Transcript Current status in rural areas & most PHC facilities: Lacking resources

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
• Epidemiologist
• Microbiologist
• Psychologist
• Teacher
• Preacher
• Economist
• 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