NHS staff who refuse to have the flu vaccine this winter will have to give reasons to their employer, as leaders make efforts to improve take-up rates| BMJ2017; 359
NHS leaders are to write to all NHS staff urging them to be vaccinated against flu as soon as possible. The letter will make it clear that staff who refuse the vaccine will have to give reasons to their employing NHS trust, which will then be recorded.
The heads of NHS England, Public Health England, the Department of Health for England, and NHS Improvement said that they were writing to remind staff of their “professional duty to protect their patients.” Trusts are also being urged to make the flu vaccine “readily available” to staff.
Although last year saw record take-up of the vaccine among staff, more than a third of NHS staff members did not take up the offer, with just a fifth being vaccinated in some trusts.
Hospitals and GP surgeries are being warned by NHS England to be prepared for a big increase in cases of flu this winter after a heavy season in the southern hemisphere.
An integrative literature review | American Journal of Infection Control
Background: Guidelines on antimicrobial stewardship emphasize the importance of an interdisciplinary team, but current practice focuses primarily on defining the role of infectious disease physicians and pharmacists; the role of inpatient staff nurses as antimicrobial stewards is largely unexplored.
Methods: An updated integrative review method guided a systematic appraisal of 13 articles spanning January 2007-June 2016. Quantitative and qualitative peer-reviewed publications including staff nurses and antimicrobial knowledge or stewardship were incorporated into the analysis.
Results: Two predominant themes emerged from this review: (1) nursing knowledge, education, and information needs; and (2) patient safety and organizational factors influencing antibiotic management.
Discussion: Focused consideration to empower and educate staff nurses in antimicrobial management is needed to strengthen collaboration and build an interprofessional stewardship workforce.
Approximately 1 in 4 (22.1 percent) adults prescribed an antibiotic in an outpatient setting for community-acquired pneumonia does not respond to treatment, according to a new study presented at the 2017 American Thoracic Society International Conference | Infection Control Today
Image shows colour enhanced scanning electron micrograph of a colony of Streptococcus pneumoniae, the species of bacterium that is the commonest cause of pneumonia.
McKinnell and colleagues conducted this study because current community-acquired pneumonia guidelines from the American Thoracic Society and the Infectious Disease Society of America, published in 2007, provide some direction, but large-scale, real-world data are needed to better understand and optimize antibiotic choices and to better define clinical risk factors that may be associated with treatment failure.
The researchers examined databases containing records for 251,947 adult patients who were treated between 2011 and 2015 with a single class of antibiotics (beta-lactam, macrolide, tetracycline, or fluoroquinolone) following a visit to their physician for treatment for community-acquired pneumonia. The scientists defined treatment failure as either the need to refill antibiotic prescriptions, antibiotic switch, ER visit or hospitalization within 30 days of receipt of the initial antibiotic prescription. The total antibiotic failure rate was 22.1 percent, while patients with certain characteristics — such as older age, or having certain other diseases in addition to pneumonia — had higher rates of drug failure. After adjusting for patient characteristics, the failure rates by class of antibiotic were: beta-lactams (25.7 percent), macrolides (22.9 percent), tetracyclines (22.5 percent), and fluoroquinolones (20.8 percent).
This poster highlights the current new campaign to encourage parents to get their child vaccinated | PHE
This poster has been revised and updated as part of the measles elimination strategy. The number of young people catching measles is rising. To be protected they need to be immunised with the MMR vaccine. It’s never too late to be vaccinated. It’s time to make measles a disease of the past.
New study claims that Vitamin D can reduce the risk of colds and influenza. A new study, published in the British Medical Journal found that daily pills of the vitamin reduced infections by 12%
Objectives To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect.
Design Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials.
Results 25 eligible randomised controlled trials (total 11 321 participants, aged 0 to 95 years) were identified. Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants. In subgroup analysis, protective effects were seen in those receiving daily or weekly vitamin D without additional bolus doses but not in those receiving one or more bolus doses. Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event. The body of evidence contributing to these analyses was assessed as being of high quality.
Conclusions Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.
Surveillance report 2017 – Surgical site infections: prevention and treatment (2008) | NICE guideline CG74
Surveillance decision: We will plan an update of the guideline on prevention and treatment of surgical site infections. The update will focus on:
nasal decontamination of Staphylococcus aureus
choice of preoperative skin antiseptics
application of intraoperative topical antiseptics/antimicrobials before wound closure
type of suture.
We will consider intraoperative perfusion and hydration, and intraoperative blood glucose control in a new guideline on perioperative care. Recommendations in the surgical site infection guideline will be withdrawn on publication of new recommendations in the perioperative care guideline.
NICE and Public Health England recommend children and young people are taught the importance of hand washing to tackle antimicrobial resistance.
The guidance recommends children in nurseries and young people at university be taught when and how to wash and dry their hands, for example after going to the toilet and before preparing food, in order to prevent the spread of infections. Public Health England’s (PHE) educational resources, e-Bug and Germ Defence, are listed as two ways to promote better hygiene.
The guidance by NICE and PHE, is aimed at NHS organisations, local authorities and health and social care professionals so they can provide information to people in their care.