to make the infection control practice sustainable in the ... · early detection of infected case :...
TRANSCRIPT
To Make the Infection Control Practice
sustainable in the Long Term Care Settings
in Hong Kong
Christine Lam,
Operations General Manager
30th October 2014
Sister Annie Skau , a missionary nurse “Respecting Life & Impacting Life
Service provision
Haven of Hope Christian Service
Location
No. of Service Centres: 56 Service Centres and 8 Service Programs No. of Staff: 2,137 (As at Mar 2013) Service Locations: Tseung Kwan O, Sai Kung, Kwun Tong, Wong Tai Sin , Sau Mau Ping, Wan Chai & Shau Kei Wan No. of People Served in Man Time Nearly 677,371 in (In the year of 2012/13)
Long Term Care Settings
• A home like setting environment
• Frail population with lower immune response
• With long term medical problems that requires assisted daily living
Elderly are receiving care
from different people
Common & frequent endemic
infection found in LTCF (Nicolle L.E. 2000)
1. Urinary Tract Infection 2. Upper Respiratory Tract Infection 3. Skin and soft tissue infection 4. Gastrointestinal infection 5. ……….. 6. ………..
Emerging and re-emerging infections
(Threats to health)
• Ebola • MDRO (MRSA, VRE, MDRA)
• Swine Flu (H1N1)
• Avian Flu (H5N1, H5N9) • Influenza
• SARS
To protect our clients:
Prevention is better than cure
• The institution is with crowded population
• High colonization of residents with antimicrobial-resistant
organisms e.g. MRSA, VRE
• Infection not fully recover after discharge from hospital : a
source of infection
Threats of outbreak in LTCF
Outbreak calls for resources management
Practical application of Infection
Control Program in LTCF
• Appointment of Chief Infection Control Officer (CICO), Infection
Control Nurse by the Infection Control Committee
• Setting up of communication channels
• Development of updating guidelines/visual instructions
• On-going in-service education
• Surveillance on the trend of infection e.g outbreaks
Appointment of Chief Infection Control Officer
(CICO), Infection Control Nurse (ICN) by the
Infection Control Committee
• The committee composed of doctor, nurses and floor i/c
• Delegation of responsibility
• 3 monthly meeting
• Environmental round & follow up
• Discussion on everyday operation regarding IC
Setting up of communication
channels with CICO & unit heads
• Newsletter for dissemination of most updated information, sharing of
guidelines
• Reporting of cluster of infections by service units
• CICO has direct contact with the service unit: advice / management
• Instant notification for risk management
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012 2013
Year
Training sessions:Attitude, Knowledge & Skills
Swine Flu
MRDO
Visual Guidelines
Proper use of gloves
感染物品 食物及食具
垃圾及拖地
一般清潔
Early detection of infected case :
Isolation
離開房間前
接觸 飛沫
+
-
- +
1. 疥瘡 (未完成治療前)
Scabies
2. 腹瀉嘔吐
Gastroenteritis
3. 諾沃克感染 (+ 眼罩)
Noro- virus infection
4. 副流感 / 呼吸合胞體病素
Para-influenza / RSV
接觸 飛沫傳染指引
Promotion of Hand Hygiene 2007
Our hands
New formula of Alcohol Hand
Rub (AHR) adopted by the
World Health Organization
(WHO) 2006
Promotion of Hand Hygiene 2007
(Collaboration with Dept. of Health)
1. 5/ 2007 Observational study of hand washing habit at the work
place + Questionnaire
2. 8-9/2007 5 Educational sessions on Hand Hygiene
3. 10/ 2007 Observation of Hand Washing activity 1 month after
education
4. 1/2008 Observation of Hand Washing activity 4 month after
education + Questionnaire
5. 9/2009 Observation of Hand Washing activity 1 year after +
Questionnaire
The process of the observation study
on Hand Hygiene activities after education
Study on Hand Hygiene
(Compliance 2007 - 2009)
Compliance of Hand Hygiene Programme
27.40%
84.90%
94.90%
80%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Before hand hygiene
Programme
1 month after Hand
Hygiene Programme
4 months after Hand
Hygiene Programme
1year after Hand
Hygiene Programme
Before hand hygiene
Programme
1 month after Hand Hygiene
Programme
4 months after Hand
Hygiene Programme
1year after Hand Hygiene
Programme
環境( Environment )
空氣 ( Air )
水 ( Water )
物品( Formite )
食物 ( Food )
醫療器具 ( Medical Devices )
氣管喉 ( ET Tube )
抽痰喉管 ( Suction catherter )
靜脈導管 ( IV Line )
人員 ( Personnel )
職員、訪客及其他院友
Source of Infection
Proper handling of equipment
Auditing
No one can be missed
Team
You Me He/She
The responsibility of Infection control
Change of Behavior
Thank
you!