Volume 17 Infection Control Passport Program Corinne Cameron-Watson Senior Infection Prevention & Control Nurse Barking Havering and Redbridge Acute NHS Trust Also In This Issue: Over the last few years many hospitals in Eng- decontamination, appropriate use of personal land have seen increasing numbers of Clos- protective clothing, effective environmental hy- tridium difficile infection (CDI) with increased giene and decontamination, waste management, Best Practices for mortality rates. This trend has been reported including sharps and clinical equipment and Infection Prevention and similarly in America and Canada. practice. The epidemiologi and management of Control Programs infections of significance, such as Methicillin in Ontario in All Health Thus, Infection Prevention and Control (IP&C) resistant Staphylococcus aureus (MRSA) ,Clos- Care Settings ...................2 has never had such a high profile globally, yet tridium difficile, norovirus and blood borne vi- so little of the basic issues are understood by ei- ruses are also covered with the principles of the A Case for Screening ......2 ther the public or practiced by clinical staff. The Standard applied to practice. In order to mini- high and mighty, the press, the politicians, they mize disruption to the clinical team, and maxi- Virox Update ...................3 all have a view on IP&C. They speak with such expertise that Welcome to Our New the true experts appear mute. Home ................................4 A subject that is based on sci- ence, knowledge and years of training is now used as a politi- The Ghost Map ................5 cal football to score points for political gain, sell newspapers Sustainable Facility and play games of “name, Care Forum ......................6 shame and blame”. In early 2005, my hospital group - Barking Havering and Redbridge Acute NHS Trust (1500 beds) - experienced an average of 15 new CDI cases a day, and by necessity, a 14 bed ward was converted into a CDI isolation cohort area. This compelled us to address the training that nurses and other healthcare workers received in topics related to mize patient benefit, employees were given a infection prevention and control, and take a new six-week period to complete their Passport. On initiative that has proven very successful, the In- completion of the first 30 passports in the pilot fection Control Passport. project, and a comprehensive evaluation of the program, and documented evidence of a reduc- Development of the Infection Control tion in Clostridium difficile infection rates, the passport infection control team proposed an extension of As part of the management program to reduce the program to a further four clinical areas. the number of CDI within the trust and to im- Following the success of the revised program, prove patient care outcomes, the Infection Con- additional evaluation was undertaken and fur- trol Team (ICT) devised a nursing educational ther reduction of CDI, the Infection Control program – the Infection Control Passport - to Passport has now developed into a full day support the principles of standard infection con- of theory delivered by the infection control trol practice and precautions, which had hitherto team and consultant microbiologists. The par- not been fully understood or practiced by clini- ticipants still have six weeks to complete their “The secret of success is cal staff. competencies with an infection control nurse. constancy of purpose” On completion of the training, staff are viewed The program was originally developed to be as champions and role models for excellence in delivered over five non-consecutive days, a infection prevention and control within there Benjamin Disraeli one-hour session each day.Components of the Infection Control Passport include correct hand Continued©Virox Technologies on page 2007 6 Best Practices for Infection Prevention and Control Programs in Ontario in All A Case for Health Care Settings Mary Vearncombe Screening Medical Director, Infection Prevention and Control Sunnybrook Health Sciences Centre and Women’s College Hospital Chair, Provincial Infectious Diseases Advisory Committee (PIDAC) Subcommittee on Infection Prevention and Control Health care-associated infections are an Committee important patient safety issue and repre- • IPAC program functions: surveillance, sent a signifi cant adverse outcome of the policies and procedures, compliance health care system. Infection prevention with legislation and accreditation stan- and control (IPAC) programs have been dards, occupational health and safety shown to be clinically effective, reduc- issues, education and training ing morbidity and mortality, as well as cost effective, providing important cost • Key components of the program: hand savings in terms of fewer health care- hygiene, Routine Practices and Ad- associated infections, reduced length of ditional Precautions, immunization, hospital stay, less antibiotic resistance cluster and outbreak investigation and and decreased costs of treatment for in- management, communications, envi- fections. ronment • Human resources for the IPAC program The Provincial Infectious Diseases Ad- including education, training and certi- visory Committee (PIDAC) Infection fi cation of IPAC professionals, ongoing Prevention and Control Subcommit- professional development, roles and re- tee has developed a document entitled: sponsibilities, staffi ng levels, adminis- “Best Practices for Infection Prevention trative assistance and IPAC physicians and Control Programs in Ontario in All Health Care Settings ”. This document • Laboratory and information technology provides a framework for Infection Pre- support vention and Control (IPAC) programs across the continuum of health care Recommendations made in the Best delivery in Ontario, and makes recom- Practice document are summarized in an mendations for specifi c activities, areas appendix, in tabular form, to assist IPAC of expertise and adequate and appropri- programs in self-evaluation. ate resource allocation on the basis of the type of institutional setting and size. The The best practices document is aimed at recommendations in this document re- senior administration, medical offi cers of fl ect the best evidence and expert opinion health and others in a management role available at the time of writing. In addi- in all health care settings. Infection pre- tion, the recommendations refl ect many vention and control programs will also best practices that are currently practiced fi nd these best practices useful for priori- in the fi eld and they should be seen as an tizing and developing their programs and enhancement to existing practices. This engaging in strategic planning activities document can be found on the PIDAC for the future. webpage: www.health.gov.on.ca/english/ providers/program/infectious/diseases/ It is expected that all settings in Ontario ic_ipcp.html where health care is provided, across the continuum of health care, will work Topics covered in this Best Practice towards implementing the basic infec- This letter to the editor was published document include: tion prevention and control practices in the September 6 issue of The Econo- and principles set out in this document. mist, and identifi es a need for expanded • Mandate and goals of the IPAC pro- This includes settings where emergency screening in healthcare facilities. This is gram (including pre-hospital) care is provided, a hotly debated point and as yet we take hospitals, long-term care homes, outpa- no position. • Structure and elements of the IPAC tient clinics, community health centres program and clinics, physician offi ces, dental of- Now, what can be done about ongoing • The Infection Prevention and Control fi ces, offi ces of allied health profession- screening of environmental surface con- als and home health care. tamination?? Volume 17 Page 2 ©Virox Technologies 2008 Virox Rescue is positioned as a safer and effective alternative to bleach as a C.diff Conference & Education Virox Update patient room disinfectant cleaner for hard Spring Schedule non-porous surfaces with reasonable sporicidal disinfection contact times and Virox representatives will be 2009 CHICA Scholarship also positioned as a task oriented product participating in the following functions Does your facility have limited funds for for C. diff outbreaks and containment in during the upcoming months: continued education? Don’t miss out on medical establishments. The Rescue C. the Virox Patron Scholarship and your difficile Intervention Program has suc- October 1st - York Region Public chance to receive funding to attend the cessfully been used by a number of facili- Health Education Day in Markham, 2009 CHICA-National Conference in ties to help combat C. difficile outbreaks. Ontario Newfoundland! For more information on the RESCUE C. difficile Intervention Program please October 2nd - IPAC Dancing with the The Virox Patron Scholarship is in its visit virox.com/medical/acute_care.asp Stars in Mississauga, Ontario 7th year and to date Virox and the Pa- or call 1-800-387-7578. October 2nd to 3rd - CIPHI Alberta tron Members (JohnsonDiversey, Butch- in Grand Prairie, Alberta ers, Deb, STERIS and Webber Training) have contributed $90 000.00 towards the Website Update: www.virox.com October 16th - Simcoe Muskoka LTC annual scholarship which has provided Virox prides itself on being a resource Education Day in Muskoka, Ontario the opportunity for over 50 Infection tool to the infection control community October16th - Lambton County Public Control Practitioners