to July 2014

  • Number of new MRSA cases - 0

What is MRSA?

S. aureus is a germ that lives on the skin and mucous membranes of healthy people. Occasionally, S. aureus can cause an infection. When S. aureus develops resistance to certain antibiotics, it is called methicillin resistant staphylococcus aureus, or MRSA.

How does MRSA spread?

MRSA is spread from one person to another by contact, usually on the hands of caregivers. It can be present on the caregiver's hands either from touching contaminated material excreted by the infected person or from touching articles contaminated by the skin of a person with MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objects in the environment.

What happens if a patient gets MRSA while in hospital?

To stop MRSA from spreading to other patients in the hospital, precautions must be taken, including:

  • Single room accommodation
  • A long-sleeved gown and gloves worn by anyone caring for the patient
  • A sign on the patient's door reminding those who enter about the special precautions
  • Regular cleaning and disinfecting of the room and equipment used in it
  • Thorough hand-cleaning by everyone who leaves the room and by the patient prior to leaving the room

What is AGH doing to prevent the spread of MRSA?

AGH staff are strongly encouraged to follow best practices in the areas of hospital cleaning and hand-washing. Special precautions (see previous answer) would be taken and the appropriate treatment would be administered to any AGH patient with, or suspect of having, MRSA.

How can I find out more?

To find out more about MRSA and efforts to improve patient safety in Ontario hospitals, visit www.health.gov.on.ca and click on "Patient Safety".



AGH VRE Infection Rates

Enterococci are a type of bacteria normally present in the human intestines and in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and are therefore called vancomycin resistant enterococci (VRE).

Each Ontario hospital is required to provide monthly updates of its VRE Infection Rate. VRE bacteraemia rates are determined by the number of patients newly diagnosed with hospital-acquired VRE bacteraemia, divided by the number of patient days in that month, multiplied by 1,000. Patient days are the number of days spent in a hospital for all patients.

The Almonte General Hospital began posting its VRE Infection Rates in September 2008.

AGH VRE Infection Rates

September 2008 to March 2009

  • Number of new VRE cases - 0

April 2009 to March 2010

  • Number of new VRE cases - 0

April 2010 to March 2011

  • Number of new VRE cases - 0

April 2011 to March 2012

  • Number of new VRE cases - 0

April 2012 to March 2013

  • Number of new VRE cases - 0

April 2013 to March 2014

  • Number of new VRE cases - 1

April 2014 to July 2014

  • Number of new VRE cases - 0

What is VRE?

Enterococci are a type of bacteria normally present in the human intestines and in the environment. These bacteria generally do not cause harm, but can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and are therefore called vancomycin resistant enterococci (VRE). If a person has an infection caused by VRE, such as a urinary tract infection or blood infection, it may be more difficult to treat.

How is VRE spread?

VRE is spread from one person to another by contact, usually on the hands of caregivers. VRE can be present on the caregiver's hands either from touching contaminated material excreted by an infected person or from touching articles soiled by feces. VRE can survive well on hands and can survive for weeks on inanimate objects such as toilet seats, taps, door handles, bedrails, furniture and bedpans. VRE is easy to kill with the proper use of disinfectants and good hand hygiene.

What happens if a patient gets VRE while in hospital?

To stop VRE from spreading to other patients in the hospital, precautions must be taken, including:

  • Single room accommodation
  • A long-sleeved gown and gloves worn by anyone caring for the patient
  • A sign on the patient's door reminding those who enter about the special precautions
  • Regular cleaning and disinfecting of the room and equipment used in it
  • Thorough hand-cleaning by everyone who leaves the room and by the patient prior to leaving the room

What is AGH doing to prevent the spread of VRE?

AGH staff are strongly encouraged to follow best practices in the areas of hospital cleaning and hand-washing. Special precautions (see previous answer) would be taken and the appropriate treatment would be administered to any AGH patient with, or suspect of having, VRE.

How can I find out more?

To find out more about VRE and efforts to improve patient safety in Ontario hospitals, visit www.health.gov.on.ca and click on "Patient Safety".



AGH Hand Hygiene Compliance Rates

Proper hand hygiene is the single most effective way of reducing health care associated infections. As part of its ongoing patient safety initiative, Ontario requires all hospitals to monitor and report hand hygiene compliance rates in their facilities so the most appropriate infection prevention and control measures can be put in place. Hospitals use this information to ensure they're maintaining the highest possible standards of patient safety.

Hand Hygiene rate before initial contact with the patient/patient's environment for all health care providers

2010-2011
Percentage compliance: 76%
Provincial average: 65.73%

2011-2012
Percentage compliance: 95.12%
Provincial average: 80.52%

Hand Hygiene rate after contact with the patient/patient's environment for all health care providers

2010-2011
Percentage compliance: 89%
Provincial average: 78.61%

2011-2012
Percentage compliance: 93.02%
Provincial average: 88.23%

2013-2014
Percentage compliance before initial patient care: 89.9%
Percentage compliance after initial patient care: 90%


AGH Surgical Safety Checklist

Ontario is enhancing patient safety by requiring all hospitals to use a surgical safety checklist. The surgical safety checklist - which covers the most common tasks and items that operating room teams carry out - has been shown to reduce rates of deaths and complications among patients. Some of the items included are the review of test results, administration of antibiotics and post-surgery recovery plans.

2012-13
Q1 Total surgeries: 199
Completed checklist: 199
Compliance rate: 100%.

April 1 to June 30, 2014
Total surgeries: 188
Completed checklist: 188
Compliance rate: 100%