Infection prevention and control
Healthcare-associated infections are the most common complication affecting patients in hospital. They cause unnecessary pain and suffering for patients and their families, and usually result in longer hospital stays. The cost to the health system is also significant.
Infection prevention and control practices play a key role in reducing antibiotic resistance in hospitals. Standard precautions for infection prevention and control should be included in every hospital program and should include:
- hand hygiene
- the use of personal protective equipment
- the safe use and disposal of sharps
- reprocessing of reusable medical equipment and instruments
- routine environmental cleaning
- respiratory hygiene and cough etiquette
- aseptic non-touch technique
- effective waste management
- appropriate handling of linen
Infection prevention and control guidelines
The Australian Guidelines for the Prevention and Control of Infection in Healthcare (the guidelines) describe the best way to prevent and reduce infections occurring in healthcare settings including resistant infections. The guidelines include how to manage common infectious agents, for example, gastrointestinal viruses and evolving infectious agents, for example influenza or multi-resistant organisms.
The guidelines contain recommendations for:
- the key design features for isolation units to minimise infection transmission
- effective work practices to assist healthcare workers, including:
- standard and transmission-based precautions
- basic management of multi-resistant organisms
- organisational support
- workplace health and safety.
An update of the guidelines is expected to be completed in late 2018.
National Safety and Quality Health Service (NSQHS) Standard 3
The NSQHS Standard 3: Preventing and Controlling Healthcare-Associated Infections aims to minimise the risk of patients acquiring a healthcare-associated infection.
Standard 3 describes the systems and strategies to prevent infection and to manage infections properly when they occur. They also explain how to limit antibiotic resistance through the development and implementation of effective antimicrobial stewardship programs.
Guidelines for multi-drug resistant organisms
Several organisations have developed specific infection prevention and control guidelines for some multi-drug resistant organisms.
The Australian Commission on Safety and Quality in Health Care has updated the national guidelines Recommendations for the control of carbapenemase-producing Enterobacteriaceae (CPE): A guide for acute care health facilities in May 2017. The Commission also developed information sheets on CPE for clinicians and patients.
Victoria has developed CPE management guidelines and a suite of information sheets to assist clinicians, patients and visitors in health services. These aim to prevent infections and control the spread of CPE.
The National Health and Medical Research Council, in collaboration with the Australian Commission on Safety and Quality in Health Care has developed fact sheets on healthcare-associated infections from:
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Vancomycin resistant Enterococcus (VRE)
- Clostridium difficile.
Healthcare workers' effective hand hygiene is the single most important strategy to prevent healthcare-associated infections.
Hand Hygiene Australia recommends using an alcohol-based hand rub as the gold standard for hand hygiene where hands are visibly clean. Staff should wash their hands when they are visibly dirty. Staff not wearing gloves when caring for a patient with a Clostridium difficile infection should also wash their hands.
The National Hand Hygiene Initiative (NHHI) was implemented in 2009 by Hand Hygiene Australia. Based on the World Health Organization’s Five Moments for Hand Hygiene, the NHHI provides education, audit and feedback to clinicians and hospital executives. Its aim is to protect patients, the health workforce and the community the spread of infection. The NHHI website also reports hand hygiene compliance data.