Comparison of key influences on governance of Health Care Associated Infections (HCAIs) and medication errors
| Actor | HCAIs | Medication errors |
| Department of Health | The Health Act and ‘Hygiene Code’ 52; 2003/04: target to reduce MRSA rate by 50% by 2008; 2007/08: target to reduce Clostridium difficile rate by 30% by 2011. HCAIs classified as a National Priority in the NHS Operating Framework 2007/2008 53 | Stated aim to reduce serious medication errors by 40% 11 54 |
| Healthcare commission/Care quality commission (annual healthcheck—standards for better health) | Annual unannounced inspection assessing compliance with Hygiene Code; Core standard C04a: ‘Healthcare organisations keep patients, staff and visitors safe by having systems to ensure that the risk of HCAI to patients is reduced, with particular emphasis on high standards of hygiene and cleanliness, achieving year-on-year reductions in MRSA’ | Core standard C04d: ‘Healthcare organisations keep patients, staff and visitors safe by having systems to ensure that medicines are handled safely and securely’ |
| NHS Litigation Authority (Clinical Negligence Scheme for Trusts) | Standard x.4.9 assessed on a biennial basis, requiring evidence that: risk-management processes exist; processes are implemented; processes are monitored and deficiencies addressed | Standard x.4.6 assessed on a biennial basis, requiring evidence that: risk management processes exist; processes are implemented; processes are monitored and deficiencies addressed |
| NICE | Guidance on infection control | Guidance on medicines reconciliation |
| National Patient Safety Agency | Receives infection rate data, feeds back through patient safety alerts; ‘Clean Your Hands’ campaign | Receives medication error reports, feeds back through patient safety alerts |
| Local organisations | Strategic Health Authorities: support improvement efforts; monitor infection rates; can raise concerns with DH portfolio manager Primary Care Trusts: service level agreements on infection control | Strategic Health Authorities: support medicines management networks Primary Care Trusts: require Trusts to learn from medication errors |
| Patient Safety First campaign | Reducing Harm in Perioperative Care | Reducing Harm From High-Risk Medicines |
| Health Protection Agency | Monitors and supports infection reduction | |
| Royal Colleges | Royal College of Nursing: ‘Wipe it Out’ campaign | Royal College of Paediatrics and Child Health: ‘Safer and better medicines for children’55 |