current issues in risk management - healthcare associated infection

CURRENT ISSUES IN RISK MANAGEMENT

- HEALTHCARE

ASSOCIATED INFECTION

CURRENT ISSUES IN RISK MANAGEMENT

- HEALTHCARE

ASSOCIATED INFECTION

Risk ManagementRisk Management

Identification

Assessment – analyse / evaluate risk

Action - eliminate / reduce risk

Monitor and review

RISK OF HAIRISK OF HAI

Exposure to micro-organisms:

Person to person spread e.g., hands Medical devices e.g., surgical instruments Airborne / droplet e.g, sneezing, contaminated

humidifiers air conditioning Environment e.g., contamination present floors

fittings, in dust etc. Contaminated food

RISK OF HAIRISK OF HAI

Other factors:

High prevalence of micro-organism e.g., high carriage in staff or patients

Concentration of compromised patients e.g., broken skin, reduced immunity

Potential routes of transmission e.g., invasive devices

Control Measures for HAIControl Measures for HAI

Result from risk identification and analysis but will include:

Policies / procedures / guidance e.g.,- Infection Control- Health & Safety

Key GuidanceKey Guidance Handwashing PPE Decontamination Sharps use Laundry Waste Patient isolation Patient personal

care/hygiene Aseptic techniques

They Look Alright To Me!They Look Alright To Me!They Look Alright To Me!They Look Alright To Me!

The Patient!The Patient!

PATIENT INFECTION RISK PATIENT INFECTION RISK ASSESSMENTASSESSMENT

PATIENT INFECTION RISK PATIENT INFECTION RISK ASSESSMENTASSESSMENT

Part of care planning cycle

Systematic process

Identify patients who might develop an infection or to be source of infection

Identification of hazards or risks to health

Target preventative measures

INFORMATIONINFORMATION

Observation

Patient

Family

GP

Laboratory

Other professionals e.g., continence advisor

INFECTION CONTROL CARE PLANNING INFECTION CONTROL CARE PLANNING Infection risk assessment/reassessmentInfection risk assessment/reassessment

Is patient a risk to others?Is patient a risk to others? Is patient at increased risk?Is patient at increased risk?

No further actionNo further action Assess degree of riskAssess degree of risk No further actionNo further action

Plan patient’s carePlan patient’s care

Protect staff, other patients & visitors

Protect staff, other patients & visitors Protect the patient at riskProtect the patient at risk

Implement careImplement care

Evaluate careEvaluate care

No Yes Yes No

Ref: Bowell 1992

What is infected?

How is infection spread?

What symptoms affect degree of risk?

What could be contaminated?

How can contamination be prevented?

RISK TO OTHERSRISK TO OTHERS

RISK TO OTHERS ASSESSMENT TOOLRISK TO OTHERS ASSESSMENT TOOL

Ref: Bowell 1990

WHAT ISINFECTED?

HOW ISINFECTIONSPREAD?

WHAT COULD BECONTAMINATED?

FACTORS THAT INCREASE RISKOF SPREAD

3 = High Risk 2 = Medium Risk 1 =Low risk

SCORE

Faeces

e.g.,salmonella

Faecal/oralroute

Anything touchingfaeces e.g.,

Hands

Bed linen

Uniforms

Bedpans

Equipment etc.

Loose stools:

< 10 / day

5 – 10 / day

10 / day

Incontinence:

- continuous

- intermittent

- occasionally

Mental State:

- wandering/uncontrollable

- confused but can be confined toone area

- confused but aware of bodyfunctions

3

2

1

3

2

1

3

2

1

POLICY GUIDANCE ?POLICY GUIDANCE ?

Required for consistent approach- high standard of care:- appropriate to needs;- to routine activities