current issues in risk management - healthcare associated infection
TRANSCRIPT
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