this HAI Learning Resource - NHS Education for Scotland

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Welcome to this HAI Learning Resource
In April 2015 two national conferences were
hosted by NHS Education for Scotland (NES).
Their aim was to raise awareness of HAI
prevention and control among acute and nonacute frontline staff across health and social
care.
The content developed for these conferences
has been used to create this HAI Learning
Resource for use by local HAI trainers. The
resource is organised into three sections:
Engage, Inform and Interact. There are also
short questionnaires to check how your learners
are doing.
Figure 1 Exhibition Hall, Glasgow
An indication of how much time each activity might
take is provided at relevant points throughout the resource. Over all, it should take you between 2.5
and 3 hours to complete (depending on size of group and the amount of additional HAI information
you provide).
1. First Questionnaire (ice breaker)
2. Engage:
This section helps learners to reflect on the human costs of HAIs. The personal experience of
Helen, a woman who contracts a surgical site infection, is examined with reference to the
global consequences of antimicrobial resistance.
3. Inform:
This section provides key messages from four different areas relevant to HAI prevention and
control:
 Antimicrobial prescribing and stewardship: continuity across health and social
care settings.
 National Infection Prevention and Control Manual: what does this mean in
practice?
 Implementing the Manual: three Examples from Practice
o Scottish Ambulance Service
o NHS Greater Glasgow and Clyde
o NHS Grampian
 HAI Standards: applying in the real world
4. Second Questionnaire (checking knowledge)
5. Interact:
This section helps learners to identify their learning and plan action to improve HAI practice in
their local area.
6. Third Questionnaire (what next)
2
First Questionnaire (Ice Breaker)
These questions were designed to capture demographic information at the conferences.
Instruction to Trainers: Following your own introduction to your session, use these questions to help
gather information about your learners. Feel free to replace them with ice breaker questions that
better suit your audience and purpose (3 mins)
1. What would you rather have?
1. A glass half full
2. A glass half empty
3. A glass with a straw
4. No glass at all
2. Which job role describes you
best?
1. Social Care Staff
2. Healthcare Support
worker
3. Nurse/ Midwife
4. Medical staff
5. Dental staff
6. Allied Health Professional
7. Ambulance Staff
8. Student
9. Care Home Manager/
Care Home Staff
10. Other
Figure 2 Response from Glasgow Conference
3. Where in Scotland do you work?
1. The Islands
2. Highlands
3. North East
4. North West
5. Central Belt
6. South East
7. South West
8. Other
4. How familiar are you with the Standard Infection Control Precautions (SICPs)?
1. Very Familiar
2. Familiar
3. Not familiar
4. Have never heard of them
5. How easily can you access information locally regarding Infection Prevention and Control?
Give a score on a scale of 1-4, where 1 is Very Easy, and 4 is Very Difficult
3
ENGAGE
The Experience of HAI
Dr Esther Walker, Tess Allen, Forum Interactive Ltd
Instruction to Trainer: use the information below to
introduce the story to your learners (5 mins)
“Helen’s Story” is designed to set the scene by
placing the complex issues around HAI prevention
and control in a practical, human context. The
dramatized story highlights the human cost of HAIs,
encouraging the learner to make a personal
connection with this aspect of patient safety and to
consider what HAI prevention and control means in
the context of their own role.
‘Helen’ goes into hospital for a routine surgical
procedure. What happens to her in the following days
and weeks was drawn up in consultation with different
professional experts.
Figure 3 Dr Esther Walker
Helen will tell learners some of what happened to her.
But this story is very much from her perspective. We
don’t hear from any of the professionals involved in her care. Neither do we hear about any of the
conversations that she may have had with any of the health care professionals she encountered.
That is intentional. What we want is to leave things open for learners to use their own knowledge,
experience and skill to imagine that side of the story and to think about the issues or questions it
raises about infection prevention and control.
The Story
The story moves backwards and forwards in time. It
begins with Helen talking about her experience of HAI one
year on.
Instruction to Trainers:
o Show learners the film Helen’s Story (25 mins)
o Ask them the questions below. If numbers allow,
ask them to work in small groups and then discuss
all together (20 mins)
o You may like to supplement this list with your own
questions.
Figure 4 Tess Allen as 'Helen'
4
Questions
1. What strikes you as important about what you’ve heard in this story?
2. What issues/questions does the story raise for you about infection prevention and control?
3. What do you make of the conversation between Helen and her friend Pam? Was Helen
‘unlucky’ or is there more that health and social care staff can do to prevent infections?
4. What do you want to learn from today’s session about HAI prevention and control?
Extension Activity
Learners have heard part of Helen’s Story, the part that she chose to tell and that was revealed
through the skyped conversations. Another part of the story is the detail of what happened to her in
terms of her changing healthcare needs and the clinical care she received in response.
Instruction to Trainers: Take a look at the sequence of events referred to above (see Appendix I).
Instruct the group to use this information to identify the possible points in Helen’s journey of care
where something may have gone wrong, leading to her contracting the HAI. Ask them to use their
own knowledge and experience to fill in the gaps. Again, if numbers allow, ask them to work in small
groups and then discuss all together (20-30 mins)
5
INFORM
Instruction to Trainers: use the information in the following presentations from the conference to
supplement the content that you would usually provide in your HAI training sessions. (approx. 60
mins)
Antimicrobial prescribing and stewardship: continuity across health and social care
settings
Professor Dilip Nathwani, Consultant in Infectious
Diseases, NHS Tayside
Antibiotic prescribing: 80% of all antibiotics are prescribed
in the community with the remaining 20% prescribed in
hospitals. Between 30-50% of these prescriptions can be
inappropriate or unnecessary. Overuse and misuse of
antibiotics in human health is a key driver for antibiotic
resistance.
Figure 5 Professor Dilip Nathwani
“The time may come when penicillin can be
bought by anyone in the shops. Then there is
the danger that the ignorant man may easily
under dose himself and, by exposing his
microbes to non-lethal quantities of the drug,
educate them to resist penicillin.”
Sir Alexander Fleming, Nobel Lecture 1945
“…hip replacement. Currently, prophylaxis is standard practice, and infection rates are
about 0.5-2%, so most patients recover without infection, and those who get an infection
have it successfully treated. We estimate that without antimicrobials, the rate of
postoperative infection is 40-50% and about 30% of those with an infection will die.”
R Smith & J Coast BMJ 2013
Antibiotic stewardship: Stewardship is a core evidence based strategy to improve the quality of
antibiotic prescribing across the health care communities. With the relative paucity of new antibiotic
development we need to preserve the durability of this precious resource.
“We have watched too passively as the treasury of drugs that has served us
well has been stripped of its value. We urge our colleagues worldwide to take
responsibility for the protection of this precious resource. There is no longer
time for silence and complacency.”
Jean Carlet et al Lancet April 2011
6
Reference to antimicrobial nurse stewardship.
Infection prevention teams: Infection prevention teams, antimicrobial management teams and
clinical or care teams need to work closely to effectively deliver better infection prevention and
management. The role of measurement and feedback through routinely collected informatics is
fundamental to measuring and driving success.
Figure 6 Priority actions to address AMR
7
INFORM
National Infection Prevention and Control Manual: what does this mean in practice?
Lisa Ritchie, Nurse Consultant Infection Control, Health
Protection Scotland
The National Infection Prevention and Control Manual for
Scotland was published on the 13th January 2012, under
CNO (2012) to be adopted by all NHS staff.
The Manual aims to align evidence based practice with
monitoring assurance, quality improvement and scrutiny by
providing a straightforward practice guide based on an
assessment of the extant professional literature.
Chapter 1 covers Standard Infection Control Precautions
(SICPs), the basic infection prevention and control measures
necessary to reduce the risk of transmission of infectious
agents, to be used by all staff, in all care settings at all times,
for all patients
Figure 7 Lisa Richie
Chapter 2 covers Transmission Based Precautions (TBPs),
the additional precautions (to SICPs) required to be used
when a patient is known or suspected to be infectious.
The Manual promotes the application of evidence based (not ritualistic) care processes. The
literature reviews are separate from the practice guide, they summarise the available evidence that
underpin and informs the practice guide, and highlight implications for further research.
The Manual complements national improvement programs and provides a focus for the development
of local measurement plans to achieve sustained practical implementation of a small number of
critical activities into everyday practice (making the right thing easy to do for every patient every time).
The Manual provides an example quality improvement data collection tool which contains a critical
elements checklist can be used as an aide memoire to monitor SICPs practice.
8
A new National Infection Prevention and Control Manual website is under construction and will be
available soon – watch this space.
Meanwhile, the manual can be accessed here.
Accessing the HAI Standards
Figure 8 Opportunities to break the chain of infection
“Good prevention control practices break the chain of infection: Infection
prevention, unlike short-term control measures used in outbreak situations
requires ongoing consistent best practice at each and every stage of every
patient’s care, from hand hygiene, to insertion of intravenous lines to routine
cleaning of the environment and patient equipment.”
Lisa Ritchie
9
INFORM
Implementing the National Infection Prevention and Control Manual
The Scottish Ambulance Service: Travelling from Strength to Strength
Sharon Doyle, HAI Quality Improvement Facilitator,
Scottish Ambulance Service
Background: The Ambulance Service undertakes about
2 million journeys per year, half a million of which are
emergency journeys.
We have about 150 service
locations including ambulance stations, air ambulance
and special operation response teams. We have over
4,000 staff.
What did we do? It was identified that SICP's (Standard
Infection Control Procedures) needed to be improved from
many different audits and data feedback we identified two
improvement projects to embed SICPs to the service and
raise knowledge, awareness and confidence among staff
of
using
and
implementing
the
guidance.
Figure 9 Sharon Doyle
Figure 10 Two projects for SICPs integration
10
Cleanliness champions (n=1000) designed and implemented an improvement project relevant to
their local area. Outcomes:
 Enhance SICPs knowledge in trial locations
 Renewed enthusiasm
 Vehicle cleaning records completion improved
We will continue with these small tests of change and the ultimate goal is to spread these throughout
the service.
Academy Education we revised the presentation for the infection control and prevention course to
make sure that SICPs was fully embedded. Outcomes:
•
•
SICPs being considered in clinical scenarios
Students have more confidence around SICPs
11
INFORM
Implementing the National Infection Prevention and Control Manual
NHS Greater Glasgow and Clyde: A Quality Improvement Approach to reduce Catheter
Associated Urinary Tract Infection (CAUTI)
Gillian Mills, Healthcare Associated Infection:
Quality Improvement Facilitator, Glasgow Royal
Infirmary.
Urinary Tract Infection (UTI) is the leading cause of
healthcare associated infection (HAI) in NHS
Scotland, with around 50% of UTIs being associated
with an indwelling urethral urinary catheter (UUC).
Alternatives to UUC should be considered prior to
inserting a UUC. If a UUC is the only option for your
patient, it should be removed as soon as possible to
reduce the risk of catheter associated urinary tract
infection (CAUTI).
Figure 11 Gillian Mills
Asymptomatic bacteriuria (ASB) is the presence of bacteria in the urine without clinical signs and
symptoms of UTI. ASB are commonly treated in patients with indwelling UUCs despite the patient
having no clinical signs and symptoms of CAUTI. Inappropriate treatment of ASB can increase the
patient’s risk of developing clostridium difficile and can have an impact on antimicrobial resistance.
Symptomatic UTI cannot be differentiated from ASB on the basis of a urine dipstick test. DO NOT
use urine dipstick test in diagnosis of UTI in people with indwelling catheters.
12
Figure 12 Improvement and Patient Outcomes of CAUTI project
Figure 13 The range of stakeholders involved in CAUTI project
13
INFORM
Implementing the National Infection Prevention and Control Manual
NHS Grampian: The Who, When, how and What of Equipment Decontamination
Catherine
Mitchell,
HAI
Quality
Improvement Facilitator & Scott Arnot,
Domestics Training Manager, NHS
Grampian
NHS Grampian received negative press
as result of a Healthcare Environment
Inspection.
In response, a short-life
working group was set up with
representation from stakeholder groups.
What has been achieved so far? The
Figure 14 Glasgow Conference
group has reviewed and improved the NHS
Grampian A-Z guide for the Decontamination of Near Patient Healthcare Equipment to include:
 Crib sheets
 Top tips for cleaning
 Clarification of responsibility
 Updated information on manufacturers’ instructions.
Figure 15 Example of Crib Sheet
14
Figure 16 Example of Top Tips
Patient Feedback
“It‘s priceless to have a clean environment – it means the world to me. I came in
with a condition and want to be cured, not go home with something else” A.D.
“I feel comfortable and more at ease knowing I am being cared for in a clean
room. I have complete confidence in the staff’s abilities” K.M.
15
INFORM
HAI Standards: applying in the real world
Alastair McGown, Senior Inspector, Healthcare Environment
Inspectorate
The Healthcare Environment Inspectorate focusses on
infection prevent and control and inspects against HAI
standards and associated guidance.
Themes from HAI Inspections
 Hand hygiene
 Safe management of blood and body fluid spillages
 Safe disposal of waste
 Cleaning of the ward and patient equipment
 Emergency trolley beds and time to clean
Figure 17 Alastair McGown
The need for robust assurance systems
Hospitals need to better use data they gather
from audits to help them identify areas where
improvement is needed. Information allows you
to identify what you are doing well and what
needs to improve. If the information is not robust
then it can lead to: false assurance, failure to
target appropriate areas for improvement,
attracting further scrutiny, potential impact on
reputation with users.
Figure 18 the positives from HAI inspection reports
Data to drive improvement
 Data that reflects practice will be more useful in identifying areas for improvement.
 Good communication of information to staff will enable them to act.
 By demonstrating self-regulation hospitals have less need for external scrutiny
 Self-regulation delivers better outcomes for service users.
New HAI Standards are now in place (2nd May 2015) and apply to all healthcare organisations.
NHS Boards are required to demonstrate that they have adopted the HAI standards as part of the HEI
inspections. Inspections against these new standards begin June 2015.
16
Second Questionnaire (checking knowledge)
These questions were designed to capture knowledge acquired by those attending the conference.
Instruction to Trainers: use these questions to get a snapshot of how much your learners have
taken in so far. Make the quiz more relevant to your content (and learners) by adding in your own
questions. (3 mins)
1. What should antibiotics be used for:
1. Treat coughs and colds
2. Treat flu symptoms
3. Treat bacterial infections
4. Treat viral infections
5. All of the above
Figure 19 Result from Glasgow Conference
2. When performing hand hygiene, do you ever miss any of the World Health Organisation
(WHO) five moments?
1.
I often miss a hand hygiene opportunity
2.
I rarely miss a hand hygiene opportunity
3.
I never miss any hand hygiene opportunity
4.
I don't work with patients.
5.
I don't know what the WHO Five Moments of Hand Hygiene are
3. What is the annual cost of
Healthcare Associated Infections in NHS
Scotland?
1.
£8 million
2.
£18 million
3.
£83 million
4.
£183 million
Figure 20 Result from Glasgow Conference
17
INTERACT
Your role in ‘strengthening our defences’
Mark Johnston, Training and Research Officer for Patient
Safety, NHS Education for Scotland
This section is to help learners to digest what they’ve
learned from today and use it to plan action that will improve
infection prevention and control in their area.
Instruction to Trainers: Help learners to reflect on their
learning by asking them this question – “What are the 3 most
important things that you’ve learnt from this session so far?”
Ask them to think about this on their own and then share
responses with the whole group (5-10 mins)
Figure 21 Mark Johnston
Instruction to Trainers: Use the following information to
introduce learners to the concept of Human Factors and to
think about what influences their own behaviour (10 mins).
Human Factors refer to environmental, organisational and job factors as well as human and
individual characteristics which influence behaviour at work in a way which can affect health and
safety.
Making errors is a normal part of being human. Errors occur due to system design and how those
systems influence behaviour.
The system we work with may be set up to ensure we fail “every system is perfectly designed to
achieve the results it gets.” Peter Senge
As the following video shows, we can all be wise in hindsight.
https://www.youtube.com/watch?v=opfXmYlTotc
Access the video at
Figure 22 Captain Hindsight video
18
It is important to plan what we are going to do and try to anticipate the unexpected. However, in real
time we need to adapt that plan to the situation and circumstances we find ourselves in. To be
effective, systems need to be designed to take account of real work situations – when things are
chaotic as well as when things are calm.
‘We cannot change the condition of those who do the work, but we can change the conditions
within which they work’ J Reason
So if we want people to behave differently then we need to change the circumstances in which they
work. In particular, we need to take into account the factors that influence human behaviour.
Instructions to Trainers: Ask learners to consider what they could do in their local area that would
improve infection prevention and control practice. It is important that they identify something that it is
in their power to influence and that is relatively easy for them to achieve.
Use these three questions below to help learners to plan that action (20 mins).
My barrier – What barrier is there to your practice in
Infection Prevention and Control?
My action – What action can you take to improve
practice in this area?
My support need – What support do you need to do
that?
At the conference, delegates wrote their mini action
plan up on postcards that were then displayed on a
‘Wall of Commitment’. Your learners might like to do
something similar with colleagues or they could use the
action planning template (see Appendix II).
Figure 23 Postcards on the 'Wall of Commitment'
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Third Questionnaire (next steps)
These questions were designed to provide a quick evaluation of the conference.
Instruction to Trainers: use these questions to evaluate the learning session. Make the quiz more
relevant to your content (and learners) by adding in your own questions. (3 mins)
Which of today’s themes had the biggest
impact on you personally?
1. Understanding the personal impact of
an infection
2. Awareness and concern of antibiotic
resistance
3. The importance of Standard Infection
Control Precautions
4. Understanding my contribution to
infection prevention
5. Other
Figure 24 Result from Glasgow Conference
After today’s event how familiar are you now
with the Standard Infection Control Precautions
(SICPs)?
1. Very Familiar
2. Familiar
3. Not Familiar
4. Don’t know
Figure 25 Result from Glasgow Conference
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Appendix I
Helen’s Story: Sequence of Events
Helen’s perspective
– what she knows
and understands
about what’s
happening to her.
Helen’s expectations
of what this procedure
would involve (this is
routine).
Helen had been
having problems with
gall stones for number
of years.
What happened?
Notes
Questions raised?
PRE-OP
Surgical removal of the
gall bladder is one of the
most common
operations performed by
the NHS. More than
60K gallbladders are
removed each year.
Was Helen screened
properly prior to
surgery?
Referral to surgeon.
Recommended
keyhole surgery.
MRSA screening
performed 3 weeks
prior to surgery at prescreening clinic.
Clinical risk
assessment.
Informed consent
sought. She was told
there’s always risk of
infection and that the
care management
may change
depending on the
individual’s disease
condition and other
risk factors.
Day 1 operation
Woke up with a wound
across stomach.
IN THEATRE
SSI bundle was
implemented.
She had some a
prophylactic antibiotic
premedication as part
of her induction to
theatre.
When surgeon
attempts key-hole
surgery he finds that
her gall bladder is
inflamed and adhered
to bowel. Has to open
up to have good look
round.
Laparoscopic (keyhole)
cholecystectomy.
Open cholecystectomy
(gall bladder removed
through incision in
abdomen)
What about her
expectations? Did she
properly understand
that the MRSA
screening was just for
MRSA?
Was anything else
missed at this stage?
SSI made up 18.6% of
HAI's based on the last
Scottish Point
Prevalence survey, 2011
[15.9% in 2007].
Was the SSI bundle
properly implemented?
What could have been
missed or gone wrong
at this stage?
Was ventilation
system operating
properly?
Inserting the drain
creates another
‘wound’ – how might
this have increased
risk of infection? Was
it done properly?
Drain inserted to
remove excess fluid.
21
Day 2 HDU
Day 3 discharged.
Helen given Melolin
(low adherent
absorbent dressing)
which she is to change
daily herself.
Day 6
Helen notices redness
on wound. She does
nothing - decides to
wait (why?)
Day 7
Wound sore. She
phones GP Practice
and the DN comes
out.
Day 8-9
Helen feeling sick;
develops thrush.
Day 11 results come
back
POST-OP
She was in HDU for
observation post
operation due to
inflammation (24
hours).
DISCHARGE
Wound checked by
nurse on ward. It
looks clean and dry.
Discharge letter sent
electronically to GP
practice.
DN makes home visit
and notices wound
red. Takes swab.
Phones GP who writes
prescription. Helen
picks that up and
starts treatment.
GP phones to say that
the lab results show
that the bacteria she
has includes a
resistant organism
(MRSA meticillinresistant
staphylococcus
aureus). The antibiotic
she’s taking won’t be
affective. Writes new
prescription.
What did the post op
monitoring reveal?
Was it done
effectively?
Charge nurse on ward –
good audit for hand
hygiene, all procedures
followed (their audit
result 93%)
The information leaflet
should be given to
patient along with a
conversation by the
nurse to make sure she
understands how to take
care of her wound, what
signs to look for that all
is not well, what action
to take, hand hygiene
training.
It would be routine and
reasonable for GP to
prescribe antibiotic that
is most likely to be
effective. GP prescribes
flucloxacillin.
Was the infection
contracted on the
ward? What about
cleanliness/
environmental audits?
What about Standard
Infection Control audit
(which would include
hand hygiene)?
Did Helen understand
how to self- care
following discharge?
What might have gone
wrong with
communication from
hospital to GP
practice?
She’s been prescribed
antibiotic but if this
isn’t the right antibiotic
then she’s taking them
for nothing.
Why did Helen delay
in contacting GP
practice? Problem in
communicating postoperative information?
If infection picked up
earlier would this have
made a difference?
New antibiotic will take
48 hours to kick in –
too little, too late?
Consider longer term
impact of taking
antibiotics.
Did she get further
advice from the DN? If
so, then what would
that have been?
22
Day 12-13
Wound continues to
feel sore. Helen waits
a couple of days for
antibiotic to take
effect.
Day 14 wound starts
to open
Wound leaking, feeling
feverish, shaking,
temperature 38.5.
Abdominal pain and
pus coming through
wound. Phones
NHS24.
The antibiotics make
her feel ill, sick.
The new antibiotic
won’t start taking
effect for 48 hours.
Helen doesn’t get new
antibiotic (vancomycin?)
in time and so she gets
sick.
RE-ADMISSION TO
HOSPITAL
While at A&E she’s
assessed & diagnose
with sepsis. (Signs of
systemic infection.)
Sepsis 6 is a full series
of interventions:
 Administer high
flow oxygen
 Take blood
cultures
 Give broad
spectrum
antibiotics
 Give
intravenous fluid
challenges
 Measure serum
lactate and
haemoglobin
 Measure
accurate hourly
urine output.
Then admitted to
emergency receiving
ward. CT scan
showed deep seated
infection.
Over the last few days
the pressure has been
mounting from the
deep infection and its
now seeping through
the wound. So the
SSI s not located in
the wound itself
(surface) but in the
abdomen, where the
surgery took place.
Within hour she
receives IV antibiotics.
Decision to take her
back to theatre, reopen wound, wash it
out, put in drain to
remove pus.
After 3 days (day 17)
she fails to progress.
She’s diagnosed with
hospital acquired
pneumonia. She’s
given oxygen and
other antibiotics.
She ends up in ITU on
a ventilator for 2 days.
A few days later, when
it looks as if she’s
improving she
develops diarrhoeal
symptoms. She’s
diagnosed quickly with
Start off with broad
spectrum and then
specify once they’re
clearer what the bacteria
is.
As a result of broad
spectrum antibiotics (a
combination of
antibiotics to kill lots of
bacteria) is Clostridium
Difficile.
This occurs naturally in
the gut and when other
bacteria are killed off by
the antibiotics, it allows
the Cdiff to develop.
In mild forms, the best
treatment is to stop
using antibiotics so that
the natural balance of
bacteria in the gut can
be restored.
The problem does
beyond the SSI itself,
to the additional risks
created by all the
interventions: e.g.
more surgery exposing
patient to risk of
anaesthetic, possible
contraction of further
infection, being
immobile so risk of
clots in legs, risks of
being in theatre,
hospital acquired
pneumonia. So not
just about wound
management.
Antibiotics are all toxic
so there are side
effects and you don’t
want to be on them for
longer than necessary.
A person’s risk of
contracting an
infection increases
with every admission
to hospital and for
what duration.
Hence, the ‘domino
effect’.
The alternative
antibiotics used for
resistant organisms
are more toxic.
Was there a full
antibiotic review with a
microbiologist?
Was the PVC IV bag
inserted, maintained
and removed
correctly?
Was everything
documented correctly?
23
Cdiff and is placed in
isolation lab.
After a further two
weeks in hospital she
goes home to recover.
In total she was in
hospital for 4 weeks.
Discharged home
without antibiotics.
Home recovering for a
further 6 weeks.
Why is the infection
resistant?
Use of antibiotics – if
you’re given the wrong
antibiotic to start with
then you’re using it
unnecessarily (it isn’t
going to help you).
What information
might the GP receive
from the hospital (and
when)? GP’s
priorities/concerns?
What questions might
Helen have asked her
GP about what
happened to her?
How might the GP
respond?
24
Appendix II
Strengthening our Defences HAI Awareness Event - Action Plan
Name: _____________________________________
Date: ______________________________________
As part of the above event you have thought about barriers, actions and support needs in
your workplace relating to HAI and associated Standard Infection Control Precautions. This
may influence your practice or may provide an educational opportunity for you and your
colleagues.
Please complete the following template to use as a record of your barrier(s), action(s) and
support need(s) and record the outcome or impact on care.
Barrier – (What barrier is there to your practice in Infection Prevention & Control?)
Action – (What action can you take to improve practice in Infection Prevention &
Control?)
Support Need – (What support do you need to improve practice in Infection
Prevention & Control?)
25
Please tick the Standard Infection Control Precaution/s associated with your action(s)
(select all the apply)
Hand Hygiene
Personal Protective Equipment
Respiratory and Cough Hygiene
Patient Placement
Management of Blood and Body Fluid Spillage
Management of Care Equipment
Control of the Environment
Safe Management of Linen
Safe Disposal of Waste
Occupational Exposure Management
Other aspect of HAI practice- please state
Post event – Implementing your action plan in practice
What did you do to implement a change in practice?
Who was involved?
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Were you successful or unsuccessful in implementing your action(s)? Why?
What has happened as a result of your action(s)? Is there evidence of positive impact
in patient care or outcome?
Please keep this template of your activity as evidence for your personal development
and for discussion with your manager at your development review.
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For further information:
Dr Gill Walker
Sarah Freeman
Programme Director, HAI
NHS Education for Scotland
Westport, 102 Westport,
Edinburgh, EH3 9DN
E-mail: gill.walker@nes.scot.nhs.uk
Direct dial: 0131 656 3375
Educational Projects Manager, HAI
NHS Education for Scotland
2 Central Quay, 89 Hydepark Street
Glasgow, G3 8BW
E-mail: sarah.freeman@nes.scot.nhs.uk
Direct dial: 0141 223 1436
This resource may be made available, in full or summary form, in alternative formats
and community languages. Please contact us on 0131 656 3200 or e-mail
altformats@nes.scot.nhs.uk to discuss how we can best meet your requirements.
NHS Education for Scotland
Westport 102
Edinburgh
EH3 9DN
www.nes.scot.nhs.uk
May 2015
© NHS Education for Scotland 2015. You can copy or reproduce the information in
this document for use within NHSScotland and for non-commercial educational
purposes. Attribution to NES as the copyright holder must be made. Use of this
document for commercial purposes is permitted only with the written permission of
NES.
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