Infection Prevention & Control Every-ones business

Health Care Associated Infection (HCAI) Any infection that arises as a result of healthcare, regardless of the care setting Any infection that arises as a result of healthcare, regardless of the care setting

Why prevent/control Infection? Impact on patientsImpact on patients Risks to staffRisks to staff Risks to communityRisks to community CostCost

The Reality of the Risk 7.6 % adult patients in UK & Ireland7.6 % adult patients in UK & Ireland 8.2% adult patients in England.8.2% adult patients in England. (3 rd National Prevalence survey 2006) (3 rd National Prevalence survey 2006) A proportion of patients who develop HCAI will die and for many others it is a major contributory factor in their death. A proportion of patients who develop HCAI will die and for many others it is a major contributory factor in their death.

The Reality……………… Viral infections: HIV, Hepatitis B & CViral infections: HIV, Hepatitis B & C Drug-resistant bacteria: MRSA, VRE, TBDrug-resistant bacteria: MRSA, VRE, TB New survival: Cystic fibrosisNew survival: Cystic fibrosis New technology: Bacterial infectionsNew technology: Bacterial infections And more, and more, and more………… And more, and more, and more…………

The reality in SUHT MRSA, GRE, Clostridium difficile, TB, Norovirus, Blood borne viruses.MRSA, GRE, Clostridium difficile, TB, Norovirus, Blood borne viruses. Trust Focus: MRSA bacteraemiaMRSA bacteraemia Clostridium difficile.Clostridium difficile.

Facts – MRSA Almost endemic in NHS acute trusts since 1980’s MRSA bacteraemia 04/05 - >7,200 cases

MRSA Facts National MRSA bacteraemia reduction target: 60% by 2008.National MRSA bacteraemia reduction target: 60% by SUHT Targets:SUHT Targets: 2005/ (actual 92) 2006/ / Rank 4 th worst performing NHS Trust.Rank 4 th worst performing NHS Trust. DH performance team visit.DH performance team visit.

Clostridium difficile Clostridium difficile 1.7% adult patients1.7% adult patients (3 rd National Prevalence survey 2006) (3 rd National Prevalence survey 2006) 05/06 England & Wales: /06 England & Wales: /06 SUHT: 82305/06 SUHT: 823

15-30% Healthcare Associated Infections are considered preventable. (DOH, guidance)

Frontline clinicians have the potential to significantly reduce infection rates by undertaking key activities correctly every time. (Saving Lives 2005 )

Hand hygiene is the single most important measure for preventing the spread of infection (Pittet et al 2001)

Hand Hygiene Guidelines SUHT 2004

Decontaminate hands before and after each patient contact Use correct hand hygiene procedure

Standard Infection Control Precautions What are these and when should they be used/ adhered too? Standard Infection Control Precautions What are these and when should they be used/ adhered too?

Standard Precautions Personal Protective Equipment Safe disposal of sharps Management f blood / body fluid spillages Disposal of waste & excreta Handling of soiled linen Cleaning & decontamination

Intravascular devices: Guidelines for preventing infection associated with Central Venous Catheters & Peripheral Venous catheters

Antimicrobial prescribing 2 Key Prescribing Principles: 2 Key Prescribing Principles: Limit use of broad spectrum antibioticsLimit use of broad spectrum antibiotics Limit use of glycopeptide antibiotics.Limit use of glycopeptide antibiotics. Follow local guidelines / policiesFollow local guidelines / policies Prescribe for correct duration & dosagePrescribe for correct duration & dosage Administer correct dosage at correct time.Administer correct dosage at correct time. Regular prescription reviews.Regular prescription reviews. Seek microbiological advice.Seek microbiological advice.

Everyone’s Responsibility. Implement best practiceImplement best practice Know & follow SUHT policies and guidelines.Know & follow SUHT policies and guidelines. Keep up to date.Keep up to date. Meet your mandatory training requirements.Meet your mandatory training requirements.