Dr Emily Macnaughton Consultant Microbiologist & Infection Control Doctor MB ChB FRCPath

Transcription

1 Dr Emily Macnaughton Consultant Microbiologist & Infection Control Doctor MB ChB FRCPath

2 Defining infection Ways to control infection In the community In the hospital Problem infections Future predictions

3 Colonisation

4 Infection

5 Basic hygiene Living conditions Vaccinations Health care facilities Hand hygiene Isolation Protective equipment Cleaning/decontamination Antibiotics Impact of modern medicine Surgery Use of technology

6

7 Vaccinations Antibiotic treatments Public Health measures Outbreak investigation Surveillance of notifiable diseases Contact tracing Specific advice for food handlers, schools and nurseries Screening

8

9

10 Basic measures still at the heart of infection control

11 WHO five moments

12 Training Audits Posters Campaigns

13

14

15

16 Cleaning protocols and intensity depending on area and infection Decontamination protocols for equipment Sterilization of surgical instruments Endoscope washer disinfectors Steam cleaning beds etc

17 HSDU (Hospital Sterilization and Decontamination Unit)

18 Infection control is the responsibility of all staff DIPC (Director of Infection Prevention and Control) Alan Sheward Deputy DIPC Deborah Matthews 2 x Infection control nurses Michelle Ould Derek Bampton Infection control doctor Infection control secretary

19 24hr availability of infection control advice Infection Control Audit Programme Investigation into incidents of Hospital acquired infection Mandatory annual infection control training for all staff with patient contact Local infection control policies

20 Close links between Microbiology dept. and infection control nurses

21 Clostridium difficile Norovirus MRSA Other multi-resistant bacteria Influenza

22 Number of cases Bowel infection related to antibiotic use Used as quality marker - local targets set IOW C. difficile infections present Total Trust CCG

23 12 Trust attributed cases 2014/15 (over target) despite success of 2013/14 (only 7 cases) 2014/15 rates comparable with regional and national rates All Trust attributed cases investigated and a variety of actions identified and implemented

24

25 Winter vomiting virus Most common cause of hospital acquired gastroenteritis Highly contagious Significant impact on hospital capacity Blocked beds Increased admissions Delayed discharges Staff sickness

26 Prompt isolation for anyone admitted with possible gastroenteritis Deep cleaning of areas where patients/ staff have had symptoms Prompt review of potential outbreaks Staff policy - off until 48 hrs symptom free Protective equipment and protocols

27 Total Trust Attributed Community Attributed

28 Increasing global antibiotic resistance problem Locally occasional multi-resistant simple infections with no tablet options e.g. urinary tract infections

29 Those with underlying health problems and the elderly at higher risk of life threatening seasonal influenza Vaccine efficacy poor for recent flu season Antivirals (e.g tamiflu) used to treat severe cases Additional infection control precautions needed in hospital

30

31 Faster, more accurate diagnosis of infections Improved finger printing of pathogens to track the source of infections Increased use of electronic surveillance and data analysis to detect infection control problems Use of newer technology for more effective cleaning and decontamination

32 Hydrogen Peroxide Vapour Use in unoccupied sealed rooms