Infection Prevention and Control: New Provincial Initiatives

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Infection Prevention and ControlNew
Provincial Initiatives

• Canadian College
• of
• Health Care Executives
• April 15, 2008

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Why is Infection Prevention and Control (IPC) a
Concern?

• Rates of antimicrobial resistant organism
  infections are increasing
• Health care acquired infections have a
  significant impact on health system costs and
  outcomes
• Health system changes increase demands on IPC

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Recent Events In Alberta

• March 2007
• Issues regarding sterilization and MRSA
  identified in East Central Health Region
• Physicians clinic in Lloydminster investigated
  due to improper sterilization procedures
• Health Quality Council of Alberta (HQCA) review
  of IPC at East Central Health
• Provincial IPC Review initiated

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Key Findings from HQCA and Provincial IPC
Reviews

• Accountability, roles and responsibilities were
  unclear
• IPC policies varied greatly and often were not
  monitored
• IPC surveillance was inconsistent
• Limited capacity to support IPC across the health
  care system

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IPC in Alberta Progress since March 2007

• Legislation passed (Bill 41 and Bill 48) to
  address gaps in accountability
• Direction to develop provincial standards and
  monitor compliance
• Funding allocated for hand hygiene infrastructure
  and IPC education and materials for supportive
  living facilities

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January 2008 Announcements

• Alberta Infection Prevention and Control Strategy
• Alberta Hand Hygiene Strategy
• 4 Infection Prevention and Control Standards
• Commitment to monitor compliance with standards

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Alberta IPC Strategy

• Developed under guidance of the Alberta IPC
  Advisory Committee
• Intent of Strategy
• Protect health of Albertans
• Assure public of the quality of IPC in Alberta
• Long term approach
• System level improvements
• Broad, overarching approach recognizing many
  sectors have a role in IPC

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IPC Strategy continued

• Strategic Directions
• Leadership and accountability
• Provincial standards and monitoring
• Province-wide surveillance
• Human resource requirements
• Physical infrastructure
• Public awareness and education

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Alberta Hand Hygiene Strategy

• Developed under guidance of working group
• Complements other initiatives
• Intent of Strategy
• Collaborative approach to improve hand hygiene to
  minimize risks to health of Albertans
• Includes comprehensive approach

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Hand Hygiene Strategy continued

• Strategic Directions
• Access to hand hygiene facilities and products
• Provider education and training
• Child education and training
• Public and community education and awareness
• Evaluation and research

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Intent of IPC Standards

• Assure the public of health system safety
• Improved consistency of IPC practice across
  health system
• Ensure minimum requirements in place
• Set clear expectations for what will be monitored
  across the system

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Intent of IPC Standards continued

• Initial focus for standards is health authorities
  via Ministerial directive
• Minister has encouraged regulatory bodies and
  other departments to adopt relevant standards

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Initial IPC Standards

• IPC accountability and reporting
• Cleaning, disinfection and sterilization of
  reusable medical devices in all health care
  facilities and settings
• Single-use medical devices
• Prevention and management of MRSA

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Accountability and ReportingStandards

• Clarify and separate operational and monitoring
  roles and responsibilities for IPC in RHAs
  (including contractors)
• Designated operational responsibility for IPC
  across organization
• Medical Officer of Health assurance role in HA
  and reporting of significant risks to Chief
  Medical Officer of Health

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Accountability and Reporting continued
Minister
Chief Medical Officer of Health
Board
CEO
Medical Officer Of Health
IPC Executive
Regional Operations
Regional IPC Committee
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Cleaning.Medical DevicesStandards

• Based on existing standards and best practices
• Sets minimum requirements
• Promote consistent practices for cleaning,
  disinfection and sterilization across the
  provinces health regions
• Developed for use in all health care settings

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Cleaning.Medical Devices continued

• Lay out specific requirements for the handling,
  transport, cleaning, disinfection and storage of
  medical equipment
• Address occupational health and safety issues
  related to the handling of reusable medical
  devices
• Educational and training requirements for
  reprocessing personnel and reprocessing
  supervisors

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Single-Use Medical DevicesStandards

• Consistent with Health Canada, CSA and other
  standards/guidelines
• Clarify practices related to the appropriate use
  of single-use and single client-use medical
  devices
• Clarify single-use issues in home settings

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Prevention/Managementof MRSA Standards

• Adapted from the Provincial MRSA Guidelines
  (August 2007) developed by a provincial MRSA
  Working Group
• Describe assessment of risk, decreasing risk of
  transmission, medical transport, surveillance,
  screening, outbreaks, decolonization and
  disclosure

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Moving Forward

• Develop requirements for initial standards
• Risk assessment protocol
• Training requirements for reprocessors
• MRSA reporting requirements
• Continue work on next standards / guidelines
• Education and training
• Infrastructure
• Immunization

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Moving Forward continued

• Implementation planning for the IPC and Hand
  Hygiene Strategies
• Finalize IPC Surveillance Plan
• Initial priority MRSA surveillance
• Establish coordination and networking mechanisms

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Alberta Health and Wellness IPC Documents

• Documents can be accessed at http//www.health.al
  berta.ca/resources/pub_infection-prevention.html