The PHA has responsibility for service improvement in the areas of health protection, health improvement and screening. The Health and Social Care Board has responsibility for performance monitoring of progress towards standards and targets, working closely with the PHA in the areas for which we have lead responsibility.
Within this context, the Healthcare Associated Infections (HCAI) team within PHA’s health protection service works in partnership with organisations across Health and Social Care. The central themes of the HCAI Team’s work are that “infection prevention and control is an integral part of safe healthcare” and that “infection prevention and control is everyone’s business”.
The responsibilities of the HCAI team include:
- implementation of DHSSPS policy on HCAIs (Changing the Culture 2010);
- progressing work on other/additional interventions to reduce and prevent HCAIs, including work on environmental cleanliness;
- providing support to HSC Trusts as required to embed processes and achieve required outcomes in respect of HCAI reduction;
- support to HSCB for performance management of HSC Trusts in achieving Ministerial targets relating to HCAIs;
- providing HP/IPC service and support to primary and community settings including nursing and residential homes;
- provision of advice and expert knowledge to DHSSPS on policy relating to HCAI reduction and prevention;
- reporting of progress and be accountable to DHSSPS for implementation of HCAI policy and achievement of HCAI reduction targets.
Publications
Summary Tables for Clostridium difficile and MRSA.doc.pdf
Pseudomonas:
Preventing infections caused by Pseudomonas - Parent/Carer Information Leaflet
Screening patients for Pseudomonas - Parent/Carer Information Leaflet
Preventing infection caused by Pseudomonas work on water supplies - Parent/Carer Information Leaflet
Recent Activities
CDI public inquiry report
The public inquiry into the outbreak of CDI in Northern Trust Hospitals 2007–08 issued its report on 21 March 2011. The report contains 12 recommendations addressing communication with patients, patient safety, quality of care, end of life care, record-keeping, death certification, outbreak control plans and guidance, and isolation of patients with suspected or known CDI. Details of the full report can be accessed through the inquiry’s website
HCAI symposium
The PHA hosted its second annual symposium on HCAIs on 30 March 2011 in the King’s Hall, Belfast. The symposium was opened by the Chief Medical Officer and included presentations from Trusts and the PHA addressing HCAI improvements and work programmes. Dr Bharat Patel (Consultant Medical Microbiologist, Microbiology Services Lead for London, Health Protection Agency) outlined HCAI improvements which have been achieved nationally, and discussed learning arising from work progressed to date.
CDI and cleanyourhands training sessions
To the end of March 2011, the HCAI team has delivered 13 training sessions on our cleanyourhands campaign and best practice in management of CDI to nursing and residential homes. A total of 580 staff representing 187 homes have attended this training, with further training sessions planned. The health protection/IPC nursing team is also establishing a ‘link system’ to support IPC training and best practice across the nursing and residential home sector.
Patient information leaflets
The HCAI team is leading work to draft and agree an updated suite of HCAI patient information leaflets (PILs). Work on these PILS is progressing in partnership with Lead IPC nurses in the five HSC Trusts. Phase 1 of this work is nearing completion and includes PILs on HCAI general information, hand hygiene, MRSA and norovirus. Phase 2 of this work will include PILs addressing laundry advice, Extended Spectrum Beta-Lactamases (ESBL) infections (a group of bacteria that are resistant to many commonly-used antibiotics), and scabies.
Areas of focus 2011-2012
The health protection and infection prevention and control nursing service (HP/IPC nursing) within the HCAI team has been enhanced during 2010–11. The team provides HP/IPC support to the nursing and residential home sector – providing facility visits, supported risk assessment and management for HCAI incidents/outbreaks, and site specific training/education. The nursing team is rolling out regional training sessions relating to the cleanyourhands hand-hygiene campaign and best practice for CDI management.
The HCAI team is working in partnership with the HSCB to draft and agree an HCAI action plan for primary and community care settings. This plan will address nursing and residential home sector, general medical and dental practices/service providers, and community pharmacies. It is envisaged that this action plan will be finalised and available in April 2011.
During 2011–2012, the team plans to establish and develop systems to support best HP/IPC practice in primary care settings. This work will form part of the roll-out of the HCAI action plan for primary and community care settings.
The team will continue to support HSC Trusts with HCAI improvement work which is currently ongoing. In particular, the team will provide advice and support through partnership working with Trusts who are not on, or are moving away from, their expected trajectory for HCAI reduction as set out in Ministerial performance targets.
The HCAI team also provides support to the HSCB for performance management of HCAI reduction targets. This is achieved through provision of comprehensive surveillance information/data used to underpin HCAI improvement across health and social care. The team also provides intelligence to support assessment of progress towards achievement of HCAI reduction targets.
The team will continue to lead (as appropriate) HCAI incidents/outbreaks arising in primary and community care settings. Team members will also continue to contribute (as appropriate) to the risk assessment and management of HCAI incidents/outbreaks arising in acute care environments.
The team (in conjunction with the health protection surveillance team) delivers all regional HCAI surveillance programmes. This includes programmes for C. difficile, Staph aureus, surgical site (orthopaedic, C-section, cardiac and neurosurgery) and intensive care surveillance.
During 2011–2012, our ICU surveillance programme will be transitioned from paper-based to electronic systems – through partnership working with the critical care network (CCaNNI) and ICU clinical staff. Our programme of enhanced surveillance of C. difficile infection (CDI) cases resident in community settings through the health protection duty room will be maintained. Regular feedback from this programme will now be included in quarterly CDI surveillance reports.
HCAIs Surveillance
Quarterly reports provide epidemiological data on C.difficle in Northern Ireland, and includes key points, a comprehensive overview of all C.diff infections, rates, trends, age-specific information and statistical process control charts. The reports also provide information on surveillance methods and data for each hospital and Health and Social Care Trust in Northern Ireland.
1. Clostridium difficle surveillance
Report 1 (Qt ending March 2012: CDI_Report_Q1_2012
Report 2 (Qtr ending Dec 2011): CDI_Report_Q4
Report 3 (Qtr ending September 2011) CDI_Report_Q3.pdf
Report 4 ( Qtr ending June 2011) CDI_Report_Q2_2011.pdf
Report 5 (Qtr ending March 2011) 2011_March_Cdiff.pdf
Report 6 (Qtr ending December 2010) 2010_Dec_Cdiff.pdf
Report 7 (Qtr ending September 2010) 2010_Sept_Cdiff.pdf
Report 8 (Qtr ending June 2010) 2010_Jun_Cdiff.pdf
Report 9 (Qtr ending March 2010) 2010_March_Cdiff.pdf
Quarterly reports provide epidemiolohical data on S. aureus in Northern Ireland, including overall infection figures as well as those specific to MRSA and MSSA. Reports highlight key points, rates, trends and statistical process control charts. The reports also provide information on surveillance methods and data for each hospital and Health and Social Care Trust in Northern Ireland.
2. Staphylococcus aureus bacteraemia surveillance
Report 1 (Qtr wnding March 2012): SA_Report_Q1_2012
Report 2 (Qtr ending Dec 2011): SA_Report_Q4
Report 3 (Qtr ending September 2011) SA_Report_Q3_2011.pdf
Report 4 (Qtr ending June 2011) SA_Report_June 2011.pdf
Report 5 (Qtr ending March 2011) SA_Report_Mar11.pdf
Report 6 (Qtr ending Dec 2010) SA_Report_Dec10.pdf
Report 7 (Qtr ending Sep 2010) S_Report_Sept10.pdf
Report 8 (Qtr ending Jun 2010) SA_Report_June 2011.pdf
Report 9 (Qtr ending March 2010) SA_Report_Mar10.pdf
Reports generated from data submitted to TESSy, the European Surveillance System showing cumulative incidemce of SSI within 30 days after Caesarian section, hip prosthesis and knee prosthesis.
3. Surgical site surveillance
Caesarean section, Reporting Year 2009 Caesarean_Section_inhospital_rates_2009.pdf
Hip prosthesis, Reporting Year 2009 Hip_prosthesis_inhospital_rates_2009.pdf
Knne prosthesis, Reporting Year 2009 Knee_prothesis_Inhospital_2009.pdf
Infection control Policies/Reports/guidance documents
- Public inquiry into the outbreak of Clostridium difficile in Northern Trust Hospitals
- Changing the Culture 2010
- Hand hygiene link
- Environmental cleaning link
Key links
Department of Health Social Services and Public Safety
Health Protection Surveillance Centre (Republic of Ireland)
Health Protection Agency (England)
Centre for Disease Control and Prevention (US)