This article discusses infection control guidelines and strategies in Australia's healthcare system. It explores the importance of prevention and control of infectious diseases and highlights the use of the Infection Prevention and Control Assessment Framework (IPCAF) tool.
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Running had: Infection Control in Australia INFECTION CONTROL IN AUSTRALIA Name of the Student Name of the University Authors Note
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1INFECTION CONTROL IN AUSTRALIA Table of Contents Introduction................................................................................................................................2 Background................................................................................................................................2 Baseline measurement................................................................................................................4 Design........................................................................................................................................5 Strategies....................................................................................................................................6 Strength and Limitation..............................................................................................................7 Conclusion..................................................................................................................................9 Ethical issues..............................................................................................................................9 References:...............................................................................................................................10 Appendix A..............................................................................................................................13 PSDA cycle..........................................................................................................................13 IPCFA framework................................................................................................................13 Appendix B..............................................................................................................................13
2INFECTION CONTROL IN AUSTRALIA Introduction Infection control is one of the most crucial features of the healthcare system. Prevention and Control of Infection in Healthcaresystem have guidelines,which are significantly associated with the National Safety and Quality Health Service Standard. NHMRCandtheAustralianHealthcareCommissionmutuallydevelopedinfection preventionand controlguidelines.Infectiousconditionsarisein the body dueto the appearance of bacteria, viruses, fungi and other pathogens in the human body (Aghdassi, Hansen, Bischoff, Behnke & Gastmeier, 2019). It has been observed that a large number of Australian affected by infection during their treatment in hospitals and healthcare centres. Infection prevention and control guidelines aim to reduce the possibilities of contamination and to spread of disease-causing germs. The experts have checked the standards from different fields of biological sciences such as infection and prevention, microbiology and general practice. The audit will be discussed about the baseline measurements, methods and strategies regarding infection prevention and control in patients. The main objective of infection control is to prevent and separate patients from contamination or related potential threats. NSQHS has prevention and control of healthcare infection standard, which are associated with the governance of safety and quality and partnering with consumers. Background Healthcare facilities are of significant importance in today's world. This fact is a result of the fact that the prevalence of infectious disease has been increasing until today. Therefore it can be stated that the need for infection control strategies is essential for the reduction of mortality rates. Other research studies have been performed with the help of the IPCAF tool (Aghdass et al., 2019). The infectious disease includes several bacterial, fungal, viral and
3INFECTION CONTROL IN AUSTRALIA protozoa infections. Intervention strategies are fundamental in controlling the prevalence of the disease. Infection can be controlled by the use of specific intervention plans which are devised by nurses and doctors. These intervention strategies mainly include the improvement of daily life habits and maintain personal significant personal hygiene. Researchers have been performed for the assessment of these intervention strategies to check their efficacy in controlling infectious diseases (World Health Organization., 2018). The evaluation procedure included the use of several tools for the study. One of the essential tools sufficient for the study of infection control strategies is the IPCAF tool. This tool can be abbreviated as "Infection Prevention and Control Assessment Framework at the Facility Level". Intervention plans are essential for controlling infectious diseases at a significant extent so that they can be evaluated based on the question-answer patterned study. Therefore IPCAF tool has been used in different studies for assessing the intervention strategies used to control the infectious diseases.Healthcare-associatedinfectionsareapproximately2,000,000innumberin Australia for each year (White et al., 2019). Infection arises complications in the patient's health by increasing pain and sufferings. The patient families are also affected by infection and contamination in hospital. Prolonged stay at the hospital and costly health care services are some issues for the patient's family (Giesecke, 2017). Healthcare providers such as nurses, doctors and administrators of the hospitals are responsible for the prevention and control of infection. There are several types of infections, such as direct contamination and indirect contamination in the health care industry. The patients, who are acknowledged for a long time in hospitals, are prone to exposure to infection. Around165, 000 patients in Australia are infected in hospitals and acute care facilities (Karalapillai et al.,2013). There is a more significant threat in the eradication of infection exposure by several health care facilities. According to a study, there are 7% of patients are affected by healthcare-associated infections, and this is one of the most significant issues in healthcare industries(van Mourik,
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4INFECTION CONTROL IN AUSTRALIA Troelstra, van Solinge, Moons & Bonten, 2013). Infection-associated disease increases 8.6% of the cost for treatment for the patients (Kirkwood et al., 2018). Baseline measurement The research considered age, sex as baseline data for analysing the intervention for infection control. This project aims to analyse the death of patients due to infection in a hospital. The intervention will be based on the baseline data as these data are associated with the assessment of infecting conditions. Infections can occur for many reasons such as infection related to injection, surgical infection, hand hygiene, PPE or Personal Practice Equipment infection. 1 in 25hospital patients per day is estimated to get affected by hand hygiene in the Australian healthcare system (Azim,Juergens & McLaws, 2016).). A lack of hand hygiene infects one in twenty patients. There are several informations related to the mentioned causes of infection which have been shown by graphs. injection related infectionhand hyglenePersonal Practice Equipments infectionsurgical site infection 0 1 2 3 4 5 6 7 male female Figure 1: Percentage of patients for different types of infections in male and females Source: (Created by author)
5INFECTION CONTROL IN AUSTRALIA Design This study will aim at finding the effectiveness of the infection control strategies implemented in the hospitals in Australia. IPCAF tool has been used here in order to assess the controlling strategies for the infection of human beings related to injection associated infections, hand hygiene-related infections, surgical infections and infections associated to personal practice equipment (Johnson, Roode & Fenton, 2015). This tool is a close structure format of the questionnaire, which is connected to a scoring system. This framework is used in different healthcare facilities which are both acute and inpatient in their settings. A series of questions are asked in the form of a questionnaire, which is related to the four stated infection control strategies. The selection of the above four infection control strategies is of utmost importance in the wellbeing of the patient. This designed study will be performed by the Infection Control Team (IC) appointed for this purpose. IPCAF tool has been devised by the World Health Organisation (WHO), which includes a practical manual supporting a strong implementation of the core IPCAF component (World Health Organization. ,2019). The primary significance of IPCAF tool is related to perform a question-answer based survey procedure for the assessment of the intervention strategies stated earlier. This factor is a self- assessment tool that can be availed and accessed by individual patients. The main goal of the IPCAF tool is to measure the IPC (Intervention Prevention Control) situation inside a healthcare facility. The efficacy of this tool depends on the fact that the objectives have been completed successfully and accurately. Honesty is the primary factor in these question- answer assessment patterns for the efficacy of infection control strategies. Honest answers will help in the creation of a specific sense of urgency to change the needs to improve the IPC. According to these tool strategies, it can be stated that it is essential to calculate the accurate score for the sections and the overall scores.
6INFECTION CONTROL IN AUSTRALIA In summary, it can be said that the IPCAF provides a score which will be used as an indicator. This indicator will give a signal of the progress level from the perspective of the improvement. Action plans involve the implementation of the four intervention strategies involving four different infection control intervention. Eight sections with a choice for answers which will describe the situation of the facility are included in the tool. Multiple and single answer questions are included in the list of questions asked in every core component of the tool. Scores are allocated to each answer which finally provides an overall score to create a visual presentation of the assessment of selected intervention strategies. Strategies The stated PDSA cycle has been used to check the efficacy of the four intervention strategies for infection control in Australian hospitals (Pietrzak & Paliszkiewicz,2015). PDSA cycle aims at implementing ideas to control the outbreak of infections in Australia. PDSA One: The first intervention for controlling the infections is based on controlling the infections associated with injection needles. This cycle length took place for two weeks, and the intervention stated aimed to prevent the use of pre-used injection needles for different individuals. The cycle started here consisted of patient participation of 70%, which allowed the infection control (IC) team to gather proper feedback from the nurses and patients individually (Fink. 2015). After collecting the feedback, it was found that the nurses were very much focussed on the use of IPCAF (Infection Prevention and Control Assessment Framework) method in order to assess the efficacy of the intervention stated above. PDSA Two:
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7INFECTION CONTROL IN AUSTRALIA The second intervention that has been used for this study purpose is hand hygiene. Maintenance of hand hygiene is of significant importance in preventing the initiation of infection caused by pathogens (Stephens et al., 2016). This intervention can be strengthened by using a method of visual presentation in every ward of the hospitals. This strategy will involve the participation of every patient who has been assessed by using IPCAF tool. This strategy is a modification of the third core component of the IPCAF tool (Tartari et al., 2019). This component states that the use of education and training procedures are of significant importance in creating public awareness about the prevalence of the infectious disease. This cycle will mainly focus on questions based on the incidence of infectious disease in Australia to gain some knowledge about the efficacy of the intervention strategies. In this case, the intervention strategy is hand hygiene. A visual presentation about the importance of good hand hygiene provides the patient with a piece of practical knowledge about its role in controlling the infectious disease. PDSA three: The IPCAF tool will be used for three weeks and will focus on the evaluation of the interventions related to the control of the infectious disease. This part will mainly focus on the "F" of IPCAF. This letter "F" in the tool states that this is a framework used to asses the efficacy of the preventive strategies that are taken to control the infectious disease. After the conclusion of the three-week trial, IPCAF was able to provide a justified evaluation of the control plans. This acronym is of significant importance in creating a brief structural framework which can be used by several healthcare facilities to assess their disease control procedures (Donnelly & Kirk, 2015).
8INFECTION CONTROL IN AUSTRALIA Strength and Limitation The research is to analyse standard base data of a hospital with proper baseline data. The IPCAF (Infection Prevention and Control Assessment Framework) is used for the analysis of infection control measures (Harder et al., 2017). Infection control is assessed based on injection-related infection, hand hygiene, surgical infection, PPE(Personal Practice Equipments)related infection among the patients.This framework helps the investigators to get proper answers and clear concepts of infection transmission with reliable feedbacks. The tool is used for three weeks trial experiment, which increases effectiveness among the health workers and mortality in patients are expected to be reduced. The tool is a set of questionnaires which can have some threats of ambiguity in research analysis. The potholes for this intervention method are fewer possibilities of scientific or statistical data or outcomes. The results are dependent on answers that are given by the health workers and patients. As a result, some ambiguities can be found from the feedbacks. The patients and the health workers can refuse to answer some questions which might affect their sense of ethics or privacy. Another issue related to this tool is infections cannot be fully assessed within few weeks trial. QI analysis requires long term sustainability for analysis of infection control condition in a health organisation.The research is to analyse standard base data of a hospital with proper baseline data. The IPCAF (Infection Prevention and Control Assessment Framework) is used for the analysis of infection control measures. Infection control is assessed based on injection-related infection, hand hygiene, surgicalinfection,PPE(PersonalPracticeEquipments)relatedinfectionamongthe patients.This framework helps the investigators to get proper answers and clear concepts of infection transmission with reliable feedbacks. The tool is used for three weeks trial experiment, which increases effectiveness among the health workers and mortality in patients are expected to be reduced.
9INFECTION CONTROL IN AUSTRALIA The tool is a set of questionnaires which can have some threats of ambiguity in research analysis. The potholes for this intervention method are fewer possibilities of scientific or statistical data or outcomes. The results are dependent on answers are given by the health workers and patients; as a result, some ambiguities can be found from the feedbacks. The patients and the health workers can refuse to answer some questions which might affect their sense of ethics or privacy. Another issue related to this tool is infections cannot be fully assessed within few weeks trial. QI analysis requires long term sustainability for analysis of infection control condition in a health organisation. Conclusion This report concludes that for different causes can be assessed and controlled by IPCAF tool, which is a framework proposed by WHO. The framework is to carry out a survey based on a question-answer method for the appraisal of the intervention strategies stated earlier. This component of the framework states that exercise of education and training procedures are of significance in creating public awareness about the prevalence of the infectious disease. The audit proposal is carried out for a better understanding of IPCAF tool in the intervention and prevalence of infection control in the hospital. Ethical issues Surveillance ethics is the most significant ethical issue that arises in the use of IPCAF tool. Cultural factors also become a major ethical issue in for this study procedure. These issues play a major factor while undergoing a question-answer survey procedure. No other ethical problems can be stated to have occurred for the particular study as it was based on a simple question-answer pattern (Vayena, Salathé, Madoff & Brownstein, 2015)
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10INFECTION CONTROL IN AUSTRALIA References: Aghdassi, S. J. S., Hansen, S., Bischoff, P., Behnke, M., &Gastmeier, P. (2019). A national survey on the implementation of key infection prevention and control structures in Germanhospitals:resultsfrom736hospitalsconductingtheWHOInfection Prevention and Control Assessment Framework (IPCAF).Antimicrobial Resistance &InfectionControl,8(1),73.Retrievedfrom: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0532-4 Azim, S., Juergens, C., & McLaws, M. L. (2016). An average hand hygiene day for nurses and physicians: the burden is not equal.American journal of infection control,44(7), 777-781. Retrieved from: https://doi.org/10.1016/j.ajic.2016.02.006 Donnelly,P.,&Kirk,P.(2015).UsethePDSAmodelforeffectivechange management.EducationforPrimaryCare,26(4),279-281.Retrievedfrom: https://www.tandfonline.com/action/showCitFormats? doi=10.1080/14739879.2015.11494356 Fink, A. (2015).How to conduct surveys: A step-by-step guide. Sage Publications. Retrieved from:https://books.google.co.in/books? hl=en&lr=&id=TNOECwAAQBAJ&oi=fnd&pg=PT14&dq=Fink,+A.+(2015). +How+to+conduct+surveys:+A+step-by-step+guide. +Sage+Publications&ots=wu4_SfVVFe&sig=YB9rc1VltW5o- XyOzUofRb0vlbk&redir_esc=y#v=onepage&q=Fink%2C%20A.%20(2015). %20How%20to%20conduct%20surveys%3A%20A%20step-by-step%20guide. %20Sage%20Publications&f=false Giesecke, J. (2017).Modern infectious disease epidemiology.CRC Press. Retrieved from:
11INFECTION CONTROL IN AUSTRALIA content.taylorfrancis.com Harder, T., Takla, A., Eckmanns, T., Ellis, S., Forland, F., James, R., ... & Zuiderent-Jerak, T. (2017).PRECEPT:anevidenceassessmentframeworkforinfectiousdisease epidemiology,preventionandcontrol.Eurosurveillance,22(40).Retrievedfrom: https://dx.doi.org/10.2807%2F1560-7917.ES.2017.22.40.16-00620 Johnson, P. T., De Roode, J. C., & Fenton, A. (2015). Why infectious disease research needs communityecology.Science,349(6252),1259504.Retrievedfrom: 10.1126/science.1259504 Karalapillai, D., Story, D., Hart, G. K., Bailey, M., Pilcher, D., Schneider, A., ... & Bellomo, R. (2013). Postoperative hypothermia and patient outcomes after major elective non‐ cardiacsurgery.Anaesthesia,68(6),605-611.doi:10.1111/anae.12129.Retrieved from: https://doi.org/10.1111/anae.12129 Kirkwood, K. A., Gulack, B. C., Iribarne, A., Bowdish, M. E., Greco, G., Mayer, M. L., ... & Raiten, J. M. (2018). A multi-institutional cohort study confirming the risks of Clostridium difficile infection associated with prolonged antibiotic prophylaxis.The Journal of thoracic and cardiovascular surgery,155(2), 670-678. Retrieved from: https://doi.org/10.1016/j.jtcvs.2017.09.089 Pietrzak, M., & Paliszkiewicz, J. (2015). Framework of Strategic Learning: The PDCA Cycle.Management(18544223),10(2).Retrievedfrom: https://web.a.ebscohost.com/abstract? direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=18544223&AN=110 130672&h=7g1kaAfZ5FcdzKHSKa9ErnUOjDSd6SxAEsz1iaA%2fb %2bMgKt3JtlvaW7grr7rSrd26%2fcyLvZrBDtvfkHXPrQxIbQ%3d
12INFECTION CONTROL IN AUSTRALIA %3d&crl=c&resultNs=AdminWebAuth&resultLocal=ErrCrlNotAuth&crlhashurl=log in.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype %3dcrawler%26jrnl%3d18544223%26AN%3d110130672 Stephens, P. R., Altizer, S., Smith, K. F., Alonso Aguirre, A., Brown, J. H., Budischak, S. A., ...&Ezenwa,V.O.(2016).Themacroecologyofinfectiousdiseases:anew perspective on global‐scale drivers of pathogen distributions and impacts.Ecology Letters,19(9), 1159-1171. Retrieved from: https://doi.org/10.1111/ele.12644 Tartari, E., Fankhauser, C., Peters, A., Sithole, B. L., Timurkaynak, F., Masson-Roy, S., ...&Pittet, D. (2019). Scenario-based simulation training for the WHO hand hygieneself-assessmentframework.AntimicrobialResistance&Infection Control,8(1),58.Retrievedfrom: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0511-9 van Mourik, M. S., Troelstra, A., van Solinge, W. W., Moons, K. G., & Bonten, M. J. (2013). Automatedsurveillanceforhealthcare-associatedinfections:opportunitiesfor improvement.Clinicalinfectiousdiseases,57(1),85-93.Retrievedfrom: https://doi.org/10.1093/cid/cit185 Vayena, E., Salathé, M., Madoff, L. C., & Brownstein, J. S. (2015). Ethical challenges of big data in public health.Retrieved from: https://doi.org/10.1371/journal.pcbi.1003904 White, N. M., Barnett, A. G., Hall, L., Mitchell, B. G., Farrington, A., Halton, K., ... & Gericke, C. A. (2019). Cost-effectiveness of an environmental cleaning bundle for reducinghealthcare-associatedinfections.ClinicalInfectiousDiseases.Retrieved from:https://eprints.qut.edu.au/132396/
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13INFECTION CONTROL IN AUSTRALIA World Health Organization. (2018). Improving the quality of health services: tools and resources.Retrievedfrom: https://apps.who.int/iris/bitstream/handle/10665/310944/9789241515085-eng.pdf World Health Organization. (2019). WHO benchmarks for International Health Regulations (IHR)capacities.Retrievedfrom: https://apps.who.int/iris/bitstream/handle/10665/310944/9789241515085-eng.pdf
14INFECTION CONTROL IN AUSTRALIA Appendix A PSDA cycle The Plan, Do, Study, Act (PDSA) cycle is a technique for quickly analysing a transformation – by planning it, try to execute it, studying or observing the results, and execute or act on the specific situation. This is a scientific method used for action-oriented learning. IPCFA framework The IPCAF is a well structured questionnaire which is formatted closely with a scoring system. This is a self-administered and self-assessment tool, which is used for assessing joints, through cautious considerations among external assessors for example, people from the Ministry of Health, WHO or other stakeholders and staffs of facility department. The primary goal of this framework is to evaluate the situationassociated current IPC in the facility of given institution, that is, existing activities or resources related toIPC, and recognize strengths and gaps that can update plans. This facility tool related to diagnosis is used to detect significant issues or limitations that need improvement and detect areas of development.
15INFECTION CONTROL IN AUSTRALIA Appendix B Check list Component 1 of IPCAF framework QuestionsAnswersScore 1.DoyouhaveanIPC programme? No Yes 2 Is the regulatory IPC programme supported by the team comprising theprofessionalassociatedwith Infection Prevention and Control? No Yes Not a team but a person 3.IsonefulltimeIPC professionalor equivalent(nurse or doctor working 100% in IPC) available in the IPC team? No (IPC professionals) No (part time professional) Yes (one per < =250 beds) Yes (one per >=250 beds) 4.DoestheIPCteamorfocal person have dedicated time for IPC Yes
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