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Welcome to the Infection Control online newsfeed. Here you’ll find all the latest research, news stories, policy updates and guidelines. View our other newsfeeds for more subject-specific news.

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WHO Report: No Time to Wait- Securing the future from drug-resistant infections

World Health Organization | May 2019 | No Time to Wait: Securing the future from drug-resistant infections

A new report from WHO- No Time to Wait: Securing the future from drug-resistant infections– makes recommendations for urgent action in the global response to antimicrobial resistance.

No Time to Wait: Securing the future from drug-resistant infections

Antimicrobial resistance: 2019/20 improvement schemes

Joint NHS England and NHS Improvement Medical Director Professor Stephen Powis has written to CCG Directors of Quality, Nursing and Medicines Optimisation about two new antimicrobial resistance schemes supporting NHS acute providers to implement the five-year UK Antimicrobial Resistance (AMR) national action plan in 2019/20.

The NHS Standard Contract now includes a target of reducing total antibiotic consumption by 1%, from the 2018 baseline, by the end of Q4 2019/20 Commissioning for Quality and Innovation (CQUIN) indicators now includes improving the management of lower urinary tract infections in older people and improving appropriate use of antibiotic surgical prophylaxis in elective colorectal surgery.

Full detail at NHS Improvement

Patient involvement in the implementation of infection prevention and control guidelines

Fernandes Agreli H, Murphy M, Creedon S, et al. | Patient involvement in the implementation of infection prevention and control guidelines and associated interventions: a scoping review | BMJ Open | 2019 | doi: 10.1136/bmjopen-2018-025824

Objective To explore patient involvement in the implementation of infection prevention and control (IPC) guidelines and associated interventions.

Design Scoping review.

Methods A methodological framework was followed to identify recent publications on patient involvement in the implementation of IPC guidelines and interventions. Initially, relevant databases were searched to identify pertinent publications (published 2013–2018). Reflecting the scarcity of included studies from these databases, a bidirectional citation chasing approach was used as a second search step. The reference list and citations of all identified papers from databases were searched to generate a full list of relevant references. A grey literature search of Google Scholar was also conducted.

Results From an identified 2078 papers, 14 papers were included in this review. Our findings provide insights into the need for a fundamental change to IPC, from being solely the healthcare professionals (HCPs) responsibility to one that involves a collaborative relationship between HCPs and patients. This change should be underpinned by a clear understanding of patient roles, potential levels of patient involvement in IPC and strategies to overcome barriers to patient involvement focusing on theprofessional–patient relationship (eg, patient encouragement through multimodal educational strategies and efforts to disperse professional’s power).

Conclusions There is limited evidence regarding the best strategies to promote patient involvement in the implementation of IPC interventions and guidelines. The findings of this review endorse the need for targeted strategies to overcome the lack of role clarity of patients in IPC and the power imbalances between patients and HCPs.

Full document available at BMJ Open

Sepsis e-learning resource

Health Education England have launched an e-learning resource for executive, non-executive and management level staff in trusts on sepsis, incorporating antimicrobial resistance and stewardship.

The learning resource and training programme is designed specifically for boards and senior leaders. It introduces the NHS clinical priorities on these areas and explains how non-clinical leaders can help to improve how we approach sepsis and antimicrobial resistance.

123,000 cases of sepsis occur in England each year with approximately 37,000 deaths annually: this is more than breast, bowel and prostate cancers combined. Prompt recognition of sepsis and rapid intervention will help reduce the number of deaths occurring annually.

The learning materials that are available via this new resource support the early identification and management of sepsis and consists of the following five sessions:

  • Session 1 – Overview of Sepsis
  • Session 2 – Adult Sepsis
  • Session 3 – Childhood Sepsis
  • Session 4 – Complex Sepsis Issues and Future Development
  • Session 5 – Sepsis, Care Homes and the Frail Elderly

Further infomation and how to access the e-learning resource at Health Education England

NHS Long Term Plan to reduce toll of ‘hidden killer’ sepsis

Hospital staff urged to be more alert to ‘hidden killer’ sepsis | via NHS England

Hospital staff must alert senior doctors if patients with suspected sepsis do not respond to treatment within an hour, as part of the NHS Long Term Plan to save thousands more lives. Every trust must take action to spot and treat the killer blood condition, which costs 37,000 lives a year, under guidance that is being mandated by NHS England.

The guidance, drawn up with the Royal College of Physicians, The Royal College of GPs, NICE and the UK Sepsis Trust, states that staff should look for sepsis at an early stage in patients coming to A&Es and those who are already on wards.

Medics must ask consultants for help if patients with suspected sepsis do not respond to treatment within an hour, and hospital teams should also take sufficient note of non-specific symptoms and concerns expressed by relatives and carers such as acute changes in behaviour.

Hospitals will be contractually obliged to ensure they fully comply with the guidance coming in from April.  The initiative comes as the NHS prepares to pilot new clinical standards aimed at providing swifter diagnosis and treatment for patients arriving at A&E with suspected sepsis.

Full story at NHS England

Related guidance: Sepsis guidance implementation advice for adults

Infection control precautions

Standard infection control precautions: national hand hygiene and personal protective equipment policy | NHS Improvement

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This national policy is a practice guide for NHS healthcare staff of all disciplines in all care settings. It covers responsibilities for organisations, staff and infection prevention and control teams. It also sets out how and when to decontaminate hands.

The national policy aims to:

  • support a common understanding (making the right thing easy to do for every patient, every time)
  • reduce variation in practice and standardise care processes
  • improve how knowledge and skills are applied in infection prevention and control
  • help reduce the risk of healthcare-associated infection
  • help to align practice, education, monitoring, quality improvement and scrutiny

Full document: Standard infection control precautions: national hand hygiene and personal protective equipment policy

 Compliance with hand hygiene in emergency medical services: an international observational study

Vikke, H.S. et al | 2019| Compliance with hand hygiene in emergency medical services: an international observational study |

An observational study, published in the Emergency Medicine Journal, identified sub-optimal levels of hand hygiene compliance among emergency medical service indications. 

The study’s results indicate a tendency to self-protection and over-reliance on gloves among emergency medical service providers (less than or equal to 15 per cent).

The research team found average hand hygiene compliance was low (3 per cent) before touching the patient and less than a fifth (19 per cent)  after having touched the patient. Gloves were worn  in more than half (54 per cent) of all hand hygiene indications.

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Abstract

Introduction Healthcare-associated infection caused by insufficient hygiene is associated with mortality, economic burden, and suffering for the patient. Emergency medical service (EMS) providers encounter many patients in different surroundings and are thus at risk of posing a source of microbial transmission. Hand hygiene (HH), a proven infection control intervention, has rarely been studied in the EMS.

Methods A multicentre prospective observational study was conducted from December 2016 to May 2017 in ambulance services from Finland, Sweden, Australia and Denmark. Two observers recorded the following parameters: HH compliance according to WHO guidelines (before patient contact, before clean/aseptic procedures, after risk of body fluids, after patient contact and after contact with patient surroundings). Glove use and basic parameters such as nails, hair and use of jewellery were also recorded.

Results Sixty hours of observation occurred in each country, for a total of 87 patient encounters. In total, there were 1344 indications for HH. Use of hand rub or hand wash was observed: before patient contact, 3%; before clean/aseptic procedures, 2%; after the risk of body fluids, 8%; after patient contact, 29%; and after contact with patient-related surroundings, 38%. Gloves were worn in 54% of all HH indications. Adherence to short or up done hair, short, clean nails without polish and no jewellery was 99%, 84% and 62%, respectively. HH compliance was associated with wearing gloves, but not associated with gender.

Conclusion HH compliance among EMS providers was remarkably low, with higher compliance after patient contacts compared with before patient contacts, and an over-reliance on gloves. We recommend further research on contextual challenges and hygiene perceptions among EMS providers to clarify future improvement strategies.

The full open-access article is available to download from the BMJ