Leading Infection Prevention & Control

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Leading Infection Prevention Control

• Ros Moore
• CNO Scotland

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Will need a pen paper for abit of audience
participation
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Together we have come a long way achieved a
great deal
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• My ambition
• Infection control and prevention happens without
  enforced compliance and when no one is watching
• It is a whole health community issue with pathway
  solutions
• It must be embedded in the heart of healthcare
  organisations through structures governance
• It must be embedded in the environment and
  culture of a ward unit or team and in how staff
  behave and interact with each other and with
  patients clients and carers
• Continue to develop the evidence base
• Be ready for the future

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HAI and the Quality Strategy

• Quality Strategy ambitions
• Person centred
• Safe
• Effective
• Priority area for improvement
• integrated programme between SPSP and HAITF to
  reduce HAI
• Must be able to
• demonstrate how HAI deliverables will support
  Quality Strategy ambitions and
• demonstrate how greater integration in delivery
  of infection prevention and control will be both
  achieved and sustained.

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HAI and the Quality Strategycontext

• Greater synergy with SPSP
• Revised HAITF Governance construct
• Horizon scanning emerging organisms and AMR
• Focus beyond hospital setting
• Quality Strategy measure prevalence of
  infection
• HEAT target development
• Spending review

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Now this is not the end. It is not even the
beginning of the end. But it is, perhaps, the end
of the beginning
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Rapid Stocktake Score lowest 1 to 4
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Leadership Challenges
Adapted from Nursing Towards 2015 Alternative
Scenarios for Healthcare, Nursing and Nurse
Education in the UK in 2015 (Longley, Shaw,
Dolan, 2007) NMC Publishing
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Ambition to Action
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Its hard its hard all the time Leadership in
this context can feel like building an
advanced aircraft , whilst it is flight, whilst
it is being designed whilst it is being shot at

• General David Patreus 2010

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Future focussed
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Industrial age medicine
Tertiary
Professional Care
Secondary
Primary
Information age health care
Individual Self care
Friends and family
Self help networks
Professionals as facilitators
Professionals as true partners
Professionals as authorities
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Real change in real organisations is intensely
personal and enormously political. Nadler 1998
Organisations are microcosm of society as a whole
with the same power structures, differentials
inequalities Lymbery (2006) described the vast
differences in power and culture between various
occupational groupings, and the inherently
competitive nature of professions jostling for
territory in the same areas of
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The Four Ps
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Picture establish a clear direction and end
point

• Its not enough to talk about SABs targets and
  patient safety.

Come my people let us kill the SABs
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Purpose

• People need the story that gives meaning beyond
  itself
• Contact hearts and minds
• Make it personal
• Make it visual

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Process infrastructure

• Make sure the processes at every level are clear
  understood that people understand how the
  process links clearly to the picture purpose

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Right sort of people in right sort of groups to
avoid problem processing
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Part

• Make people actors not characters
• Ensure they can see their unique contribution to
  the whole
• Articulate expectations of every person at every
  level be consistent
• Make sure they know other peoples part

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Self Audit We found that successful leaders
cultivated a culture of clinical excellence and
effectively communicated it to staff focused on
overcoming barriers and dealt directly with
resistant staff or process issues that impeded
prevention of HAI inspired their employees and
thought strategically while acting locally, which
involved politicking before crucial committee
votes, leveraging personal prestige to move
initiatives forward, and forming partnerships
across disciplines. Hospital epidemiologists and
infection perfectionists often played more
important leadership roles in their hospitals
patient safety activities than did senior
executives.

• Reference Saint SS, Kowalski CP, Banaszak - Holl
  J, Forman J, Damschroder L and Krein SL. The
  Importance of Leadership in Preventing
  Healthcare-Associated Infection Results of a
  Multisite Qualitative Study. Infect Control Hosp
  Epidemiology. 201031901-907

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Try Hard
Know yourself How do you respond to stress ?

• Be Perfect

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Using people Ken Thompson 2010

• Mediocre leaders play draughts with their workers
  they assume we all move in the same way and are
  motivated by the same things.
• Good leaders play chess they learn what's
  unique about each person and the best way to
  energise us.

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Leadership Toolkit this is mine whats yours ?
Making groups work
TA
Herons 6 Targeted interventions
Four Ps
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Get coaching feedback
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RCN 2008

• This nonspecific guidance may at first seem
  intangible and perhaps even unhelpful.
• However, this review has identified a number of
  risks for infection and infection control
• problems. None may be sufficient to cause
  problems and their removal may not be
• sufficient to rectify problems. Indeed in some
  cases (for example high turnover) there may
• be no direct remedial action. However, awareness
  of these risks provides the potential to
• prioritise interventions and take preventative
  actions before harm comes to patients
• Weak or negative clinical leadership at ward
  level
• Weak or negative clinical leadership above ward
  level
• Absence of clear lines of clinical management
  and responsibility from ward to board
• Excessive span of control among clinical
  leaders
• Unclear roles and responsibilities for
  infection control
• Lack of clear policies and active support for
  training
• Absence of an effective multidisciplinary
  infection control team perceived as exercising
• positive leadership at ward or unit level
• High staff turnover
• High use of bank or agency staff
• Low staff morale
• High patient throughput
• Workload not matched to available staffing

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This is how change happens. It is a relay race.
Our job is to be part of the race, and then we
pass it on, and then someone picks it up, and it
keeps going. And that is how it is