Healthcare Associated Infection (HAI)

“Infection Prevention is Everybody’s Business”

About the Program

The program will achieve a measurable reduction in Healthcare Associated Infection (HAI). Building on facility and jurisdictional initiatives, the program proposes a national and systematic approach to infection control, hand hygiene, health care associated infections and antimicrobial resistance including antibiotic stewardship.

View HAI flow chart (PDF 15 KB)

There are five key initiatives in the overall strategy:

1. National Surveillance System

Aim: To reduce harm to patients from hospital associated infections through the use of surveillance.

As the first of several initiatives to reduce hospital associated infections, this report seeks to explore options for surveillance systems to monitor health care associated infection and provide timely feedback to jurisdictions, managers and clinicians. The result is an evidence-based and authoritative analysis that can promote stronger linkages between other health data systems and with policy makers, and to ensure that the messages derived from surveillance data can be turned into public health action for better health outcomes.This publication was compiled by 51 experts from across Australia and provides an overview of current healthcare associated infections issues and surveillance initiatives in Australia, and a review of international and Australian surveillance literature. This report provides a comprehensive picture of the surveillance of HAI in Australia, demonstrates the costs that these infections impose upon individual Australians and the health system. Each chapter includes recommendations and a summary of key points based on the material presented.

HAI Surveillance Document Editors and Contributors (PDF 24 KB)

Stakeholder consultation on the Reducing harm to patients from healthcare associated infection: the role of surveillance white paper

The Commission is inviting comment on the Reducing harm to patients from healthcare associated infection: the role of surveillance.

A focus of the work of the Australian Commission on Safety and Quality on Health Care (ACSQHC) is on areas of the health system where current and complex problems or community concerns could benefit from urgent national consideration and action. The healthcare associated infection program, nominated as one of the priority areas for 2007/10, aims to develop a national approach to reducing health care associated infection by identifying and addressing systemic problems and gaps, and ensuring comprehensive actions are undertaken in a nationally coordinated way by leaders, decision makers in both public and private health sectors.

As the first of several initiatives, this report seeks to explore options for surveillance systems to monitor health care associated infection and provide timely feedback to jurisdictions, managers and clinicians. The result is an evidence-based and authoritative analysis that can promote stronger linkages between other health data systems and with policy makers, and to ensure that the messages derived from surveillance data can be turned into public health action for better health outcomes.

This report was compiled by 51 experts from across Australia and provides an overview of current healthcare associated infections issues and surveillance initiatives in Australia, and a review of international and Australian surveillance literature. This report provides a comprehensive picture of the surveillance of HAI in Australia, demonstrates the costs that these infections impose upon individual Australians and the health system.

Each chapter includes recommendations and a summary of key points based on the material presented. We greatly appreciate your comments and your assistance in helping us ensure that this strategy is of value to those receiving health services and those working in the field.

A copy of Reducing harm to patients from healthcare associated infection: the role of surveillance and a copy of the key working document to assist with your submission is available for downloaded from the ACSQHC website www.safetyandguality.gov.au

A template is provided to assist should you wish to comment on recommendations from individual chapters.

The ACSQHC will accept written submissions up to 30 September 2008.

Submissions marked "Surveillance of healthcare associated infections" should be forward to:
GPO Box 5480 SYDNEY NSW 2001

Or emailed to:
mail@safetyandquality.gov.au

It should be noted that to ensure maximum transparency all submissions will be published on the Commission's website, including the names of individuals and /or organisations making the submission. The Commission will consider requests to withhold the contents of any submissions made in whole or part.

Reducing harm to patients from healthcare associated infection: the role of surveillance
Consultation re implementation of surveillance recommendations (Template for single chapters)

2. Updated National Infection Control Guidelines

Aim: To improve useability and provide permanent currency of information. The NHMRC has been engaged to carry out this work which will be completed by July 2009.

To ensure permanent currency and greater usability of the National Infection Control Guidelines the Commission has engaged the NHMRC to undertake the revision process to provide Guidelines relevant to infection prevention and control across the broad spectrum of health care settings:

• examination of international guidelines on infection control;
• sourcing feedback on the usefulness and relevance of the current Guidelines produced by the CDNA through stakeholder forums and invitation for submissions;
• the development of an implementation strategy to enhance uptake and adoption including stakeholder consultation throughout the guideline development process;
• the development of contingency and implementation infection control plans for the management of emerging pathogens that require a rapid response (this will be achieved by liaison with the OHP and the CDNA);
• development of educational materials and companion documents for user groups;
• development of indicators and an evaluation and monitoring plan for the guidelines;
• a process by which the guidelines can be monitored and reviewed to maintain currency.

The Stakeholder Forums were held in March 2008 to discuss the key issues for consideration in the revision of the National Infection Control Guidelines.

The National Infection Control Guidelines Project

3. National Hand Hygiene initiative adapted from World Health Organization (WHO) Guidelines on Hand Hygiene in Healthcare

Aim: To leverage existing initiatives beginning with national hand hygiene program to embed local initiatives to enable wider national implementation and provide for sustained monitoring of compliance.

Hand Hygiene has been identified as a high priority for preventing health care associated infection worldwide and forms part of the Commission's healthcare associated infections (HAI) initiative. The Commission has awarded a contract to Austin Health Victoria under the leadership of Professor M Lindsay Grayson, Director of the Infectious Disease Department to undertake the Commission's National Hand Hygiene Initiative. The purpose of the National Hand Hygiene Initiative is to develop a national approach to hand hygiene.

The National Hand Hygiene Project will deliver:

1. Australian hand hygiene guidelines adapted from the WHO — World Alliance for Patient Safety "Clean Care is Safer Care" Program
2. A National Hand Hygiene Initiative Education Strategy based on the Australian hand hygiene guidelines
3. Establishment of clearly defined Outcome Measures for accurate auditing applicable across all health care settings
4. Development of guidelines and audit tool/s based on the Outcome Measures
5. Education program to support the hand hygiene audit tools
6. Development of a mechanism for the electronic collection of outcomes data and information transfer to Hand Hygiene Australia

The first advisory committee meeting was held in Melbourne on Friday 20 June 2008.

Hand Hygiene flyer (PDF 160 KB)
WHO poster - Your 5 moments for Hand Hygiene (PDF 461 KB)

4. Building clinician capacity

Aim: To increase the ability of infection control practitioners by providing them with skills and resources to engage and educate clinicians, managers and healthcare consumers to adopt a collective HAI prevention mindset.

A workshop was held on 26 September 2007 at Bellerive Oval in Hobart for Infection Control Practitioners (PDF 40 KB) from around the country to identify the issues that they saw as important ones facing them as Infection Control Practitioners (ICP). The participants worked in small groups to discuss a range of ICP issues (PDF 22 KB) and Hand Hygiene strategies (PDF 15 KB) that affected infection control practitioners.

Infection Prevention is Everybody's Business Workshop presentation (PDF 448 KB)

An Implementation Advisory Committee, consisting of Infection Control Practitioners from around the country, has been convened to provide technical, systems and / or expert advice and assistance on issues which impact on Infection Control Practitioners. This includes the provision of advice on strategy options and to make recommendations to the Commission on short term and long term implementation strategies around the implementation of Commission’s HAI program initiatives. Membership consistes of 8 clinical experts, 3 academics/researchers who had experience in infection control issues, 1 nominee with experience in the role of the jurisdictions and 2 representatives from the Commission. A list of HAI Implementation Advisory Group Membership Participants is available for viewing or download (PDF 25 KB). Photographs of the members are also available.

Australian Infection Control Association (AICA) Infection Control Practitioners Survey (PDF 86 KB)

The Implementation Advisory Committee is developing strategies to assist Infection Control Practitioners and other health professionals who undertake healthcare associated infection surveillance. A literature review and review of scope of practice in Australian jurisdictions is now being undertaken.

Specific Outcomes and Objectives of this clinical capacity initative are:

• to engage clinicians at a local level;
• development of a communication process to engage senior managers about the role of the ICP in prevention and reduction of HAI's;
• to foster consensus regarding realistic organisational HAI prevention goals and resource allocation based on the use of data for reporting, planning and action including a risk management approach to infection control issues;
• development of a method for estimating the economic impact of HAls as the basis for an annual organisational assessment and development of an annual prevention plan;
• a formalised Mentoring program that targets rural/ isolated and novice Infection Control Practitioners and which supports experienced Infection Control Practitioners to undertake the
• role of mentor;
• the development, endorsement and release of national standardised best practice approaches to eliminating Healthcare Associated Infections.

5. Antibiotic Utilisation

Aim: Development of a national system to monitor antibiotic usage.

Scoping work has commenced. More details of the initiative will be available in August 2008.

HAI Events

Upcoming Events

1 August 2008 - National Hand Hygiene Advisory Committee Teleconference.

13 August 2008 - TICPA Conference, Hobart.

19 August 2008 - HAI Surveillance Document Expert Working Group Meeting 3, Sydney.

7-10 September 2008 - International Symposium on Staphylococci and Staphylococcal Infections, Cairns Convention Centre Cairns.

11 September 2008 - Forum on Antibiotic Stewardship, Sydney.

19 September 2008 - National Hand Hygiene Advisory Committee Meeting 2, Melbourne.

26 September 2008 - HAI Implementation Advisory Committee Meeting 4, Sydney.

8-10 October 2008 - AICA Conference, MCG Victoria.

29-31 October 2008 - National Forum on Safety and Quality in Health Care, Adelaide Convention Centre Adelaide.

12 December 2008 - HAI Implementation Advisory Committee Meeting 5, Sydney.

19 December 2008 - National Hand Hygiene Advisory Committee Meeting 3, Melbourne.

Recent events

6 June 2008 - HAI Implementation Advisory Committee Meeting 3, Sydney.

20 June 2008 - National Hand Hygiene Advisory Committee Meeting 1, Melbourne.

12 May 2008 - Infection Control Guidelines Steering Committee Meeting 2, Sydney.

26 March 2008 - Infection Control Guidelines Steering Committee Meeting 1, Canberra.

7 March 2008 - HAI Implementation Advisory Committee Meeting 2, Sydney.

3-6 March 2008 - NHMRC Infection Control Guidelines Stakeholder Forums.

4 - 5 February 2008 - HAI National Surveillance Expert Working Group Meeting, Sydney.

Links to other HAI websites

Australian Infection Control Association (AICA)
Healthcare Infection Control Special Interest Group (HICSIG)
Australian Group on Antimicrobial Resistance (AGAR)
Australian Society for Antimicrobials
Australian Society for Infectious Diseases
Communicable Diseases Network of Australia
Expert Advisory Group on Antimicrobial Resistance (EAGAR)

Contacts

Marilyn Cruickshank, Program Manager
(02) 9263 3786

Susanne Mouwen, Project Officer
(02) 9263 3641

Email: mail@safetyandquality.gov.au

Updated: 05 August, 2008

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