CHC WORKSHOP

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CHC WORKSHOP

• SEPTEMBER 11TH 2008

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Programme

• Introduction
• Ward Environment
• Infection Prevention and Control
• Cleaning Services
• Discussion

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HOW WE ARE IMPROVING THE HEALTHCARE
ENVIRONMENT
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• Increased acutely ill complex patients
• Ward requires larger equipment to meet patients
  needs
• Old stock, furniture etc needs removing from
  wards to create space for new equipment
• De clutter will improve ability to clean
• Clearer and organised environment motivates staff
• Multi disciplinary team approach essential in
  delivery of recommendations in Free to lead,
  Free to care WAG 2008

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FUNDING- 18 MONTH PLAN

• 500,000 INTERNAL INVESTMENT
• 100,000 INFECTION, PREVENTION CONTROL
• 400,000 IMPROVING ENVIRONMENT
• Improving cleaning outcomes.
• Public Areas/out of hours
• General Ward Environment- de clutter, reorganise
  stock etc
• FURTHER OPPORTUNITIES
• Charitable Funds

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SCOPE OF PROJECT

• De-clutter and create space
• Amending housekeeping schedules to match ward
  activity
• Remove equipment from walkways
• Improve stock control
• Improve general maintenance
• Upgrade areas for improved patient
  access/experience
• Monitoring and sustainability

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CURRENT WARDS

• UHW
• C2, B5, A1, A3, A5, PAEDS
• LLANDOUGH
• EAST 2, 3, 7
• ROOKWOOD
• All ward bathroom/toilet areas at Rookwood

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West 2 Bathroom Before
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West 2 Bathroom After
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West 2 TV Before
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West 2 TV After
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C6- Cubicle Toilet Before
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C6 Cubicle Toilet After
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C6 Reception Before
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C6 Reception After
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OUTCOME OF PILOT

• Improved cleanliness
• Reduced stock levels/more space
• West 2 100 Compliance SPI Audit
• Improved Ward Facilities staff motivation
• Staff working more effectively
• Audits show sustained improvements
• Patients feedback very positive

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Infection Control at Cardiff and Vale NHS Trust
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The Team

• Director of Infection Control Eleri Davies
  (NPHS) since March 2008
• Senior Nurse Sacha Coodye (full time)
• Clinical Nurse Specialists
• Ingrid Foster (2 days per week)
• Yvonne Hyde (full time)
• Michelle Abel (3 days per week)
• Cathrine Cutts (3 days per week)
• Vince Saunders (full time)
• Associate CNS
• Faye Horner (full time)
• Sandra Wooler (full time)
• Claire Harwood (full time)
• Vacant post (3 days per week)
• Infection Control Scientists (NPHS)
• Dylan Hill (full time)
• David Jenkins (full time)

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The Aim

• To provide a fully comprehensive infection
  control service to Cardiff and Vale NHS Trust
• Preventing the spread of HCAI
• Empowering clinical staff
• Supporting surveillance activity
• Developing and implementing IC procedures
• Responding to outbreaks and incidents
• Advising clinical staff and Trust board
• Outbreak meetings
• Investigations

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Reporting Structures

• Infection Control Team
• Team meetings / advice / reports
• Infection Control Committee
• Operational Group (1st Meeting October 2008)
• Clinical Standards and Patient Experience
  Committee
• Clinical Governance Committee
• Reports to Trust Board

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Annual Programme

• Management and Organisation
• Surveillance / Audit and Practice
• Education and Training
• Research and Development
• Ongoing Work / Objectives
• Team Development and External Representation

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Current Key areas of Work

• Revision and development of IC procedures
• Support for the 1000 Lives and SPI campaigns
• Clostridium difficile task group
• B5 Renal task group
• Infection Reduction Target (C2 ward)
• HCAI data reports to directorates
• Collaboration and support for Improving the
  Healthcare Environment project

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Reducing Healthcare Associated Infections (HCAI)
21st April 2008
Reducing HCAI
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Content Areas

• Improving leadership for quality
• Reducing healthcare associated infections
• Improving critical care
• Improving medicines management
• Reducing surgical complications
• Improving general medical and surgical care
• Development Sites
• Trusts Only

Reducing HCAI
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HCAI surveillance

• Staphylococcus aureus bacteraemia
• Top Ten Bacteraemia
• ICU surveillance
• Clostridium difficile
• Surgical Site Infection Surveillance
• Orthopaedics
• C-section
• Vascular
• Outbreak surveillance

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Local Surveillance

• Extracts from DataStore
• Ward visits
• Currently developing monthly reports to all
  directorates
• Reports to Infection Control Committee

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National Surveillance
www. wales.nhs.uk/WHAIP
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National Surveillance
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Staphylococcus aureus bacteraemia
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MRSA
Year 1.04.2007 31/03/2008 CV - 98 cases of
MRSA bacteraemia CV rate - 13 per 100,000 bed
days All Wales rate 10 per 100,000 bed days
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Clostridium difficile
2007 CV cases 604 (gt65 years) CV Rate 27.18
per 1000 admissions All Wales Rate 16.84 per
1000 admissions
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Surgical Site Infection Surveillance

• Progress being made in orthopaedics and C-section
  surveillance
• Vascular surgery at UHW pilot site for national
  scheme in development.

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Key Points

• Additional funding has resulted in more staff for
  the infection control team.
• Key priority embedding infection control at all
  levels of the Trust.
• Engaging clinical staff.
• Using our data for action and improvement within
  the Trust.
• Collaborative and Multidisciplinary working is
  the best way forward.

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Cleaning Services
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Cleaning Services

• Cleaning Specifications
• Variation in specification across sites
• Monitoring of standards
• Satisfaction surveys
• Staffing
• Training
• Finance

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Specification

• National Standards of Cleanliness for NHS Trusts
  in Wales July 2003
• 5 Functional areas
• Local decision re Wards
• Cleaning strategy group
• Patient champion
• Free to lead Free to care

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Monitoring of Standards

• AusPed Current and Future
• Monitoring
• Scores
• Future

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Satisfaction Surveys

• New patient satisfaction form
• Current system
• Dealing with concerns raised
• Complaints

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Staffing

• Establishment
• Vacancies
• Sickness rates
• AfC
• Training

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Establishment (WTE)
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Housekeeping Sickness WTE
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Vacancy and Sickness WTE
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Finance

• UHW Budget
• EFPMS
• Investment
• 2008/09
• 2005/06
• Questions