Healthcare associated infections

Infection prevention and control (IPC) for healthcare

The National Australian Guidelines for the Prevention and Control of Infection in Healthcare note that healthcare associated infections (HAIs) are infections acquired as a direct or indirect result of healthcare, and can occur as a result of the provision of healthcare in any setting.

In order to prevent HAIs, it is important to understand how infections occur in healthcare settings and then institute ways to prevent them, which includes the two-tiered approach of standard and transmission-based precautions.

The Australian Commission on Safety and Quality in Healthcare (ACSQHC) National Safety and Quality Health Service (NSQHS) Standard: Preventing and Controlling Infections Standard provides the requirements and recommendations to reduce the risk to patients, consumers and members of the workforce to acquiring preventable infections and effectively manage infections if they occur.

The SA Health Infection Prevention and Control and Healthcare Associated Infection (HAI) Surveillance and Reporting Policy sets out the mandatory requirements that apply across SA Health in relation to infection prevention and control (IPC) and HAIs.

The SA Health Infection Control Service (ICS) coordinates the SA Health HAI surveillance program to monitor the occurrence of specific HAIs and provides state guidelines, tools and resource materials to assist health service providers with HAI prevention for healthcare professionals and consumers.

National Safety and Quality Health Service Standards

The ACSQHC National Safety and Quality Health Service (NSQHS) Standard: Preventing and Controlling Infections Standard intention is to reduce the risk to patients, consumers and members of the workforce of acquiring preventable infections. Implementation of the Standards is mandated in all hospitals, day procedure services and public dental services across Australia.

Health service providers are to ensure the implementation of ACSQHC resources and guides (including Accreditation Guides) are part of achieving compliance with the mandatory NSQHS Standards.

The ICS has developed an audit toolkit aimed to provide additional exemplar audit tools which may be of additional assistance to healthcare facilities.

Clinical governance and quality systems 

The ACSQHC provides information regarding the requirements of Clinical governance and quality improvement systems which must be in place to support and promote prevention and control of healthcare-associated infection, improve antimicrobial stewardship and support sustainable use of infection prevention and control resources, these include:

• integrating infection prevention and control and antimicrobial stewardship into clinical governance and quality systems
• use of a risk management approach when implementing policies, procedures and/or protocols
• undertaking surveillance of healthcare associated infections
• partnering with consumers in their care.
  
  

The Australian Guidelines for the Prevention and Control of Infection in Healthcare outlines core components of an infection prevention and control program.

The SA Health Commissioning Framework outlines the approach by which the Department for Health and Wellbeing (DHW) identifies the health and wellbeing outcomes that need to be achieved by the South Australian health system.

The SA Health Performance Framework outlines the structure by which the DHW monitors, assesses and responds to the performance of public sector health services in South Australia.

Infection prevention and control systems

Strategies for the prevention and control of healthcare associated infections include development, implementation and maintenance of:

• standard and transmission-based precautions
• a hand hygiene program consistent with the ACSQHC National Hand Hygiene Initiative (NHHI)
• systems and protocols for aseptic technique
• systems and protocols for indwelling medical device management
• a clean and hygienic environment; details on protocols and risk assessment for cleaning of the healthcare environment can be found in the SA Health Cleaning Standard for Healthcare Facilities.
• a risk-based health workforce immunisation program.

Managing patients with infection or colonisation

Patients presenting with, or acquiring, an infection or colonisation with a multidrug-resistant organism, Clostridioides difficile, Candida auris or other transmissible infection during their care are identified promptly and receive the necessary management and treatment.

This includes:

• the appropriate use of standard and transmission-based precautions 
• completing a risk assessment for the appropriate placement of patients with infectious diseases and multi-resistant organisms; tools include:
  • Management of infectious diseases summary table (PDF 467KB)
  • Bed management toolkit for infectious diseases and multi-resistant organisms (PDF 415KB)
    
• protocols for communicating a patient’s infectious status on transfer between service providers.

Reprocessing of reusable equipment and devices

Reprocessing of reusable equipment and medical devices must meet current best practice and is consistent with relevant national standards.  Health service organisation must minimise infection risks to patients and the workforce by ensuring adequate identification of, and procedures for reprocessing, reusable medical equipment.

Antimicrobial stewardship (AMS)

Implementation of systems for the safe and appropriate antimicrobial prescribing and use, this includes

• monitoring of antimicrobial usage
• monitoring and surveillance of antimicrobial resistant organisms
• National alert system for critical antimicrobial resistance (CARAlert).

Communicating with patients and carers

Information on healthcare associated infections should be provided to patients, carers, consumers and service providers.

Further information

For further information on the prevention of healthcare associated infection contact SA Health's Infection Control Service on (08) 7425 7161.