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Infection control, from policy to practice

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How one independent sector healthcare provider tackled infection control

This blog is a summary of a presentation at the Performance Improvement Network meeting in June 2008 given by Sue Millward, infection prevention nurse consultant at Nuffield Health and highlights one independent organisation’s approach.

As mentioned in a previous blog, Independent Healthcare Advisory Services has a number of working groups. The Infection Control Working Group, which is attended by infection prevention leads from independent sector hospitals, Healthcare Commission and a DH lead.

Recent work has included:

  • reviewing the Hygiene Code and its implications for the independent sector;

  • standardising job specifications for infection control link nurses and practitioners;

  • working with the Health Protection Agency to gain access to the surveillance programme.

Implementation of consistent, evidence-based clinical care policies and procedures, use of national tools to provide robust evidence on the outcomes of care, and compliance to national standards are all key aspects of putting policy into practice in the independent sector.

The Nuffield Health strategy described by Sue Millward includes ownership; evidence-based policy to support best practice; staff empowered to challenge clinical care and change practice and provision of robust evidence on the quality of infection control practice and clinical outcomes.

There are infection prevention link practitioners (IPLPs) in place and their role is to support matron in the detection of risks and implementation of best practice. The IPLP is a registered practitioner who acts as a ”link between their clinical area and hospital management, and has matrons’ authority to challenge practice.

The responsibility is to be a role model/change agent and to detect potential/actual problems. The IPLP reports to matron and there is a policy that requires dedicated time (out of duty rotas) to undertake activities (audit, surveillance, training) to be allocated. The limitation of the role is that the IPLP does not manage outbreaks of infection.

Nuffield Health’s target for this year is to that there will be a trained IPLP in every clinical department in every hospital.

Three examples of putting policy into practice are described as follows:

1. Hand hygiene

  • Expert advice at planning stage of buildings to ensure excellent hand hygiene facilities.

  • Currently not a clinical hand wash basin in all patient rooms but working towards it.

  • Matron, General Manager and Consultant ‘sign up’ to ‘my five moments of hand washing’.

  • Alcohol ATPB is at reception/entrance to wards and departments in order to raise public awareness and participation in improving hand hygiene standards.

  • Prescriptive audit programme to monitor compliance to policy standards.

2. Environmental Hygiene

Environmental cleanliness is frequently interpreted as a key indicator of the attitude of staff toward patients in relation to the healthcare that they are providing.

  • Detailed cleaning schedules.

  • Disposable curtains.

  • Carpets being replaced with laminate floors.

  • Cleaning standards monitored (audit program).

  • Participation in forthcoming PEAT inspections.

3. MRSA policy

  • Patient health questionnaire and Pre assessment programme to detect any infection risk (CJD, Clostridium difficile, MRSA).

  • Admission process to check pre assessment screen.

  • Decolonisation prior to admission.

  • Admission to single room if results not known.

  • Standard precautions for all patients.

  • Participation in Saving Lives HII audits.

  • Working towards “bare below the elbows”.

National audit tools, which are considered robust evidence, are used to monitor the implementation of Policies and Best Practice.

Thanks to Sue for representing the sector at this important event.

Click here for Sue Millward’s presentation in full

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