Infection Prevention & Control

Neil WigglesworthNurse Consultant, Infection Control23rd June 2008

Context

• Infection Prevention and Control– Top priority for our patients and their families– Top priority for the Trust

• Integral part of Trust Quality Improvement Strategy

– Top priority for external bodies• Department of Health/NHS bodies

• Healthcare Commission

• Local Authority

Sustained investment

• 2006– Nurse Consultant – Infection Control

• 2007– Antibiotic Pharmacist– Intravenous Nursing Team – Cleaning Team

• 2008– Increased screening for MRSA– Increase in Matrons– Environmental and hygiene improvements

Recognition

• Healthcare Commission ratings – ‘excellent’

• NHS Litigation Authority – level 3

• Department of Health Performance Improvement Team…

Cont…• “The Improvement team were pleased to be invited into your organisation and

wish to acknowledge your progress in addressing the issue of health care associated infections (HCAI`s) and noted several areas of good practice which include:

• Strong leadership from the CEO and the Executive Board• Clear evidence of strong medical engagement from most clinicians• High level of engagement with the infection prevention agenda• Managers and staff alike are open to suggestions about improving infection

prevention and control (IPC) practice, and accepting of the areas identified for improvement.

• An enthusiastic and cohesive IPC Team who are engaged with the wards as `facilitators rather than doers`

• A culture of challenge throughout the organisation• Strong stewardship of antibiotic use• Domestic services are well managed in house• 24 hour cleaning services are provided and most areas visited by the team

were spotlessly clean”

OutcomesMRSA Bacteraemia

0

5

10

15

20

25

30

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

2005/06 2006/07 2007/08

Clostridium difficile

C. difficile collaborative/Scale-up and Spread

OutcomesC. difficile Incidence, Care of the Elderly April 2006 - March 2008

0

2

4

6

8

10

12

14

16

20

06

/07

20

07

/8

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

No

. o

f c

as

es

Start of collaborative

Mean number of cases per month

Outcomes

2006 20082007

Next steps…

Clean

1. Reduction of infection Clostridium difficile Central and peripheral line Surgical site infection Urinary catheter infection Ventilator associated pneumonia

2. Environment 1. Toilets and bathrooms