Infection Control Audit 2005

Building Foundations & Partnerships Infection Control: Annual Report Fiscal Year 2005-2006 1. Introduction ...........................................................................................................................................................1 2. Building the Foundations.......................................................................................................................................2 3. Executive Summary...............................................................................................................................................3 4. Regional Infection Control Team Members ..........................................................................................................5 5. Infection Control Indicators...................................................................................................................................8 A. Development of a Standardized Regional Surveillance Program ..................................................................8 B. Key Performance Indicators ..........................................................................................................................9 C. Key Indicator Report ...................................................................................................................................10 5.1. Surveillance (MRSA and VRE).......................................................................................................................10 Methicillin resistant Staphylococcus aureus (MRSA).........................................................................................10 Regional Summary of MRSA..............................................................................................................................10 MRSA in Acute and Long Term Care .................................................................................................................11 Describing MRSA in Acute Care Facilities.........................................................................................................11 Community MRSA: A Closer Look ....................................................................................................................13 Regional Costs for MRSA Management .............................................................................................................14 Vancomycin Resistant Enterococci (VRE) .........................................................................................................15 Regional Summary of VRE.................................................................................................................................15 VRE in Acute and Long Term Care ....................................................................................................................15 Regional Costs for VRE Management.................................................................................................................16 Describing VRE in Acute Care Facilities ............................................................................................................17 5.2. Clostridium difficile Associated Diarrhea (CDAD)– Laboratory Based Surveillance.....................................18 Regional Summary of CDAD..............................................................................................................................18 CDAD in Acute and Long Term Care Facilities..................................................................................................18 Regional Costs for CDAD Management .............................................................................................................18 5.3. Selected Inpatient Surgical Procedures Complicated by Surgical Site Infections ...........................................19 5.4. Syndromic Surveillance of Respiratory Diseases at Vancouver General Hospital..........................................20 5.5. Hospital Acquired Bacteremias at Vancouver General Hospital.....................................................................23 5.6. Patients Identified as Having Pulmonary Tuberculosis ...................................................................................26 Regional Summary of Tuberculosis ....................................................................................................................26 5.7. Outbreaks of Communicable Infections ..........................................................................................................26 Regional Summary of Communicable Infections................................................................................................26 5.8. Infection Control Team as Educators ..............................................................................................................27 By Type of Education*........................................................................................................................................27 6. Projects/Research.................................................................................................................................................28 7. Partnerships .........................................................................................................................................................30 A. The VCH Regional Microbiology Laboratory: Building Communications and Support for a Regional Infection Control Service.....................................................................................................................................30 B. Vancouver Coastal Health-Occupational Health .....................................................................................34 C. Provincial Infection Control Network .....................................................................................................34 D. Occupational Health & Safety Agency for Healthcare............................................................................34 E. Public Health Agency of Canada.............................................................................................................34 F. Other Provincial/National/International Commitments ...........................................................................34 8. Professional Development...................................................................................................................................36 9. Presentations, Publications and Awards ..............................................................................................................36 10. References ...........................................................................................................................................................39 11. Appendices ..........................................................................................................................................................40 Appendix A: Categorization of Vancouver Coastal Facilities.............................................................................40 VCH-Infection Control Report FY 2005-2006 1. Introduction I am pleased to again update the Vancouver Coastal Health (VCH) Board, Executive, and community on the success of our regional infection control program. This report, which has been shifted to appear on a fiscal year basis instead of calendar year, summarizes the activities across VCH sites in 2005-06. A dominant theme for us again this year has been around partnerships and we have been very successful in this area. I am particularly proud of the work done by our staff on the Clean Hands for Life™ campaign, a partnership of VCH, Providence Healthcare (PHC), and Bayer Healthcare Canada. Staff participation across our acute and community sites has been tremendous and as some of you are aware, some of the materials for this campaign have received an international award for their content and design. Surveys of hand hygiene in our facilities were completed by over 3,606 of our staff, a great response and a sign of their commitment to this most basic but powerful part of infection control. We have also leveraged internal and business partnerships in other ways. Our regional staff has worked hard to standardize definitions and to develop and begin to implement our regional database. We have worked with Occupation Health and Safety around exposure management for staff, with Facilities Planning and Construction around common infection control standards for construction in our sites, and with operational flow leaders across VCH and PHC regarding outbreak management. The latter subject is worthy of special note. Our Infection Control Practitioners and medical staff are continually assessing the risks posed at our sites by infectious agents such as Norwalk and Noro-like viruses and influenza. Working with local and regional leaders from Emergency, operational units and public health, they are constantly balancing the best in infection control techniques and outbreak management with the operational needs of a busy and multi-site health authority. I think the dedication that all staff, both within Infection Control and at the nursing unit or site level, show in these situations is a credit to them and I thank all of them for this dedication. VCH and PHC have also worked over the last year showing leadership in provincial initiatives, particularly the Provincial Infection Control Network, co-chaired by Elizabeth Bryce of VCH. PICNet is working to establish province wide standards and data reporting and VCH will certainly

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