Mrs Rebecca Edgar1, Ms Christine Sharp1, Ms Kaye Bellis1, Ms Pauline Bass1
1Alfred Health, Melbourne, Australia
Cleaning of shared patient equipment and use of personal protective equipment (PPE) is standard care, yet is often sub-optimally performed. In the setting of a carbapenemase-producing Enterobacteriaceae (CPE) outbreak, a program was implemented at our facility to enable hospital-wide auditing and education of healthcare workers to enhance cleaning of shared patient equipment and promote compliance with standard and transmission based precautions (STBP).
A risk matrix was developed to prioritise high-risk clinical areas. A ‘train the trainer’ strategy for engaging local champions was employed, together with face-to-face education of clinical staff. Fluorescent marking of shared patient equipment was utilised to evaluate cleaning processes and a standardised electronic audit tool was used to assess compliance with STBP. Statewide guidelines for CPE screening were implemented, with continuous surveillance.
Over 40 multi-disciplinary staff education sessions were hosted between January and June 2019. Compliance with equipment cleaning increased from 13% to 82% in ICU over this period. Auditing of compliance with application and removal of PPE is ongoing. In the 5-month period prior to implementation, 86 incident cases of CPE were identified. Following implementation, 15 cases were identified during a 3-month period.
A dedicated multimodal program to promote cleaning of shared patient equipment and STBP has improved compliance. This was undertaken as one aspect of a strategic organisation wide campaign to reduce CPE transmission.
Rebecca is a Standard and Transmission Based Precautions Project Coordinator in the Infection Prevention & Healthcare Epidemiology unit at The Alfred hospital in Melbourne. She is currently working towards a Masters in Public Health at James Cook University. Her years of clinical experience in medical & radiology nursing is a major driving force behind her passion for improving patient outcomes.
Christine has held the Infection Prevention portfolio in the Intensive Care Unit at The Alfred hospital in Melbourne. Her extensive nursing career includes her leadership role as a Nurse Unit Manager on a busy respiratory ward specialising in Lung Transplants and Cystic Fibrosis management. As an experienced educator currently working in the Infection Prevention and Healthcare Epidemiology Unit at Alfred Health, she brings valuable skills and a wealth of knowledge as one of the Project Coordinators for Standard and Transmission Based Precautions.