PREPARING FOR PARTICIPATION IN HALT-2

1. LECTURE 6 PREPARING FOR PARTICIPATION IN HALT-2

2. LECTURE OBJECTIVES • To outline the steps necessary to prepare successfully for the HALT 2013 PPS.

3. LOGISTICS OF HALT-2 POINT PREVALENCE SURVEY (PPS) • Nomination of leads in each Long-Term Care Facility (LTCF)/ group of LTCF • Ethical considerations • IT access • Considerations when picking a date to carry out point prevalence survey (PPS)

4. LOGISTICS OF HALT-2 POINT PREVALENCE SURVEY (PPS) • Informing and educating LTCF staff • Printing out forms and protocols • Viewing results and feedback • Sending results to the national centre

5. 1. NOMINATION OF A STUDY LEAD • Assign a study coordinator (‘lead’) in your facility who will be responsible for: • Informing staff and residents about the study • All contacts with the national HALT coordinator • Preparing the PPS in all wards (distribution of documents etc.) • Sending/receiving all documents, feedback reports etc. • Asking written consent of the residents (if required in your country) • This person can (but does not have to be) the local surveyor.

6. 2. ETHICAL CONSIDERATIONS • The ethical requirements are different depending on country. • Ethical committee approval may be necessary. • Committee may require written consent from at least each resident (or proxy) with signs/symptoms of infection or using antimicrobial(s) on survey day. • Informed discussion with residents/ proxies on necessity of such surveys aids consent. • Confidentiality is secured. • LTCF study number i.e. no facility identified in reports etc. by name • Resident study numbers used in software • Ward list, if used, must be kept securely in LTCF and destroyed at end of project • Data collected for project use only.

7. 3. IT ACCESS • Data collected in paper form via the questionnaires will need to be entered into a software package. • A user guide on how to install and work the software will be provided prior to the study. • This software will need to be installed on a local computer. • Once the data has been entered in the software a report with preliminary results for the facility will be generated. • The data must also be sent to your national HALT study coordinator via email or data storage device (e.g. CD, USB stick).

8. 4. PLANNING A DATE TO CARRY THE POINT PREVALENCE SURVEY (PPS) • Plan to collect data on a single day between 01/04/2013 and 31/05/2013. • In large LTCF, there are two possibilities: - Several persons collect data on the same day (e.g. one person/ward) - One person collects data over two or more consecutive days Important: each ward should be completed on the same day it is started

9. Consult with: - Infection prevention and control (IPC) staff, if available - Medical staff - If possible coincide study with ward rounds • Consider staffing levels. • Consider requesting night staff to complete ward lists the night before the survey date, especially in large facilities –these night staff must be trained in HALT study procedures.

10. 5. INFORMING AND EDUCATING LTCF STAFF AND RESIDENTS • Inform all staff members about the aims and methods of the study. • Use staff information leaflets. • Plan when to give feedback to staff. • Inform residents and their families of the study. • Use resident information leaflets. • Depending on national/local legislation,written consent of residents (for whom a resident questionnaire has to be completed) may need to be obtained.

11. 6. PREPARATION OF STUDY DOCUMENTS • Print out all the necessary documents: - HALT-2 user guide/ protocol - HALT-2 software user guide - Institutional questionnaire - Resident questionnaire - Ward list - Microorganism code list - Information leaflets - Consent form (if necessary) • Be aware of where to access these documents e.g. national HALT study coordinator/ HALT website.

12. 7. CARRYING OUT THE HALT PPS • Complete the institutional questionnaire (as per lectures 2 and 3). • Obtain written consent if necessary. • Fill out ward list(s) (as per lecture 3). • Identify eligible residents. • Identify residents with conditions of interest (antimicrobial use and/ or signs and symptoms). • Complete residents questionnaires for those residents with conditions of interest (as per lecture 3).

13. 7. CARRYING OUT THE HALT PPS • Check that all parts of all questionnaires are completed. • Check that there is a resident questionnaire for each resident with conditions of interest identified in ward list. • Input data into software (as per lecture 7) as soon as possible after the PPS date.

14. 8. VIEWING RESULTS AND FEEDBACK • A report summarizing your data can be created by the application. In the menu, select “Reports > View Report” • The report can be printed or saved on your computer as a simple HTML file that can be viewed with any browser (Firefox, Internet Explorer…). Click the floppy disk icon to save or the printer icon to print the report.

15. Don’t forget to feedback results to all staff • On completion of HALT data entry and • On receipt of the national report • Ask staff • For feedback on HALT methodology • Ideas for future preventative programmes • What areas requiring improvement could be targeted immediately (e.g., staff and resident vaccination, antimicrobial stewardship, urinary catheter care etc.)?

16. 9. SENDING RESULTS TO THE NATIONAL CENTRE • Once all data have been inputted into the software, click on the menu “Data > Export” (see also lecture 7) • Select a place (folder) where you want to save the file containing the data. Click OK to validate your choice.

17. 9. SENDING RESULTS TO THE NATIONAL CENTRE • The name of the file is automatically generated: [ID of your facility].[Name of your facility].HALTDatabase.zip • Send the file to your national representative. Instruction on how to do this will be provided. • Store your paper questionnaires in a safe place until the end of the project (December 2013)