Medtronic Standard Blue Slide Format

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Biological risks in health service The WHO
experience
Dr Gail Thomson Biorisk reduction for Dangerous
Pathogens (BDP) Department of Epidemic and
Pandemic Alert and Response (EPR)
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WHO

• WHOs objective, as set out in its constitution
  is

The attainment by all peoples of the highest
possible level of health
A state of complete physical, mental and social
well-being and not merely the absence of disease
or infirmity
Protect the public the patients from disease
There is also a need to protect the health care
workers
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WHO Network
Needs
Global challenges
192 MEMBER STATES
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WHO regions

• HQ, Geneva
• Regional offices
• AFRO, Brazzaville
• Harare
• PAHO, Washington
• EMRO, Cairo
• EURO, Copenhague
• SEARO, Delhi
• WPRO, Manilla
• 141 country offices

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Listen to and address the fears needs of our
HCWs

• Global Health workforce is estimated gt 100
  million people
• There is a recognised need to strengthen health
  care systems
• such systems are impossible without health
  workers who are the ultimate resource of health
  systems Joint Learning Initiative
• HCWs more than a resource
• Listen to address their fears and needs
• We are afraid. We question our safety.
• But we are obliged to our patients.
• (Congolese nurse, Ebola outbreak, Hewlett 2005)

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12th session of the Joint ILO WHO Committee on
Occupational health in 1995

• adopted a new definition of occupational health
• aiming at the promotion and maintenance of the
  highest degree of physical, mental and social
  well being of workers in all occupations

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Healthcare Worker safety

• Occupational and Environmental Health Programme
• Injection Safety Related Infection Control
• Safe Injection Global Network (SIGN) Secretariat
  
• Department of EPR
• Healthcare-Associated Infections Prevention and
  Control focal point
• Deployment of field teams with Personal
  Protective Equipment (PPE)
• Training materials/ Outbreak Response
  Leadership Course

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The Department of EPR assists with the control
of outbreaks. This may be done through
triggering the GOARN Network.
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GOARN Global Outbreak Alert Response Network

• GOARN is an independent network of institutions
• The GOARN Project Manager and Secretariat sit
  inside the Department of EPR, WHO Geneva
• WHO has mounted 30 missions since 1 Jan 2006
• Revolved around Avian Influenza
• Human or animal epidemiologists
• Case management infection control
• Logistics
• Social mobilisation
• Laboratory experts

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Outbreak coordination slide
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Outbreaks show where the strengths and
weaknesses are in a system

• Find the weak link/s strengthen it/them
• Preferably before an outbreak

Disrupt the interaction between man, agent
environment
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Where in the patients journey through the
health care facility is there a risk of
nosocomial amplification?
Identify at risk personnel activitiesManage
the risk
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Trying to create a safety culture climate at
an outbreak

• Senior management support for the safety of
  personnel
• Appropriate administrative and engineering
  controls in place
• Hazard identification and risk assessment
• Buddy system can provide informal feedback
• Adequate accessible supplies of PPE
• Consistent use of PPE
• Review of work processes to ensure that the risk
  of exposure is eliminated or minimised
• Try to identify job hindrances and remove them

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Able to smile behind their masks
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In certain situations the usual controls may be
absent
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Scenario - Outbreak investigationNon hospital
setting

• You are asked as part of a GOARN response to go
  to a village and investigate an outbreak. This
  will include taking samples from a sick patient
  who has a fever, has been vomiting blood and who
  is unable to leave his/her house because he/she
  is so weak.

In such a situation it is important to be well
prepared and to be aware of the emotions and
beliefs of the community For example
establishing good links with community leaders,
ensuring you have all necessary material with you
decide where to put on and take off PPE
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In certain situations the usual controls may be
absent

• STOP Stop, Think, Observe and Plan what to do
  next
• Hazard identification
• Risk management
• Appropriate precautions
• Aiming for SOS
• Safety of Staff Others resulting in Safe
  patient care

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Community support
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In summary

• An outbreak response requires
• Prompt initiation
• Strong coordination
• Clear lines of communication
• Community support
• Adequate appropriate staff who have their needs
  addressed

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Thank you