Hepatitis C outbreak

Good controls exist already: Experts

In the wake of the hepatitis C outbreak at SGH, world health experts say regular audits - internal and external - will help ensure strict adherence to infection control measures. Speedy reporting of cases is also necessary.
In the wake of the hepatitis C outbreak at SGH, world health experts say regular audits - internal and external - will help ensure strict adherence to infection control measures. Speedy reporting of cases is also necessary.ST PHOTO: KUA CHEE SIONG

What hospitals need to do is to instil 'a culture among staff of keeping patients safe'

Singapore already has good infection control measures in place - it just needs to make sure that people stick to them, world experts say.

Ways to do that include building a culture that ensures sticking to strict hygiene practice, led and reinforced by the chief executive officers or chief nurses of hospitals.

"There are many standard infection control measures with which healthcare facilities in Singapore are familiar," said Professor David Heymann, chairman of Public Health England, an executive healthcare agency in Britain.

"What is needed is to ensure adherence all the time; hence there is a need for regular internal and external audits."

Sir Liam Donaldson, former chief medical officer at England's Department of Health and now chair of World Alliance for Patient Safety, World Health Organisation, agreed.

He said: "I'll be surprised if Singapore isn't already familiar with international best practices of infection control. The challenge is if there is a culture of carelessness, lack of leadership.

"The board, the CEO and the chief nurse should be instilling a culture among the staff of keeping the patients safe. The big question now is, could this happen in any other Singapore hospital?"

The topic came under the spotlight after the committee investigating the hepatitis C outbreak at the Singapore General Hospital (SGH) concluded that poor infection control practices and a slow response time were to blame.

Last week, Minister of State for Health Chee Hong Tat named the eight members of a task force which will work to plug these gaps. It is expected to finish its work by the middle of next year.

Professor Seto Wing Hong, who is director of WHO's Collaborating Centre for Infection Control in Hong Kong, said Singapore should also pay closer attention to the health organisation's guidelines.

The committee reviewing the outbreak suggested that SGH adhere to infection control precautions under the US Centres for Disease Control and Prevention guidelines.

However, Prof Seto pointed out that while infections are broadly similar, these guidelines are formulated for the United States context.

Both he and Sir Liam added that Singapore needs to speed up its reporting process.

"If there is even one case of hepatitis C infection, that should be the trigger for action," Sir Liam said.

Changi General Hospital chief nurse Paulin Koh, who was on the review committee, said improving staff education could help improve infection control in hospitals.

"Understanding the rationale for the prescribed infection control protocols should help staff to remain vigilant at all times, and to appreciate the importance of adhering strictly to (such measures)," she said.

Going forward, the latest advances in medical innovations should be used to track such infections. For instance, other countries have started to explore the genetic fingerprinting of infections, which will help to track the way they spread, said Sir Liam.

A version of this article appeared in the print edition of The Straits Times on December 17, 2015, with the headline 'Good controls exist already: Experts'. Print Edition | Subscribe