Quality improvement guide: prevention and control of healthcare-associated infections Learning and development resource for board members 2012 NICE public.

Quality improvement guide: prevention and control of

healthcare-associated infections

Learning and development resource for board members

2012

NICE public health guidance 36

• Tackling HCAIs: why it is important• Infection prevention and control: an escalated priority • HCAIs emerging priorities• Surgical site infections• Infection prevention and control: key improvement areas• Governance • Delivering harm free care • Costs and savings • Find out more

What this session covers

Alison and Sue’s storyis one family’s experienceof healthcare associated infection, arising froma routine hospital admission (running time: 5 minutes)

Tackling HCAIs: why it is important

Learning bite: what

How do we incorporate the experiences of people who are cared for and treated within our trust into our infection prevention and control work?

This film is licensed for educational use within the NHS and is reproduced with permission from PATIENTSTORIES www.patientstories.org.uk

Infection prevention and control (IPC) has escalatedin priority because:

•IPC quality improvement measures will help trusts deliver against domains 4 and 5 of the ‘NHS outcomes framework’

•Mid-Staffordshire Inquiry findings

•National Audit Office (2009) recommendations: - encourage a culture of continuous improvement - foster a whole-system approach - ensure staff compliance with good IC practice- monitor/record hospital use of antibiotics

Infection prevention and control: an escalated priority

HCAIs: emerging priorities

MRSA bacteraemias and C.difficile are the tip of the iceberg for HCAIs. What steps are we taking to reduce all other HCAIs? What should we monitor to help drive this improvement?

MRSA Clostridium difficile

Surgical site infections

Urinary catheter

UTIs

Ventilator-associated pneumonia

Enteral feeding tube infections

Line associated

sepsis Dialysis related

infections

34 trusts reported zero

MRSA bacteraemias

between 11.2010 – 11.2011

Surgical site infections

How are we monitoring surgical site and device related infections to drive improvement in our trust?

Organisms reported as causing SSI (all surgical categories) NHS hospitals, England 2010/11

The NICE/HPA quality improvement guiderecommends:

• Strong board leadership• A culture of continuous improvement• Surveillance and effective use of information• Workforce development • Effective environmental control • Effective communication – staff, patients and carers• Effective partnership working with other agencies• Robust assessment and use of (new) technology

Infection prevention and control: key improvement areas

What does a gap analysis of the NICE and HPA quality statements and our current performance show? When do we plan to achieve these standards?

Governance

Many models, such as ‘Governance as Leadership’ require active discussion between board members, staff and service users

Improving service user and staff contributions to governance can significantly enhance effectiveness

  What scrutiny mechanisms can we use to lever a reduction in HCAI’s, and to also demonstrate our public accountability? How can we be satisfied that our moral and professional duties as a board are being met?

Delivering harm free care

How can we demonstrate improvements toward achieving

the NICE and HPA quality standards to our stakeholders? What further indicators could we add to this list?

Quality improvement – examples of evidence of achievementtowards achieving the NICE/HPA standards

A system for regular board updates on trust IPC activities

Locally agreed ‘kite mark’ to signify successful implementation of patient safety activities

Board-approved IPC accountability framework

Board level KPIs for infection prevention and control (including compliance with antibiotic prescribing)

Board members have an up-to-date working knowledge of infection prevention and control

The trust’s IPC aims and objectives are included in the board’s ‘balanced score card’

Annual IPC improvement programme linked to the business planning cycle with identified actions and resources

Costs and savingsSignificant national resources have been invested in tackling HCAIs such as MRSA and C.difficile so the NICE/HPA guide is not expected to result in significant costs to the NHS at a national level

Which statements in the NICE/HPA guide are likely to generate savings for our trust and benefit the reputation of our organisation? [The NICE costing template may be useful for this]

The NICE and HPA guide could generate national savings ofat least £4.9 million Examples of local savings that could be generated include:

Surgical site infections £4000 per case Dialysis related peritonitis £1,746 per caseHaemodialysis related infection £3,118 per case

Find out more

Visit www.nice.org.uk/PH36 for:•the quality improvement guide•information for people visiting, or receiving treatment in an NHS hospital •the costing report and template •the learning from practice podcast

Endorsing partners for the NICE and HPA guide include:

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