The Fraser Health Authority has rolled out a laundry-list of changes at Burnaby Hospital in an effort to tackle the ongoing C. difficile infections at the site.
Efforts to get the problem under control include more effective cleaning procedures - including the use a sporacidal bleach - and extensive prevention and education plans to help limit the transfer of the highly infectious bacteria.
Earlier this month, a letter written by several of the hospital's head doctors to the Fraser Health Authority about the problem was made public by NDP leader Adrian Dix. In it, the doctors said that the hospital had a persistent problem with outbreaks of Clostridium difficile - a highly infectious bacteria that causes diarrhea, nausea and dehydration - among patients at a rate that topped regional or national averages.
Outbreaks of C. difficile led to the closure of two units between July and December 2011 for nine and 12 days each. The doctors also said that more than 470 patients had contracted C. difficile in a twoanda-half year period from 2009 to mid-2011 and that 84 patients with C. difficile had died.
The health authority countered that it was inaccurate to claim that the individuals may have died as a result of C. difficile, noting that in almost all cases the individuals were elderly and had other complicating medical conditions. The authority also reassured the public that the hospital was a safe place to get medical care.
That was a message reiterated this week by Burnaby Hospital executive director Cathie Heritage in an interview with the NOW.
"As a resident of this community, my family is served by services here, and I would not hesitate at any time from receiving care here," she said.
Heritage said the staff - from doctors to
cleaners - are "incredibly committed" to their work and to the patients.
Heritage, who spent 23 years in Vancouver Coastal Health Authority including 10 as a front-line nurse, noted that the problem of C. difficile is a challenge for health facilities everywhere.
She herself contracted C. difficile in a hospital outside this region, she said.
"I've had it personally, I have a great deal of empathy for anyone that gets it," she said.
Heritage said they're taking the concerns "very seriously" and noted that much of the work being carried out now began prior to the recent media coverage.
For example, an external review by Dr. Michael Gardam, an international authority on infection prevention, was done in late 2011, with a 13-point recommendation report returned to the health authority in early February.
Those recommendations are now being implemented.
Heritage outlined to the NOW some of those changes, including:
? a twice-daily "twice over" cleaning of all clinical areas using a sporacidal bleach;
? deep cleaning in all clinical and public areas supervised by the infection prevention and control team;
? enhanced cleaning observation audits;
? bed management to separate medical patients from surgical patients; and
? distribution of patient hand hygiene and hand hygiene wipes at each patient bed.
The action plan will continue to March 23, and Heritage says they're currently in the process of laying out a "sustainability" plan to go forward from there.
She notes that the sporacidal bleach hadn't been used previously for a number of reasons, particularly that the smell can be strong and offensive for patients and visitors.
One problem contributing to the infection control issue is the building itself - specifically, the hospital's age and layout.
The letter from the doctors earlier this month indicated "aged hospital infrastructure" as one of the key factors, and Health Minister Mike de Jong has said in recent weeks that the patient room model in the hospital is contributing to the spread of C. difficile.
The original hospital was built in 1952, with an extended care wing and an acute care tower added in stages during the 1970s. In many patient rooms, there is one washroom to four patients.
Heritage said the enhanced cleaning is one component of tackling that issue, and they are now providing individual hand cleanser to each patient to help limit cross-infection. They're also looking at replacing older style taps with no-touch taps where possible.
As well, there will be public notices posted in the main areas of the hospital if there is an infection outbreak in a specific unit.
"We're doing everything we can within our current infrastructure," she said.
However, she noted that plans are already in the works for the future of the building itself.
"Prior to this all happening, with the support of the Burnaby Hospital Foundation, we were in the process of site redevelopment planning, talking to the community at large, looking at the growth in population, exploring what (might work) for Burnaby Hospital," she said.
That planning is in very early stages; no decisions have yet been made on what will happen on the site, but de Jong has indicated that a site redevelopment will be necessary in the future.
Burnaby MLA Raj Chouhan questioned de Jong in the legislature on March 6, saying that he'd heard from a Burnaby family about poor cleaning in a patient room.
"Is this the kind of standard of care patients can expect at Burnaby Hospital?" he asked.
De Jong responded that the ministry and health authority are taking the issue seriously and tracking appropriate data to make sure they see improvements.
"That's the basis of the public confidence that we will ensure British Columbians can have in the safety of the hospitals," he said.
C. difficile is not typically contracted by people with otherwise healthy immune systems or who have not been on antibiotics for extended periods.
Those most at risk include people age 65 and older, those with underlying diseases and weakened immune systems, patients in intensive care, those with prolonged hospital stays and people who have a history of antibiotic usage.
