190 likes | 348 Views
Organization & Sustainability. By Prof. OSSAMA RASSLAN. Secretary General, Egyptian Society of Infection Control. Current Status . Current status in rural areas & most P.H.C. facilities:. 1. Lack of structure - No ICC - There may be ICP 2. Lacking or inadequate policies
E N D
Organization & Sustainability By Prof. OSSAMA RASSLAN Secretary General, Egyptian Society of Infection Control
Current Status Current status in rural areas & most P.H.C. facilities: 1. Lack of structure - No ICC - There may be ICP 2. Lacking or inadequate policies 3. Lack of resources • Lacking resources: • - Running water • - Hand.W. facilities • - Protective clothes • - Steriliz., disinf. facilities • - Sharps disposal facilities • - Waste disposal facilities • - Incineration facilities Organization & Sustainability
Current Status (cont.d) Current status in rural areas & most P.H.C. facilities: 4. Lack of knowledge 5. Lack of compliance 6. Lack of concept 7. Lack of control - Loss - Overconsumption Organization & Sustainability
How to practice • 1.Establish a structure • - ICC, ICT, ICD, ICN, ICLN • - Minimal requirements • Who is the ideal IC man? • Who is the ideal IC nurse? Organization & Sustainability
Infection control Personnel The ideal IC man is a combination of: • Inf. ds. specialist • Teacher • Epidemiologist • Preacher • Microbiologist • Economist • Psychologist • Environmentalist • (Never ever be a policeman) Organization & Sustainability
Infection control Personnel The ideal IC nurse is: • The fairy good mother • St. Francis assist • Margaret Thatcher Organization & Sustainability
How to practice • 2.Formulate & monitor policies(Guidelines) • - Protective barriers • - Ward specific policies • - Site specific policies • - Disease specific policies • 3. Use the existing system(Modify interventions) • e.g. a) Cleaning, disinfection & sterilization • b) soiled linen mgt • 4. Educate all healthcare workers • 5. Raise awareness & establish the right concepts Organization & Sustainability
How to practice • 6. Control & security • to control overconsumption & avoid loss • 7. Recycling & Reuse • Recycling: Most of hosp. waste is of the • household type & is recyclable. • Reuse: of non critical items, e.g. masks, • gloves, etc. (after being cleaned & • disinfected). Organization & Sustainability
Modify existing systems - basic concepts - The basic requirement is clean objects - Determine when sterilization is needed & when disinfection is sufficient - 10 min boiling is sufficient to avoid almost 90% of infections - Highly sophisticated equipment is not required - Less costly methods may be used to eradicate many organisms - Proper use of available resources in due time is very important Organization & Sustainability
Education of HCW What are the basic concepts for education? - Hand hygiene - Personal hygiene - Protective barriers - Cleaning, sterilization & disinfection - Aseptic work techniques - Safe food and water supply - Special skills, e.g. communicology Organization & Sustainability
Education of HCW Who should be educated? - The general population - Special population groups Teachers, parents, medical & non-medical staff, children, pupils, ... Who should educate? - Educated experts - IC doctors - IC nurses - Infectious Diseases specialists Organization & Sustainability
Education of HCW • How to communicate with IC users? • - Handouts; mostly not read: • Doctors have no time to read, • what they read, they do not believe, • What they believe, they do not do • - Posters; mostly not noticed • - Lectures; mostly not attended • - Scientific literature; • mostly not understood &/or believed • - IC folders; where are they? Organization & Sustainability
Education of HCW (How to communicate w IC users) • - Ward rounds • - Quality circles; • Group meeting • Adequate time • With very ltd. no. • At work times • Different levels • Results discussion • Regular meetings • Role playing • From different work areas • Discuss self-chosen subjects Organization & Sustainability
Education of HCW How to achieve? - Kill all opponents immediately! - Wait until they die! - Try not to convince strong opponents - Collaborate with supporters - Use the top to bottom approach - The hosp. administrator must be your partner - The hosp. IC nurses are the key players Organization & Sustainability
Education of HCW What should be our goal? - Infection rate; not above average - Low rates of MRSA & VRE - No outbreaks - We are partners - We save you Organization & Sustainability
Education of HCW What should not be our goal? - Teach everybody - Reach everybody - Reach 100% achievement or 100% compliance Organization & Sustainability
Education of HCW How to accomplish? - Clearly define your goal - Involve keen staff - Keep it simple - Do not try to reach 100% compliance - Do not try to impose - Do not expect immediate change Organization & Sustainability
Education of HCW • How to accomplish? (cont.d) • - Go to the ward & talk to the people • - Do not wait to approach • - Keep regular meetings • with sterilization units • with ICC • with regular ward rounds Organization & Sustainability