A week in the life of……..!

1. A week in the life of……..! Alison MacLean Senior Infection Prevention & Control Nurse NHS Highland

2. Annus horribilis 2012

3. 2012 • January outbreak of Clostridium difficile • 6 patients in a surgical ward • March outbreak of Clostridium difficile • 3 patients in the oncology ward • June-Unannounced HEI visit • 9 requirements • 2 recommendations

4. Exemplar ward • Concept of an exemplar ward suggested by Lead Nurse, Una Lyons. • Ensure all process where correct • Ward 4C, surgical ward was identified • Action plan created

5. Ivory Tower • Stephen R Covey, ‘The 7 Habits of Highly Effective People’, Habit 5 • Seek first to understand, then to be understood! Out of my ivory tower and back to the shop floor!!!

6. Day 1-Domestic Assistant • Hardest days work I’ve ever done! • Resulted in a review of when was the most appropriate time for the clinical areas to be cleaned. • Fewer staff available at the weekends and evenings. • Single DSR per floor-time spent looking for keys • Became invisible

7. Day 2-Domestic Supervisor • Suggested use of inventory for DSR to reduce amount of time spent fetching stock • Increased awareness of environmental monitoring tool • Issues with bodily fluids!

8. Day 3-Nursing Auxiliary • How easy is it to do the right thing? • Use of PPE, hand hygiene and appropriate disposal. • Reinstated clinical waste bins in multi bed bays. • Housekeepers appointed .

9. Day 4-Staff Nurse • Aligned IP&CN to each division • Induction process for new staff. • Testing use of booklet/checklist • Ward environment • Team members • Documentation • Training requirements

10. Conclusion • Ward have continued to progress-currently doing SICPs compliance measurement. • No evidence of spread of infection. • HEI unannounced revisit in November • 1 requirement • 2 recommendations

11. Cleanliness Champions Programme • Good basic foundation • Opportunity to reflect on current practice • Improve processes