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Statutory & Mandatory Training Infection Prevention & Control

Statutory & Mandatory Training Infection Prevention & Control. Aims. By the end of the session staff will have an increased understanding of: Healthcare Associated Infections (HAI) Management of Significant Organisms Hand Hygiene

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Statutory & Mandatory Training Infection Prevention & Control

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  1. Statutory & Mandatory TrainingInfection Prevention & Control

  2. Aims By the end of the session staff will have an increased understanding of: Healthcare Associated Infections (HAI) Management of Significant Organisms Hand Hygiene Application of Standard Infection Control Precautions (SICP) in Daily Practice Communication with the Infection Prevention & Control Team Linked to KSF Core dimension 1 – Communication Core dimension 3 – Health, Safety & Security

  3. Background HAI How many people every year in Scotland are affected by HAI? • HAI affects approx 4.9% of hospital patients How much does it cost in Scotland? • The financial cost of HAI within NHSScotland runs into millions HPS. (2012). Scottish National Point Prevalence Survey of Healthcare Associated Infection and Antimicrobial Prescribing 2011

  4. How does HAI affect the Public? MRSA and C.diff cases fall in Scottish hospitals but more focus must be put on keeping hospitals clean INFECTION rates are falling in hospitals but health boards have to do more to keep them clean, an inspection has found. Daily Record 5 Feb 2013 Professor warns we are losing fight against bugs as harmful bacteria become resistant to antibiotics THE World Health Organisation have warned we are heading for a post-antibiotic era as mutating bacteria becomes resistant to existing drugs. Daily Record 18 Feb 2013 Stethoscopes 'more contaminated' than doctors‘ hands BBC News 27 February 2014

  5. Significant Organisms Staphylococcus aureus (inc MRSA) Clostridium difficile Acinetobacter baumannii Vancomycin resistant enterococci (VRE)

  6. Consequences of HAI • Increased morbidity and mortality • Increased length of stay • More investigations • Longer absence from work • Increased financial cost • Litigation

  7. Consequences of spread… Infections due to Multi Drug-Resistant organisms are increasingly difficult to treat • Limited antibiotic options • Using “older” antibiotics with significant toxicity Clostridium difficile infection (CDI) • 20-25% have one recurrence, 50-60% have two recurrences • Pseudomembranous colitis has a mortality of 6-30%

  8. How do we stop HAI? By applying Standard Infection Control Precautions: • SICP are precautions necessary to reduce the risk of transmission of micro-organisms from both recognised and unrecognised sources. • ALL healthcare workers in ALL situations involving the care of patients or contact with the environment must use SICP. • There are 10 elements of SICP.

  9. 10 Elements of SICPs • Hand Hygiene • Personal Protective Equipment (PPE) • Occupational Exposure Management including Sharps • Management of Blood & Body Fluids Spillages • Management of care Equipment • Control of the Environment • Waste Management • Linen Management • Patient Placement • Cough Etiquette

  10. Hand Hygiene • Hand Hygiene is the single most important means of preventing healthcare associated infections • Improved adherence to hand hygiene (i.e. hand washing or use of alcohol-based hand rubs: ABHR) has been shown to help reduce overall infection rates • Audit of hand hygiene practice is used to measure compliance for improvement

  11. Hand Hygiene Audit Compliance In recent hand hygiene audits ward scores and Local Health Board Co-ordinator (LHBC) were compared • Average score for ward audits was 89% • Average score for LHBC audits was 76% • 5 wards scored 100% for 8+ months • No ward scored 100% when audited by LHBC • Biggest deficit in scores was 30%

  12. SCENARIO

  13. Scenario 1 Mrs A has developed diarrhoea and has had several episodes overnight. As a precaution she was moved from a six bedded bay to a single side room. The next day a patient from the same six bedded bay develops diarrhoea. What SICPs do you use – discuss

  14. Scenario 2 A patient is admitted into your ward from a Nursing Home following a fall. She will be attending Theatre in the morning. She is known to be MRSA positive. What SICPs do you use – discuss

  15. Scenario 3 A patient has arrived at your ward/dept. They have a 2 day history of coughing, sneezing and difficulty breathing. What SICPs do you use – discuss What respiratory precautions do you ask the patient to follow?

  16. Scenario 4 (Community) You have a patient on your caseload who was discharged from hospital recently who was known to be CDI +ve. On visiting, the patient has been incontinent of diarrhoea. What SICPs do you use – discuss How do you ensure that hand hygiene is carried out effectively?

  17. Scenario 5 (Non Clinical) You are visiting a friend /relative in hospital and when you arrive at the ward you are advised that the ward is closed due to winter vomiting. Discuss

  18. Scenario’s • Mrs A has developed diarrhoea and has had several episodes overnight. As a precaution she was moved from a six bedded bay to a single side room. The next day a patient from the same six bedded bay develops diarrhoea. What SICPs do you use – discuss • A patient is admitted into your ward from a Nursing Home following a fall. She will be attending Theatre in the morning. She is known to be MRSA positive. What SICPs do you use – discuss • A patient has arrived at your ward/dept. They have a 2 day history of coughing, sneezing and difficulty breathing. What respiratory precautions do you ask the patient to follow? What SICPs do you use – discuss • You have a patient on your caseload who was discharged from hospital recently who was known to be CDI +ve. On visiting, the patient has been incontinent of diarrhoea. How do you ensure that hand hygiene is carried out effectively? What SICPs do you use – discuss • You are visiting a friend /relative in hospital and when you arrive at the ward you are advised that the ward is closed due to winter vomiting. Discuss

  19. Infection Prevention & Control Team Who can contact the IPCT? There is a IPCT available for specialist Infection Control advice across NHSGGC for all staff, patients and visitors to access. How do you access your local team and policies? Contact details of local IPCT can be found within NHSGGC via your local switchboard or website www.nhsggc.org.uk/infectioncontrol ICON should be on every computer desktop across NHSGGC

  20. Summary • Background of HAI • How does HAI affect the public? • Significant Organisms • Consequences of HAI • Consequences of spread • How do we stop HAI? • 10 Elements of Standard Precautions • Contacting your IPCT

  21. Conclusion Compliance with policies ensures that we maintain a safe environment and reduce the risks of infection to patients, staff and visitors. Infection Prevention & Control is Everybody’s Business

  22. References • http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf • http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf • http://www.bnf.org/bnf/index.htm • NHSGGC/Prevention & Control of Infection Manual

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