BEST PRESENTATION
AWARD
Dr. Venkat Sivaprakasam, Consultant Microbiologist - Hereford Hospitals NHS Trust
CURRENT STATUS
Consultant Microbiologist with additional
responsibilities of Head of The Department and
Director of National Leptospirosis Reference
Unit at Hereford Hospitals NHS Trust.
END IN MIND (VISION)
committed team which includes all the staff in the
of
Microbiology
to
Pilot project initiated after creating awareness and inciting interest
‘clostridium difficile associated diarrhea’
uncertainties in testing algorithms and the role of Toxin gene detection
Objectives To define an optimum testing algorithm for the laboratory diagnosis
A highly motivated and
Department
Introduction of molecular diagnostic techniques in the diagnosis of health care
associated infections (MRSA and C.diff) - CONCEPTION AND INCEPTION
facilitate
of CDAD with the use of clostridium difficile gene detection system (PCR assay)
by GeneXpert (Cepheid), with the single objective to achieve zero tolerance to
hospital acquired CDAD.
time scale, that would assist and support the
clinicians to deliver a safe, high quality and
evidence based health care package to the
patients,
their
relatives
and
people
of
Herefordshire that they could be proud of and
enable them to enjoy their cushioned journey
Methods – 261 Stool samples from patients with loose stools attending
Hereford hospitals NHS trust in UK, were tested for the presence of Clostridium
difficile toxin by VIDAS assay (Biomerieux) and cell culture cytotoxin assay (CTA)
and the clostridium difficile toxin gene by PCR assay.
Results – With reference to CTA as the gold standard the sensitivity and
specificity of the VIDAS assay was 83.92% and 75.72 and that of PCR assay was
100 % and 77.66% respectively..
arises.
Conclusion – The superiority of the GeneXpert gene detection assay over
INNER CHALLENGE
VIDAS in terms of efficacy is significant. In terms of efficiency (user comfort, turn
around time and no equivocal results) we feel the PCR assay is far more superior.
The ability to identify the ribotype 027 strain at the same time is beneficial to
prevent harmful cohorting.
Unpolished and untested leadership qualities.
Time management.
OUTER CHALLENGE
THIS PROJECT WAS PRESENTED AT ECCMID IN VIENNA IN ARPIL 2010
Team more comfortable with historical practices.
Resistance to change
Perceived benefits to the team –
Increased awareness and interest leading to confidence.
Lack of awareness to recent advances and
developments.
Financial constraints.
First step: Set exceptional standards for
myself by regular training and practising the
“SEVEN HABBITS OF LEADERSHIP”
stakeholder mapping.
Empathising
Giving and receiving feedback
Setting targets
meeting deadlines and promises.
Sharpening the Saw
Regular social meets,
The attendance to this year Christmas party is 100% ( First time
ever in the History of Hereford Microbiology).
Mile stones set and achieved: (MISSION)
SWINE FLU PCR TESTING –
The team has developed respiratory PCR assays including
swine flu testing. Routine testing is likely to happen this
winter. (The team is very excited and enthusiastic by the
product of their synergistic efforts.
MRSA TESTING BY PCR:
through the health care system as and when one
New team and new environment.
Delegation
MOLECULAR GROUP FORMED
synergistic work to deliver the highest quality
Microbiology services in the most appropriate
Tool kits the team embraced in planning strategy:
Awards, recognition and the feeling of being valued was motivating and
inspiring to the team.
No time was lost in spreading the team dynamics and building the team spirit
by crediting every member of the team for whatever little contribution made.
Project has been developed to do MRSA PCR testing for
the high risk patients group as POCT using the same platform
as for C Diff toxin gene testing.
LEPTSPIROSIS TESTING BY PCR:
Routine PCR testing is likely to roll out early next year as
part of the reference services to the whole of UK..
Molecular work shop:
Planned for the entire team and for BMS from neighboring
trusts.
MARCH CONTINUES WITH INCREASING VIGOUR
AND TEAM SPIRIT TOWARDS
THE SAME END IN EVERY TEAM MEMBER’S MIND
Thanks to Merlin and Penny AND all others who have been instrumental in facilitating this seemingly MIRACLE.