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The Never ending story……… Beating the bugs Cheryl Etches, Director of Nursing and Governance

The Never ending story……… Beating the bugs Cheryl Etches, Director of Nursing and Governance Royal Wolverhampton Hospitals NHS Trust. August 2005. “Infection what??” Culture …… Can’t do “Target unrealistic and not statistically sound” MRSA Bacteraemias 03/04 - 38 04/05 - 66

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The Never ending story……… Beating the bugs Cheryl Etches, Director of Nursing and Governance

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  1. The Never ending story……… Beating the bugs Cheryl Etches, Director of Nursing and Governance Royal Wolverhampton Hospitals NHS Trust

  2. August 2005 “Infection what??” Culture …… Can’t do “Target unrealistic and not statistically sound” MRSA Bacteraemias 03/04 - 38 04/05 - 66 05/06 - 83 Infection Control Team and function

  3. August 2005 – changes commenced • Launch of Saving Lives • Executive Lead • Infection Prevention • Infection Prevention Board • Leadership of IPT changed • Review of IP Strategy and annual plan of work • 100 new commodes - guess what………………. C.Diff reduced!

  4. May 2006 – DoH team engagement meeting The credo commenced……………..

  5. I Action planning - systematic Leadership Policy Accountability Information Training Audit

  6. Staff and patient involvement • Communication strategy • PPI Forum • Staff side involvement • Local press • Complainants • NED champion

  7. Commode Audit Commode replacement Mattress replacement Grand Round presentation RCA for all c diff cases introduced High Impact Intervention No 6 introduced Bed space checklists introduced Commode re-Audit &feedback Matrons lead Ward Declutter programme Medical division training Antibiotic review commenced Domestics training delivered by IPT

  8. Impact………… A rollercoaster year…………. But the overall results have been encouraging…….

  9. What made the difference? • CEO active support • Leading from the front • Consistent message • Align structures, processes with outcomes • Pre-empt knock backs – keep the faith • Engage Drs very early on – but don’t hold up the campaign until all there • Be determined • Celebrate success publicly

  10. How the improvement is being maintained • Objectives and KPIs • Inclusion in all job descriptions • Consultants’ objectives/appraisal • New mattresses – audit process • Capital programme • Training - domestic staff/junior Drs • Full implementation and audit of HIIs • Audit processes - environment - cleaning regimes • Regular performance reporting

  11. Success? • Culture change • From Board to ward • Impact on all HAIs • Consultant objectives • Not seen as a nursing problem only • IPT of the year 2007!

  12. But there are blips……….. So we have refocused our efforts: • High Impact interventions • Seek out the cause • Increase supervision and audit • Re-engage medical staff • New dress code

  13. Summary • Infection prevention elevated to a high priority • Leadership and accountability • Action focused & outcome orientated • Whole system approach – not just MRSA, not just “problem” areas • Executive lead →operational engagement – made a reality by IPT

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