Minimizing infection through improved infection control Topic 9 Minimizing infection through improved infection control When Rabia first mentioned this conference to me in September 2007 I was impressed with her commitment, vision and energy for this international event. But frankly, I was a little nervous at how much work was needed to deliver such an ambitious programme in such a short time. It is an amazing testament to Rabia, Mustafa and other members of the organising committee and staff that this impressive programme has been realised here in this fantastic venue. I am delighted to be able to support this congress and the initiatives that are being shared to improve patient safety globally In my presentation I will draw on the global work on patients safety, reflecting on how patient safety affects us all how we should and can learn from error the work of the WHO World Alliance for Patient Safety and the personal experience of some clinicians, professionals, policy makers and patients in their efforts to make healthcare safer across the world I will be expending on this introduction in two interactive workshop sessions, one on Patients for Patient Safety and patient engagement and the other, a Learning from Error workshop

Learning objective Demonstrate the devastating effects of inadequate infection control and know how to minimize the risks of contamination Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Knowledge requirements know the extent of the problem of infection know the main causes and types of infection Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Performance requirements apply universal precautions be immunized against Hepatitis B use personal protection methods know what to do if exposed encourage others to use universal precautions Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

What is the urgency? can no longer rely on antibiotics increased rates of nosocomial infections infected patients: stay longer in hospital die treated with more toxic and less effective drugs prone to surgical site infections Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Campaigns to decrease infection rates WHO “Clean hands are safer hands” campaign Centers for Disease Control and Prevention campaign to prevent antimicrobial resistance in health-care settings Institute for Healthcare Improvement “5 million lives” campaign Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Main causes of infection person-person via hands of health-care providers patients and visitors personal equipment (e.g. stethoscopes, personal digital assistants) and clothing environmental contamination airborne transmission carriers on the hospital staff rare common-source outbreaks Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Main types of infections urinary track infections usually associated with catheters Surgical infections blood stream infections associated with the use of an intravascular device pneumonia associated with ventilators other sites Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Main types of infections Burke J Infection control-a problem for patient safety New Eng Journal of Medicine

Prevention in hospitals visibly clean increased cleaning during outbreaks use hypochlorite and detergents during outbreaks Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Prevention through handwashing how to clean hands rationale for choice of clean hand practice technique for hand hygiene protecting hands from decontaminates promoting adherence to hand hygiene guidelines Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Protective equipment gloves aprons face masks Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Safe disposal of sharps keep handling to a minimum do not recap needles; bend or break after use discard each needle into a sharps container at the point of use do not overload a bin if it is full do not leave a sharp bin in the reach of children Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Performance requirements apply universal precautions be immunized against Hepatitis B use personal protection methods know what to do if exposed encourage others to use universal precautions Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Act to minimize spread of infection before contact with each and every patient: clean hands before touching a patient clean hands before an aseptic task after contact with each and every patient: clean hands after any risk of exposure to body fluids clean hands after actual patient contact clean hands after contact with patient surroundings Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Encourage others to participate in infection control students may routinely observe staff who: apply inadequate technique in handwashing fail to wash hands routinely violate correct infection control procedures Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.

Summary know the main guidelines in each of the clinical environments you are assigned accept responsibility for minimizing opportunities for infection transmission let staff know if supplies are inadequate or depleted educate patients and families/visitors about clean hands and infection transmission ensure patients on precautions have same standard of care as others frequency of entering the room monitoring vital signs Launched in 2004 following the WHA Resolution which called for Member States to "pay the closest possible attention to the problem of patient safety" Promote awareness and political commitment Expert-led technical programmes to improve patient safety worldwide The Alliance will be publishing its 2008-09 Forward programme shortly.