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Webinar IPC Roadmap Development and IPC Roadmap Implementation

Webinar IPC Roadmap Development and IPC Roadmap Implementation. TB CARE II 23 September 2019. Introduction. Designing and Implementing IPC Roadmaps. Introduction and Purpose. To discuss the use of IPC roadmaps for institutionalizing data collection and use

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Webinar IPC Roadmap Development and IPC Roadmap Implementation

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  1. WebinarIPC Roadmap Development and IPC Roadmap Implementation TB CARE II 23 September 2019

  2. Introduction Designing and Implementing IPC Roadmaps

  3. Introduction and Purpose • To discuss the use of IPC roadmaps for institutionalizing data collection and use • To discuss IPC roadmaps in the context of reporting on NAP progress • To understand the specific, operationalized measurements of IPC interventions and hear experiences from country teams on how they measure IPC interventions at national and sub-national levels.

  4. IPC Roadmap Developing an Implementation Roadmap

  5. IPC Roadmap: Core Components • Core components for developing and implementing an IPC roadmap include the following: • New or Existing: is the indicator already in use? • Data Source: what data systems are used to collect data for this indicator? • Responsible Parties: who (at each level) is responsible for data collection, aggregation, analysis and presentation? • Frequency: How frequently is this indicator reported? • Timeline: for new indicators, when will the indicator be in use and reported?

  6. Core Components: New or Existing? • Is the indicator currently in use in the country? • To what extent? • Is the indicator included in guidance document? • Are data available for this indicator? • If the indicator is new in the country, is it being collected elsewhere? • To what extent?

  7. Core Components: Data Source • What data systems are in place for collecting this indicator? • At what level is the indicator collected (i.e. facility, laboratory)? • At what level is the indicator aggregated and summarized? • What is the general data flow (i.e. collected at the facility, summarized and validated at district level, summarized and validated at provincial level, summarized and validated at national level)

  8. Core Components: Responsible Parties • Who is responsible for data collection, aggregation, validation and presentation? • At all levels (i.e., facility, district, provincial, national) • Is there a champion for the given indicator or intervention who understands the indicator and data collection methods?

  9. Core Components: Frequency • How frequently are data aggregated and presented? • For example: collected at the facility level and then aggregated monthly, with summary results presented in a quarterly report

  10. Core Components: Timeline • For implementing new indicators in a given country context, what steps must be taken to establish data systems, responsible parties and other factors, and what is the projected start date for data collection and subsequent reporting?

  11. IPC Roadmap: Levels of Implementation • Most indicators are facility level indicators (with aggregation to various higher levels for reporting purposes) • National level indicators could include the following • Incidence of TB infection among health care workers • National TB infection control guideline scorecard

  12. IPC Roadmap Operationalizing the Roadmap

  13. IPC Roadmap: Reporting Progress on NAP Milestones • Assess current indicators in the country • Which IPC indicators are currently in place? • For new indicators, follow the “essential elements” to define a plan for implementing • Define a baseline for new indicators • Use a set of IPC indicators to report progress toward NAP milestones in a standardized, comparable manner (or as comparable as possible)

  14. Country Example South Africa

  15. South Africa Existing IPC Practices

  16. Existing practices for TB infection control • Existing tools, checklists, SOPs, and scope of use • Screening Tool - TB symptomatic screen for all patients and HCW • Risk Assessment Tool – for clinics and hospitals, conducted annually • IPC Evaluation checklist – conducted monthly, used to monitor implementation of IPC plans • Ideal Clinic Dashboard – used to assess compliance to IPC at facility level, used monthly • Other tools in use • Household risk assessment tool – being piloted, used every 6 months • Risk assessment tools for Correctional facilities (prisons) and police cells

  17. Roadmap/Pathway to Adapting and Adopting Best IPC Practices

  18. Roadmap/Pathway to Adapting and Adopting Best IPC Practices

  19. South Africa Example: FAST

  20. FAST & U-LAM administrative process indicators. To evaluate the proportion of patients in care who are screened for TB and put on treatment. To evaluate time from sample submission to diagnosis to treatment. Cascade Data reported monthly

  21. South Africa Example: Health Care Worker Surveillance

  22. Screening of LTBI among HCWs • Study conducted to determine the prevalence of LTBI and progression to active TB using QuantiFERON-Plus (QFT-Plus) in three hospitals • 1) Pelonomi Regional hospital, Free State • 2) Zithulele District hospital, Eastern Cape and • 3) Pretoria West District Hospital, Gauteng • Phase one (recruitment and enrolment of 272 participants) at Pretoria West District Hospital has been completed. • Preliminary findings show that 121 (44.5%) were LTBI positive and 129 (54.8%) negative.

  23. Healthcare worker surveillance • There is a draft national policy on Occupational TB and HIV services for healthcare workers • IPC guidance documents do not include surveillance for healthcare workers • Provinces have guidelines that include TB medical surveillance and indicators, this is not standardized across provinces • Number of health care workers diagnosed with TB (DS/ MDR/ XDR-TB) • Systems used to collect the data vary – OHASSYS, DHIS, ETR • Data not flowing to national level but can be obtained from the provinces • Data not reported to the WHO currently

  24. Legal and Policy Framework • Constitution of the Republic of South Africa (Act No. 108 of 1996) • The National Health Act (No. 61 of 2003) • Occupational Health and Safety Act (No. 85 of 1993), and Regulations for Hazardous Biological Substances, 2001 • Roles of employer and employees • Record keeping of risk assessment, monitoring activities, medical surveillance (the last being subject to confidentiality) for a period of 40 years • Compensation for Occupational Diseases and Injuries Act (No. 130 of 1993) • TB schedule 5 Biological Hazard • Compensable disease

  25. Healthcare worker surveillance future plans • Approval of policy • Development of guidelines • Training of Occupational Health Practitioners • Develop M and E framework • Roll out the OHASYS (Occupational health Information system) • Only for health care workers • Confidential • Quarterly and Annual reports will be provided by the Occupational Health Unit for all medical conditions

  26. IPC Roadmap Conclusions

  27. Questions

  28. USAID TB CARE II The TB CARE II project is funded by the United States Agency for International Development (USAID) under Cooperative Agreement number AID-OAA-A-10-00021 and is managed by the prime recipient, URC. In partnership with:

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