Key Issues and Priorities for Southwark re HCAIs. Monitoring of MRSA and C.difficile rates at KCHFTDulwich Intermediate Care UnitCare Homes and Care Homes with NursingCommunity Services. Work In Progress or Completed. Healthcare Act 2006
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1. INFECTION CONTROL UPDATE Donna Kinnair
Director of Infection Prevention and Control
2. Key Issues and Priorities for Southwark re HCAIs Monitoring of MRSA and C.difficile rates at KCHFT
Dulwich Intermediate Care Unit
Care Homes and Care Homes with Nursing
3. Work In Progress or Completed Healthcare Act 2006 – Code of Practice
- Gap analysis
Infection Control and Minimum Standards for Premises Audits of all PCT and GP Practice Premises - completion end Nov 07
Mandatory Infection Control Training for all relevant staff on appointment and yearly thereafter
All training required for Core Standards will be audited as part of 07/08 Core Standards Quality Assurance Plan
Development of a Quick Reference Guide for Staff, Patients and Carers
4. Planned Work Nov 07 – April 08 Targeted work around standards of care
Review of guidelines for the management of high risk patients
DIPC and Senior Nursing Staff to work with front line staff
Joint work with KCHFT & HPA to review the management of high risk patients transferring from acute to community setting
Successful bids – NHS London reduction in incidence of HCAIs
- £31,050.00 awarded
- Infection control audits Care Homes
- Infection Control Conferences 5th/18th Feb 2008
5. Healthcare Commission Investigation into outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells NHS Trust October 2007 April 2004 – June 2006
Healthcare Commission estimates deaths definitely or probably due to C.difficile were between 47 and 127
Implications for PCT as both a provider of in-patient care, community care and as a commissioner of acute services and services from independent contractors.
6. Key Lessons Learnt Robust Governance systems
Trust boards must be well informed
Clear guidelines on the effective isolation of patients
Guidance on risks of broad spectrum antibiotics
High quality medical and nursing care
7. 5 National Recommendations
1. The diagnosis of C.difficile needs to be regarded as a diagnosis in its own right, with proper continuity of management.
2. Further consideration needs to be given to the education and supervision of trainee doctors, with a view to improving the recording of C. difficile on death certificates.
3. Antibiotics should be targeted, of the narrowest spectrum possible, and used for the shortest possible time.
4. The NHS and HPA should agree clear and consistent arrangements for the monitoring of rates of C. difficile infection.
5. The board of every NHS Trust must understand the roles and responsibilities of the Director of Infection Prevention and Control (DIPC), and receive regularly, information about incidence and trends.
8. Specific Recommendations For PCT’s as Commissioners
Communications between the PCTs and Trust must focus on the quality of care and not soley on numbers of patients treated and associated costs.
Service Level Agreements must include indicators related to healthcare acquired infections and be monitored both at performance meeting between the PCT and Trust and by PCT Boards