Microsoft Power Point - 1 Clean-care-safer-care Stefanus
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Transcript of Microsoft Power Point - 1 Clean-care-safer-care Stefanus
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8/8/2019 Microsoft Power Point - 1 Clean-care-safer-care Stefanus
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World Health Organisation
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Simple measuressave lives
The focus is onpreventing infection
associated withhealth care
www.who.int/patientsafety/events
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"Clean Care is Safer Care" Initiative
Objectives
Global Awareness- raising
Country commitment and campaigns
Development and Implementation of the WHOGuidelines on Hand Hygiene in Health Care
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Health care-acquired infection: the scale
At any time, over 1.4 million people worldwide are suffering frominfections acquired in hospital.
Between 5% and 10% of patients admitted to modern hospitals in thedeveloped world acquire one or more infections.
The risk of health care-associated infection in developing countries is 2 to20 times higher than in developed countries.
In some developing countries, the proportion of patients affected by ahealth care acquired infection can exceed 25%.
In the United States, 1 out of every 136 hospital patients becomesseriously ill as a result of acquiring an infection in hospital; this isequivalent to 2 million cases and about 80 000 deaths a year.
In England, more than 100 000 cases of health care-associated infectionlead to over 5000 deaths directly attributed to infection each year.
A NZ study of hospital-acquired infection estimatedprevalance rate of 9.5% (Graves 2003)
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Health care-acquired infection: the cost
Added to the considerable human misery caused by healthcare- associated infections is their economic impact.
In the USA, the risks of acquiring these infections haverisen steadily over the last decades with accompanyingextra costs estimated at US$ 45005700 million a year.
In England, health care- associated infections are estimatedto cost 1 billion annually to the National Health Service.
Predicted annual cost for hospital acquired- infection in NZ
up to $136.61M
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Elements of the Global Safety Challenge
Blood Safety
Injection practices and immunisation
Environmental hygiene and waste management
Clinical procedures safety
Hand hygiene
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BLOOD SAFETY
Between 5%-10% of HIV infections
world-wide transmitted throughtransfusion of contaminated blood andblood products in the past
Between 1990-92 in NZ at least 600patients were put at risk and
transmission of Hepatitis C occurred (toan unknown number) throughtransfusion of contaminated blood
Currently the risk of bacterialcontamination from transfusionexceeds the risk of HIV, HBV and HCV
transmission in developed countries
Haemo-vigilance data from around theworld shows errors in proceduresleading to ABO incompatibility is themost common serious hazard of
transfusion
Actions: Promotion of optimal
hand hygiene associated with
procedures for collection,
processing and use of blood
products
Comprehensive haemo-vigilance
programmes
Focuspreventing transfusion-transmitted infection
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Injection practices and immunisation
One injury from a needle used on aninfected patient carries 30% risk of
transmitting Hep B, 1.8% risk oftransmitting Hep C and 0.3% risk oftransmitting HIV
In some countries up to 90% of
people seeking primary care receiveinjections of which 70% areunnecessary or could be replacedwith oral formulations
Actions
Raising awareness of risks ofunsafe injection practices andadoption of safe injection practice
Safe disposal of sharps andeffective management of sharpswaste
Promote use of auto-disable(single use) syringes inimmunisation
Vaccination of healthcare
workforce
Focussafe injection that does not harm the recipient,
does not expose the provider to any avoidable
risks, and does not result in any waste that is
dangerous.
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Environmental hygiene and waste
management
Focusachieve safe environment needed for healthcare andthe safe disposal of waste generated
1.8 million people die every yearfrom diarrhoeal diseases
Most legionella cases arenosocomial and concern healthcarefacilities worldwide
ActionHygiene education andpromotion of hand washing canlead to a reduction of cases bymore than 50%
Safe disposal waste, particularlyneedles, syringes and body fluidsHealthcare processes thatprevent the transmission by thefaecal-oral routeEnvironments that are low risk tohealth from micro organisms thatgrow in the environmentAdequate cleaning of facilities
and equipment
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Health care-associated infection
Health care-associated infection is one of the leadingcauses of premature mortality in some countries.
International studies show 5% -10% of patients acquireinfection
In intensive care, health care-associated infection affectsabout 30% of patients and the attributable mortality mayreach 44%.
The infection rate associated with vascular devicesamong neonates is 3 to 20 times higher in developingthan in developed countries
NZ study estimated prevalance rate of 9.5% (Graves2003)
During the SARS pandemic, the proportion of infected
health-care workers ranged from approximately 20% to60% of cases worldwide.
FocusPreventing infection associated with
health care
ActionIncreasing good
hand hygienepractice
Use of an alcohol-
based hand rub
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Clinical procedures safety
Surgical site infection accounts forabout 14% of possible adverseevents threatening patient safety inhospitals in developed countries.
Surgical site infection occurs in at
least 2% to 5% of the 27 millionpatients undergoing surgicalprocedures every year.
Surgical site infection accounts forabout 25% of health care-associated infections.
In the United States, surgical siteinfection prolongs hospital stay byan average of 7.4 days at anaverage cost of US$ 400 to US$2600 per wound infection.
FocusPreventing surgical site infections
ActionCorrect surgical hand preparationEnvironmental hygiene
Surgical training experience
and supervisionBest practice wound care
Appropriate antibiotic
prophylaxis and treatment
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Hand Hygiene
Clean Handsare
Safer Hands
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Guidelines on Hand Hygiene
in Health Care
WHO GUIDELINES ON HANDHYGIENE IN HEALTH CARE(ADVANCED DRAFT):A SUMMARY
Objective of the Guidelines:
To provide health-care workers,administrators and health
authorities with:
a thorough review of hand
hygiene
in-depth information tohelp them overcome
obstacles to improvement
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Guidelines main recommendations
Hand washing with soap and water when hands
are visibly dirty
Adoption of alcohol-based hand rub as the goldstandard
Use multiple strategies including
education
leadership
patient participation
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Perceived barriers to appropriate
hand hygiene
Lack of active participation in hand hygiene promotion
at individual or institutional level
Lack of role model for hand hygiene
Lack of institutional priority for hand hygieneLack of administrative sanction ofnoncompliers/rewarding of compliers
Lack of institutional safety climate
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Factors influencing poor adherence to
recommended hand hygiene practicesWorking in intensive care
Working during the week (vs. week- end)
Wearing gowns/gloves
Automated sink
Activities with high risk of cross- transmission
Understaffing or overcrowding
High number of opportunities for hand hygiene per hour
of careNursing assistant status (rather than a nurse)
Physician status (rather than a nurse)
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Self-reported factors for poor adherence
Hand-washing agents cause irritations and dryness
Sinks are inconveniently located or shortage of sinks
Lack of soap, paper, towel
Often too busy or insufficient time, patient needs take priorityHand hygiene interferes with health-care workerpatient relationship
Low risk of acquiring infection from patients
Wearing of gloves or belief that glove use obviates the need for hand hygiene
Lack of knowledge of guidelines and protocols
Not thinking about it, forgetfulness
No role model from colleagues or superiors
Scepticism about the value of hand hygiene
Disagreement with the recommendations
Lack of scientific information of definitive impact of improved hand hygiene
on health care-associated infection rates
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Risk factors associated with poor
adherence to hand hygiene
Individual level:
lack of education or experience
lack of knowledge of guidelines
being a refractory noncomplier
skin irritation by hand hygiene agents.
Team level:
lack of education or lack of performance feedback
working in critical care or in high workload conditions
downsizing or understaffing
lack of encouragement or role modelling from key staff
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Risk factors associated with poor
adherence to hand hygieneOrganisational level:
lack of written guidelines
lack of suitable hand hygiene agents
lack of skin-care promotion or agents
lack of culture or tradition of compliance
lack of administrative leadership, sanctions, rewards or support.
System level:
lack of awareness and commitment regarding the importance of healthcare-associated infection
lack of specific regulations and policies on prevention of health care-associated infection
lack of guidelines on hand hygiene in health care
lack of promotion of national or regional campaigns to improve handhygiene
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Clean Care is Safer Care
Risks to consumers are minimised when there is:
Leadership and commitment
Well designed processes and systems
Clean hygienic environment
Safer practices
Concerted and coordinated actions