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 use of standard precautions is a strategy for minimising the transmission of healthcare associated infections, and are recommended to be used for the care of all patients at all times.
Transmission-based precautions are used in addition to standard precautions, where the suspected or confirmed presence of infectious agents represents an increased risk of transmission via contact, droplet, airborne or other route. The application of transmission-based precautions is particularly important in containing multi-resistant organisms and in outbreak management.
The Australian Commission on Safety and Quality in Health Care (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 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:
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 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.
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.
The ICS has developed an audit toolkit aimed to provide additional exemplar audit tools which may be of additional assistance to healthcare facilities.
The use of standard precautions for all patients is the primary strategy for minimising the transmission of infections in health care settings. It is essential that standard precautions are always applied when caring for any patient regardless of their infectious disease status. This is becoming more important as the prevalence of unidentified carriage of multidrug-resistant organism (MRO) in community settings increases.
The practices that form part of standard precautions include:
Transmission-based precautions are applied in addition to standard precautions for patients suspected or confirmed to be infected with specific organisms. The transmission-based precautions required to manage these infections varies according to the route of transmission (airborne, droplet or contact).
Specific transmission-based precautions in addition to standard precautions may involve the use of:
Details of these requirements are found in local facility procedure manuals, state guidelines for management of multi-drug resistant organisms, and the Australian Guidelines for the prevention and control of infection in healthcare.
Patients presenting with, or acquiring, an infection or colonisation with an organism requiring transmission-based precautions, e.g. 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:
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.
Implementation of systems for the safe and appropriate antimicrobial prescribing and use, this includes
Information on healthcare associated infections should be provided to patients, carers, consumers and service providers.
The ACSQHC also has a number of generic resources available, such as a set of standardised standard and transmission-based precautions posters on standard and transmission-based precautions, and sequence for putting on and removing PPE.
Education and courses are available from a number of providers including SA Health elearning, the ACSQHC, The Australasian College for Infection Prevention and Control (ACIPC) and a number of universities. See the SA Health Infection Prevention and Control Education webpage.
For further information on the prevention of healthcare associated infection contact SA Health's Infection Control Service on (08) 7425 7161.