396 / Implementation and practice of infection control

HUNGARY
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Infection control / Prevention of surgical site infections
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Topic of the reported practice
Clinical risk management
Aim and the benefit of the Patient Safety Practice
 
The practice aims at preventing healthcare acquired infections based on a complex set of measures: from medical care to changes in the environment. Its benefits are various, such as reduction in costs, drug usage, length of hospital stay, and in the number of complications.
Description of the Patient Safety Practice
 
MAIN ELEMENTS OF INFECTION CONTROL ACTIVITY

At the start of the program it is vital to compose an Infection Control Manual and thereafter annual actualization of the Infection Control Plan is continuously required.

Hygienic schedule annually with targeted and random surveys and check up programmes both at the departments and at the clinics.

Continuous microbiologic surveillance based on patient charts.

Continuous supervision of the sterilization and disinfection activity.

Microbiologic efficiency surveillance coordination of the sterilization equipment used in the Hospital.

Comprehensive and continuous investigation of the disinfectants used on site. (Mapping of wall mounted dispensers, continuous measurement of disinfectant consumption, annual hand hygiene training)

Targeted environmental bacteriology, sterility investigations and tracking of blood traces, air analysis following the disinfectant cleaning of air conditioning devices.

Surveillance of hand hygiene compliance and surgical scrubbing among staff members twice a year.

Surveillance of clean and dirty linen management.

Surveillance of communal and dangerous waste disposal processes.

Continuous supervision of wound dressings.

Surveillance of the proper use of various protective devices and clothing.

Staff education annually or at any time when the need arises.

The toolkit of the above programme contains numerous forms and appendices (e.g. Form for Nosocomial Multi Resistant Infections, Form for Clostridium Difficile Infections, Data Form for Perioperative Antibiotic Prophylaxis, Hand Hygiene Control Sheet),some of them are enclosed below.
387_WP4_7. sz. mellekeltangol.doc

Implementation:
Units: The program has been introduced in all departments and wards of Zala County Hospital. (22 departments) The installed practice has already been in practice in the Hospital but only in the Departments with High Priority. Full, all-hospital implementation is not compulsory, but preferred. (CDC, WHO). The Hungarian guideline (The practice of hand hygiene in Healthcare and Social Welfare Institutions providing care) issued by the National Epidemiology Centre and the No. 20/2009 (VI.18) ordinance of the Hungarian Health Secretary (About the prevention of Healthcare associated infections and about the professional surveillance and minimum requirements of such activities) also suggests the use of such practice.

Costs: No incremental costs are involved but the program does require human resourced (coordinators).

Evaluation process: The evaluation is planned to be a part of the development process shown below: a) assessment of wall mounted dispensers – creating a map
b) defining the necessary amounts of disinfectants for each ward
c) installation of wall mounted and bedside dispensers
d) completion of disinfectant master list
e) education
f) feedback in writing
g) inspection of hand hygiene compliance (direct observation, microbiology sampling by fluorescent lighting)
h) education
i) assessment, analysis, evaluation.

This project started on 28 May, 2013 and it will continue until 28 May, 2014. Tasks outlined from point “a” to “e” have been realized. A test has been done in October. Education, analysis and evaluation happen continuously. On the basis of our experience so far, the commitment and motivation of the leaders and also that of the staff members is excellent. Our colleagues are happy to participate in the program. Based on inspection survey results on hand hygiene practice, the hand hygiene compliance has improved. Additionally, the rate of nosocomial infections has been showing a decreasing trend.
Attachment of relevant written information and/or photos, as appropriate
387_WP4_7. sz. mellekeltangol.doc
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
LECTURES AND PRESENTATIONS ON THE TOPIC:

1. Infection Control and Antiobiotics Policy
16th. Annual Institutional Postgraduate Training Conference
Szeleste, Hungary
2. XXIXth Congress of the Nursing Section of the Hungarian Society of Infectology and Clinical Microbiology
Szombathely-Kőszeg, Hungary
3. Infection Control and Antiobiotics Policy
17h. Annual Institutional Postgraduate Training Conference
Szeleste, Hungary
4. XXXth Congress of the Nursing Section of the Hungarian Society of Infectology and Clinical Microbiology
Vonyarcvashegy, Hungary
5. Congress of the Association of Hungarian Nursing Directors
Visegrád, Hungary
6. Science Day for Nurses and Technicians
Mosonmagyaróvár, Hungary
7. Infection Control and Antiobiotics Policy
18th. Annual Institutional Postgraduate Training Conference
Zalakaros, Hungary
8. XXXIth Congress of the Nursing Section of the Hungarian Society of Infectology and Clinical Microbiology
Székesfehérvár-Balatonvilágos, Hungary
9. Days of Healthcare in Hungary
Annual Meeting of the Association of Financial Managers in Healthcare
Balatonfüred, Hungary




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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Equipment was not enhanced or new
Lack of incentive
Staff or management did not recognise the need for change
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
Yes
Total number of person days required to implement this Patient Safety Practice
Clinical staff: 40
External consultants: 0
Support staff: 0
Managerial staff: 0
Others: 0
Not relevant: 0
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: 5280
External consultants: 0
Support staff: 288
Managerial staff: 0
Others: 0
Not relevant: 0
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
0
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
0
Contact information
 
Name: Gabor Kecskés
Country: HUNGARY
Organisation: Zala County Hospital
E-mail: minoseg.min@zmkorhaz.hu
Phone: +36 92 507500 Ext. 1101
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