Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Presentation at 2007 Annual Meeting of VA Patient Safety Managers and OfficersNoel Eldridge
This presentation was for 150 or so Dept of VA Patient Safety managers with and for whom I worked at VA Central Office while they worked at the VA Medical Centers and Network offices. The main items of interest are the preliminary work that I was describing from the periphery of the then developing VA MRSA Prevention Program, which was quite successful and led by Dr. Rajiv Jain (and published in NEJM: http://www.nejm.org/doi/full/10.1056/NEJMoa1007474#t=abstract). Also of interest is the wide-ranging work that VA NCPS led on the follow up on an OIG report that identified problems in some of VA's operating rooms. Also of interest is slide 36 where I present some interesting data on VA's reduction in unadjusted inpatient mortality - this hasn't been widely publicized or published to my knowledge. The second to last slide refers to the fact that the day after the meeting I was going to the Grand Canyon and planning to hike to the bottom one day and out the next day. That turned out to be a great experience.
Purpose of the Call:
Call attendees will learn:
•About the importance of participating in MedRec Quality Audit Month
•How to participate in MedRec Quality Audit Month
•About the use of the MedRec Quality Audit tool (i.e. who should use it and how)
•Tips on the proper use of the tool and the Patient Safety Metrics System
•Where they can access MedRec Quality Audit Month tools and resources
Access the webinar: http://bit.ly/1xVtmDn
Description of the Call:
Objectives:
•To review the results of the Canadian Falls Audit Month 2015
•To discuss lessons learned from the audit month – strengths and areas for improvement
•To gather ideas about how to improve the information submitted on falls prevention
WATCH: http://bit.ly/1RkG84k
Sandra Maddock, RN, BSN, CCRA and President of IMARC Research, Inc. presents on Applying FDA’s Risk-Based Approach in an audio conference on September 11, 2012.
Risk-based Monitoring Strategies for Improved Clinical Trial PerformanceCognizant
To address draft regulatory guidance for risk-based clinical trial monitoring, sponsors should consider strategies that utilize social, mobile, analytics and cloud technologies to create responsive methodologies that satisfy both the spirit and the letter of these new guidelines.
CDISC & Risk Based Monitoring to Compress Clinical Trial DurationClinical Data Inc .
Technology adoption in the clinical trial space has lagged other industries resulting in high cost / risk of new drug development and ongoing safety concerns of clinical trials.
The focus of this presentation is to educate bio-pharma companies, data managers and CROs on technological advances in the clinical trial space.
Oct 24 CAPHC Breakfast Symposium - Sponsored by Hitachi, CGI, Evident and I...Glenna Gosewich
The document discusses methods for improving patient safety through data analysis and trigger tools. It provides an overview of trigger tools and their use in identifying adverse events. It also describes an example use case where trigger tools are automated through natural language processing and analytics to rapidly identify triggers from patient data. Expanding use of real-time trigger detection and adverse event prevention is discussed.
The document introduces the Falls Audit Tool for home care. It discusses why falls prevention is important for older adults, noting that falls are a leading cause of injury and that repeated falls can negatively impact independence and health. It then provides an overview of the Falls Audit Tool, which is used to retrospectively review client charts and measure falls prevention processes. The tool consists of a series of columns to record information about risk assessments, care planning, interventions, monitoring after falls, and more. Guidance is provided on how to complete the audit accurately and submit data through the Patient Safety Metrics system.
Presentation at 2007 Annual Meeting of VA Patient Safety Managers and OfficersNoel Eldridge
This presentation was for 150 or so Dept of VA Patient Safety managers with and for whom I worked at VA Central Office while they worked at the VA Medical Centers and Network offices. The main items of interest are the preliminary work that I was describing from the periphery of the then developing VA MRSA Prevention Program, which was quite successful and led by Dr. Rajiv Jain (and published in NEJM: http://www.nejm.org/doi/full/10.1056/NEJMoa1007474#t=abstract). Also of interest is the wide-ranging work that VA NCPS led on the follow up on an OIG report that identified problems in some of VA's operating rooms. Also of interest is slide 36 where I present some interesting data on VA's reduction in unadjusted inpatient mortality - this hasn't been widely publicized or published to my knowledge. The second to last slide refers to the fact that the day after the meeting I was going to the Grand Canyon and planning to hike to the bottom one day and out the next day. That turned out to be a great experience.
Purpose of the Call:
Call attendees will learn:
•About the importance of participating in MedRec Quality Audit Month
•How to participate in MedRec Quality Audit Month
•About the use of the MedRec Quality Audit tool (i.e. who should use it and how)
•Tips on the proper use of the tool and the Patient Safety Metrics System
•Where they can access MedRec Quality Audit Month tools and resources
Access the webinar: http://bit.ly/1xVtmDn
Description of the Call:
Objectives:
•To review the results of the Canadian Falls Audit Month 2015
•To discuss lessons learned from the audit month – strengths and areas for improvement
•To gather ideas about how to improve the information submitted on falls prevention
WATCH: http://bit.ly/1RkG84k
Sandra Maddock, RN, BSN, CCRA and President of IMARC Research, Inc. presents on Applying FDA’s Risk-Based Approach in an audio conference on September 11, 2012.
Risk-based Monitoring Strategies for Improved Clinical Trial PerformanceCognizant
To address draft regulatory guidance for risk-based clinical trial monitoring, sponsors should consider strategies that utilize social, mobile, analytics and cloud technologies to create responsive methodologies that satisfy both the spirit and the letter of these new guidelines.
CDISC & Risk Based Monitoring to Compress Clinical Trial DurationClinical Data Inc .
Technology adoption in the clinical trial space has lagged other industries resulting in high cost / risk of new drug development and ongoing safety concerns of clinical trials.
The focus of this presentation is to educate bio-pharma companies, data managers and CROs on technological advances in the clinical trial space.
Oct 24 CAPHC Breakfast Symposium - Sponsored by Hitachi, CGI, Evident and I...Glenna Gosewich
The document discusses methods for improving patient safety through data analysis and trigger tools. It provides an overview of trigger tools and their use in identifying adverse events. It also describes an example use case where trigger tools are automated through natural language processing and analytics to rapidly identify triggers from patient data. Expanding use of real-time trigger detection and adverse event prevention is discussed.
The document introduces the Falls Audit Tool for home care. It discusses why falls prevention is important for older adults, noting that falls are a leading cause of injury and that repeated falls can negatively impact independence and health. It then provides an overview of the Falls Audit Tool, which is used to retrospectively review client charts and measure falls prevention processes. The tool consists of a series of columns to record information about risk assessments, care planning, interventions, monitoring after falls, and more. Guidance is provided on how to complete the audit accurately and submit data through the Patient Safety Metrics system.
A project was initiated at Lakeland Regional Health to improve patient readiness for surgical cases by ensuring required documents and physician orders were received by noon the day before surgery. The initial patient readiness rate was only 41% but through process changes, the goal of 80% readiness has been consistently met since October 2014. A multidisciplinary team standardized processes, developed technology tools like an electronic tracking board, and held physicians accountable through performance scorecards. As a result, patient safety has increased by reducing delays from missing paperwork.
The document provides an introduction to the Surgical Site Infection (SSI) Audit Tool. It describes the objectives of the tool which are to retrospectively review patient charts and measure processes to help drive continuous improvement in preventing SSIs. The tool measures adherence to best practices across pre-operative, peri-operative, and post-operative periods using a series of yes/no questions. Hospitals are encouraged to begin using the tool to collect monthly SSI data and track their progress towards reduction goals. Support is available from Central Measurement Team and SSI experts to help sites implement and utilize the audit tool.
This document introduces a new tool to assess the quality of admission medication reconciliation (MedRec) processes. The tool allows hospitals to collect patient-level data on key determinants of admission MedRec quality. It focuses on the three core steps of MedRec: collecting a best possible medication history, comparing it to admission orders, and correcting any discrepancies. The tool is designed for easy data submission and analysis through an online system. Using this tool, hospitals can identify specific areas in their MedRec processes needing improvement by quantifying how well each step is performed.
Lakeland Regional Health initiated a project in 2013 to improve patient readiness for surgical cases. The goal was to increase patient safety, decrease delays, and improve the patient experience. They defined patient readiness as receiving all required documents by noon the day before surgery. Initially only 41% of patients met this criteria, but through process changes they achieved over 80% readiness each month since 2014. Key changes included tracking documents electronically, notifying doctors of missing information, and rescheduling cases if documents were not received in time.
If you had time for an open discussion with our MyRBQM® Academy instructors, what would you ask Johann, Jo, Linda, or Artem? In our monthly Ask the Expert webinars, we give you that chance. These webinars will focus on trending topics in the area of risk-based quality management (RBQM) - like remote and adaptive monitoring, centralized statistical monitoring, change management, predictive analytics... and more.
Besides a 20-minute Q&A session, our industry experts Jo Burmester and Dr Johann Proeve will dive into:
- How things might change while going forward post-COVID-19
- Statistical guidance for trials impacted by COVID-19
Learn more about MyRBQM Academy here: https://cyntegrity.com/myrbqm-academy/
This document discusses the paradigm shift towards quality management systems and risk-based monitoring at clinical research sites. It emphasizes that sites must adapt to industry standards like risk-based principles in order to ensure data quality and validity. A successful site will implement a quality management system through preventative measures like risk assessment and auditing. This helps identify issues, ensure compliance, and mitigate risks to subjects, data and the site's sustainability.
The document discusses indicators for accrediting infection control units and hospitals. It proposes assessing structure, process, and outcomes, including monitoring incidence of multidrug-resistant organisms, adherence to infection control guidelines, and environmental cleaning. Outcome indicators like infection and colonization rates are prioritized. Risk stratification into categories like low, medium, and high is recommended based on national guidelines and expert opinion. Both resident and ward-level factors should be considered.
This document describes the Pediatrix Clinical DataWarehouse and its role in quality improvement initiatives for neonatal medicine. The Clinical DataWarehouse contains clinical data on over 700,000 patients and is one of the largest databases for neonatal outcomes. Data from electronic medical records is extracted and analyzed to identify areas for improvement. Quality improvement projects are developed and tracked using the QualitySteps system. Analyzing outcomes data allows Pediatrix to benchmark performance and drive continuous quality improvement that improves patient care.
After reviewing the FDA regulations on Risk Based Monitoring, review the details on how to put the principles into action! We include two reference documents to help you get started... and to make it a success.
Mary Lewis presented "Medical Device Development Lifecycle: Demonstrating Clinical Utility" at the Regulatory & Quality Solutions’ Medical Device Breakfast Briefing held at JumpStart, September 11, 2014.
Purpose of the Webinar
1.Describe the process of developing an undergraduate MedRec IPE Event involving > 480 senior Medicine, Pharmacy and Nursing students;
2.Explain the logistics of conducting the event in multiple venues and urban/remote locations;
3.Discuss the successes and challenges of communicating MedRec patient safety concepts through this process; and
4.Describe future opportunities for enhancing undergraduate MedRec training in an interprofessional environment.
Watch the webinar recording: http://bit.ly/1fSqsqv
Purpose of the Call:
•Review the results of the Canadian MedRec Audit Month
•Discuss lessons learned from the audit month – strengths and areas for improvement
•Suggest future value of audits and audit tools for your organization
•Gather ideas about how to improve the quality of MedRec at admission
Watch the recorded webinar: http://bit.ly/19aUYbU
Increasing your Value-Based Purchasing Score through 5 Patient Rounding Best ...Qualtrics
This document discusses best practices for implementing a patient rounding program to improve a hospital's Value-Based Purchasing score. It recommends 5 key steps: 1) design the rounding experience for end users, 2) make a plan and outline the process, 3) evaluate opportunities with change agents by reviewing data, 4) drive actions by addressing issues found and facilitating connections between departments, and 5) use data to create accountability through dashboards and reports. Implementing an effective rounding program requires leadership buy-in, mapping the process, inviting various departments to review data, designing structured questions, and driving follow-up actions to address issues in a coordinated way.
Botswana has a high rate of tuberculosis (TB) transmission in healthcare settings. A training package developed by the Centers for Disease Control and Prevention (CDC) was piloted in 10 Botswanan health facilities to improve TB infection control practices. Facilities were assessed at baseline and 6 months following training. A color-coded dashboard tracked implementation of key practices, with red indicating those not being done. On average, implementation improved from 65% red at baseline to 19% red after 6 months. The pilot demonstrated the training package was effective at positively changing infection control practices.
Explaining the Different Types of Routine Monitoring VisitsAnand Butani
In the clinical research industry, there are several types of basic monitoring visits that everyone involved in it should differentiate, especially CRAs (monitors). A CRA (clinical research associate) or a monitor is the person responsible for visiting a site in order to ensure that the clinical trial is being conducted properly. The CRA’s tasks include on-site visits and ensuring compliance, subjects’ safety, data quality and integrity, etc. Although clinical trials belong in the medical field, a CRA doesn’t have to be a doctor or a medical professional. It’s enough if a CRA has a background in Life Sciences, past experience in clinical trials (most often as a coordinator), and the proper training.
The main monitoring visits are the Site Selection Visit, Site Initiation Visit, Regular (Interim) Monitoring Visits, Site Close-Out Visit, and the Pre-Audit Visit. Out of all these monitoring visits, here we’ll pay more attention to the Routine Monitoring Visits, as one of the most frequent and important visits at a site.
Chapter 2 Patient Safety and Risk Managementczvelasco4248
This document outlines learning objectives and content about patient safety and risk management in the perioperative setting. It discusses the roles of major regulatory organizations in patient safety and initiatives like the Universal Protocol. Key aspects of risk reduction covered include handoffs, counts, specimen handling, and maintaining fluid/electrolyte balance. Nursing safety issues and ensuring patient rights through informed consent are also addressed.
Dr. Ralf Kaiser discusses challenges and the future of risk-based monitoring in clinical trials. Some key challenges include getting approval from pharmaceutical companies and investigator sites for the new paradigm, training site personnel on new technical approaches, and ensuring compatible systems between CROs and sponsors. Over time, Dr. Kaiser envisions a transition to a common global database managed by regulatory authorities where most clinical trials are informed by big data rather than conducted de novo, with only confirmation studies involving limited subjects.
The document provides directions for a nursing assignment involving developing an evidence-based quality improvement campaign. Students will select a safe nursing process, research best practices, and develop a poster and worksheet presenting their campaign. The worksheet requires outlining a PDSA cycle to test a change to improve compliance. An example worksheet is included showing a "Clip, Don't Nick" initiative to switch from shaving to clipping surgical sites based on infection risk evidence. The poster must address the problem scope, safety link, evidence source, and plan. The assignment is due by a specified date and will be graded based on a rubric.
MAST and its application in RENEWING HEALTHAnna Kotzeva
This document discusses the Model for Assessment of Telemedicine (MAST) and its application in the RENEWING HEALTH project. MAST provides a comprehensive framework for the multidisciplinary assessment of telemedicine, including preceding considerations, assessment across multiple domains, and evaluating transferability. The RENEWING HEALTH project applies MAST to evaluate telemedicine interventions for diabetes, COPD and CVD across multiple outcomes like clinical effectiveness, user perspectives, economic impacts and organizational effects. Common tools were developed to ensure quality and comparability, including a minimum dataset, common templates, and guidance for analysis and reporting. By validating MAST across diverse settings, the project aims to establish an accepted methodology for complex telemedicine evaluations.
The Integrated Disease Surveillance Project (IDSP) aims to establish a decentralized disease surveillance system in India to improve disease control. It integrates existing surveillance programs, coordinates surveillance activities, and establishes quality data collection, analysis, and feedback using information technology. The IDSP covers diseases like malaria, acute diarrheal diseases, tuberculosis, and measles. It is implemented in phases across states and union territories of India and involves strengthening laboratories, training health professionals, and creating an IT network to link surveillance sites. The goal is to provide data to enable efficient public health decision making and interventions for priority diseases.
Dr. Mary Ann Lansang teaches us how to use the concepts of evidence-based medicine in our daily lives as infection prevention and control practitioners
A project was initiated at Lakeland Regional Health to improve patient readiness for surgical cases by ensuring required documents and physician orders were received by noon the day before surgery. The initial patient readiness rate was only 41% but through process changes, the goal of 80% readiness has been consistently met since October 2014. A multidisciplinary team standardized processes, developed technology tools like an electronic tracking board, and held physicians accountable through performance scorecards. As a result, patient safety has increased by reducing delays from missing paperwork.
The document provides an introduction to the Surgical Site Infection (SSI) Audit Tool. It describes the objectives of the tool which are to retrospectively review patient charts and measure processes to help drive continuous improvement in preventing SSIs. The tool measures adherence to best practices across pre-operative, peri-operative, and post-operative periods using a series of yes/no questions. Hospitals are encouraged to begin using the tool to collect monthly SSI data and track their progress towards reduction goals. Support is available from Central Measurement Team and SSI experts to help sites implement and utilize the audit tool.
This document introduces a new tool to assess the quality of admission medication reconciliation (MedRec) processes. The tool allows hospitals to collect patient-level data on key determinants of admission MedRec quality. It focuses on the three core steps of MedRec: collecting a best possible medication history, comparing it to admission orders, and correcting any discrepancies. The tool is designed for easy data submission and analysis through an online system. Using this tool, hospitals can identify specific areas in their MedRec processes needing improvement by quantifying how well each step is performed.
Lakeland Regional Health initiated a project in 2013 to improve patient readiness for surgical cases. The goal was to increase patient safety, decrease delays, and improve the patient experience. They defined patient readiness as receiving all required documents by noon the day before surgery. Initially only 41% of patients met this criteria, but through process changes they achieved over 80% readiness each month since 2014. Key changes included tracking documents electronically, notifying doctors of missing information, and rescheduling cases if documents were not received in time.
If you had time for an open discussion with our MyRBQM® Academy instructors, what would you ask Johann, Jo, Linda, or Artem? In our monthly Ask the Expert webinars, we give you that chance. These webinars will focus on trending topics in the area of risk-based quality management (RBQM) - like remote and adaptive monitoring, centralized statistical monitoring, change management, predictive analytics... and more.
Besides a 20-minute Q&A session, our industry experts Jo Burmester and Dr Johann Proeve will dive into:
- How things might change while going forward post-COVID-19
- Statistical guidance for trials impacted by COVID-19
Learn more about MyRBQM Academy here: https://cyntegrity.com/myrbqm-academy/
This document discusses the paradigm shift towards quality management systems and risk-based monitoring at clinical research sites. It emphasizes that sites must adapt to industry standards like risk-based principles in order to ensure data quality and validity. A successful site will implement a quality management system through preventative measures like risk assessment and auditing. This helps identify issues, ensure compliance, and mitigate risks to subjects, data and the site's sustainability.
The document discusses indicators for accrediting infection control units and hospitals. It proposes assessing structure, process, and outcomes, including monitoring incidence of multidrug-resistant organisms, adherence to infection control guidelines, and environmental cleaning. Outcome indicators like infection and colonization rates are prioritized. Risk stratification into categories like low, medium, and high is recommended based on national guidelines and expert opinion. Both resident and ward-level factors should be considered.
This document describes the Pediatrix Clinical DataWarehouse and its role in quality improvement initiatives for neonatal medicine. The Clinical DataWarehouse contains clinical data on over 700,000 patients and is one of the largest databases for neonatal outcomes. Data from electronic medical records is extracted and analyzed to identify areas for improvement. Quality improvement projects are developed and tracked using the QualitySteps system. Analyzing outcomes data allows Pediatrix to benchmark performance and drive continuous quality improvement that improves patient care.
After reviewing the FDA regulations on Risk Based Monitoring, review the details on how to put the principles into action! We include two reference documents to help you get started... and to make it a success.
Mary Lewis presented "Medical Device Development Lifecycle: Demonstrating Clinical Utility" at the Regulatory & Quality Solutions’ Medical Device Breakfast Briefing held at JumpStart, September 11, 2014.
Purpose of the Webinar
1.Describe the process of developing an undergraduate MedRec IPE Event involving > 480 senior Medicine, Pharmacy and Nursing students;
2.Explain the logistics of conducting the event in multiple venues and urban/remote locations;
3.Discuss the successes and challenges of communicating MedRec patient safety concepts through this process; and
4.Describe future opportunities for enhancing undergraduate MedRec training in an interprofessional environment.
Watch the webinar recording: http://bit.ly/1fSqsqv
Purpose of the Call:
•Review the results of the Canadian MedRec Audit Month
•Discuss lessons learned from the audit month – strengths and areas for improvement
•Suggest future value of audits and audit tools for your organization
•Gather ideas about how to improve the quality of MedRec at admission
Watch the recorded webinar: http://bit.ly/19aUYbU
Increasing your Value-Based Purchasing Score through 5 Patient Rounding Best ...Qualtrics
This document discusses best practices for implementing a patient rounding program to improve a hospital's Value-Based Purchasing score. It recommends 5 key steps: 1) design the rounding experience for end users, 2) make a plan and outline the process, 3) evaluate opportunities with change agents by reviewing data, 4) drive actions by addressing issues found and facilitating connections between departments, and 5) use data to create accountability through dashboards and reports. Implementing an effective rounding program requires leadership buy-in, mapping the process, inviting various departments to review data, designing structured questions, and driving follow-up actions to address issues in a coordinated way.
Botswana has a high rate of tuberculosis (TB) transmission in healthcare settings. A training package developed by the Centers for Disease Control and Prevention (CDC) was piloted in 10 Botswanan health facilities to improve TB infection control practices. Facilities were assessed at baseline and 6 months following training. A color-coded dashboard tracked implementation of key practices, with red indicating those not being done. On average, implementation improved from 65% red at baseline to 19% red after 6 months. The pilot demonstrated the training package was effective at positively changing infection control practices.
Explaining the Different Types of Routine Monitoring VisitsAnand Butani
In the clinical research industry, there are several types of basic monitoring visits that everyone involved in it should differentiate, especially CRAs (monitors). A CRA (clinical research associate) or a monitor is the person responsible for visiting a site in order to ensure that the clinical trial is being conducted properly. The CRA’s tasks include on-site visits and ensuring compliance, subjects’ safety, data quality and integrity, etc. Although clinical trials belong in the medical field, a CRA doesn’t have to be a doctor or a medical professional. It’s enough if a CRA has a background in Life Sciences, past experience in clinical trials (most often as a coordinator), and the proper training.
The main monitoring visits are the Site Selection Visit, Site Initiation Visit, Regular (Interim) Monitoring Visits, Site Close-Out Visit, and the Pre-Audit Visit. Out of all these monitoring visits, here we’ll pay more attention to the Routine Monitoring Visits, as one of the most frequent and important visits at a site.
Chapter 2 Patient Safety and Risk Managementczvelasco4248
This document outlines learning objectives and content about patient safety and risk management in the perioperative setting. It discusses the roles of major regulatory organizations in patient safety and initiatives like the Universal Protocol. Key aspects of risk reduction covered include handoffs, counts, specimen handling, and maintaining fluid/electrolyte balance. Nursing safety issues and ensuring patient rights through informed consent are also addressed.
Dr. Ralf Kaiser discusses challenges and the future of risk-based monitoring in clinical trials. Some key challenges include getting approval from pharmaceutical companies and investigator sites for the new paradigm, training site personnel on new technical approaches, and ensuring compatible systems between CROs and sponsors. Over time, Dr. Kaiser envisions a transition to a common global database managed by regulatory authorities where most clinical trials are informed by big data rather than conducted de novo, with only confirmation studies involving limited subjects.
The document provides directions for a nursing assignment involving developing an evidence-based quality improvement campaign. Students will select a safe nursing process, research best practices, and develop a poster and worksheet presenting their campaign. The worksheet requires outlining a PDSA cycle to test a change to improve compliance. An example worksheet is included showing a "Clip, Don't Nick" initiative to switch from shaving to clipping surgical sites based on infection risk evidence. The poster must address the problem scope, safety link, evidence source, and plan. The assignment is due by a specified date and will be graded based on a rubric.
MAST and its application in RENEWING HEALTHAnna Kotzeva
This document discusses the Model for Assessment of Telemedicine (MAST) and its application in the RENEWING HEALTH project. MAST provides a comprehensive framework for the multidisciplinary assessment of telemedicine, including preceding considerations, assessment across multiple domains, and evaluating transferability. The RENEWING HEALTH project applies MAST to evaluate telemedicine interventions for diabetes, COPD and CVD across multiple outcomes like clinical effectiveness, user perspectives, economic impacts and organizational effects. Common tools were developed to ensure quality and comparability, including a minimum dataset, common templates, and guidance for analysis and reporting. By validating MAST across diverse settings, the project aims to establish an accepted methodology for complex telemedicine evaluations.
The Integrated Disease Surveillance Project (IDSP) aims to establish a decentralized disease surveillance system in India to improve disease control. It integrates existing surveillance programs, coordinates surveillance activities, and establishes quality data collection, analysis, and feedback using information technology. The IDSP covers diseases like malaria, acute diarrheal diseases, tuberculosis, and measles. It is implemented in phases across states and union territories of India and involves strengthening laboratories, training health professionals, and creating an IT network to link surveillance sites. The goal is to provide data to enable efficient public health decision making and interventions for priority diseases.
Dr. Mary Ann Lansang teaches us how to use the concepts of evidence-based medicine in our daily lives as infection prevention and control practitioners
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
The document outlines the chapters and components of the January 2022 National Healthcare Safety Network (NHSN) Patient Safety Component Manual. It describes the seven NHSN components, including the Patient Safety Component which covers device-associated infections, procedure-associated infections, antimicrobial use and resistance, and multidrug-resistant organisms. It provides an overview of each component's modules and their focus on specific infection types, practices, or outcomes related to patient and healthcare personnel safety.
This document provides resources for strengthening infection prevention and control (IPC) in primary care. It discusses how the COVID-19 pandemic showed the importance of IPC at the first point of patient entry. Data shows poor IPC in primary care facilities globally. The document offers IPC standards, measurement tools, and implementation guidance. It includes the WHO IPC minimum requirements and details how to meet each requirement. Implementation resources provide strategies like WHO's multimodal approach. The document aims to support primary care facilities in developing and implementing effective IPC programs.
The document discusses the need for an infection control committee and outlines its proposed responsibilities. It describes different types of infections that can be acquired in a hospital setting. It also summarizes the key components of an infection control program, including surveillance, preventative activities, staff training, and an infection control manual. The roles of the infection control team and committee are defined in establishing standards and policies to minimize hospital-acquired infections.
This document provides guidance for the Clinical Outcomes Publication (COP) program, which publishes quality measures from National Clinical Audits at the consultant, team, and unit level. It covers topics like quality measures, data quality, outlier identification and management, legal considerations, and more. The goal of COP is to improve clinical quality and support transparency by learning from high performers and celebrating excellence. Participating audits are expected to report risk-adjusted mortality as well as additional specialty-specific quality measures of importance to patients.
The document describes a quality improvement project to increase hand hygiene compliance at a hospital. Baseline data showed compliance was only 26%. A team analyzed the problem and identified solutions. These included an awareness training program, educational materials, ensuring hand hygiene supplies, and involving leaders. Regular audits and feedback to staff on compliance will also be implemented. The plan is to improve compliance to 90% by March 2014 through these multi-pronged interventions.
This document outlines the steps for developing quality standards for clinical and managerial functions of healthcare services. It begins by having organizations identify high-volume, high-risk, or problem-prone functions that would benefit from quality standards. As an example, it identifies immunization services. The next steps are to identify the inputs, processes, and outcomes of the selected function, and then define quality characteristics for key elements. Finally, standards are developed by writing statements, guidelines, algorithms, or pathways to clearly define the quality characteristics. The document provides examples of applying these steps to develop quality standards for immunization services.
The document discusses the standards and process for NABH accreditation of hospitals in India. It describes the components that go into developing the standards, which are organized around important hospital functions. The accreditation process involves surveyors conducting interviews, reviewing documents, and visiting patient care areas to assess compliance with over 100 standards across 10 chapters. Surveyors score hospitals on a scale of 0 to 10 for each standard based on the degree of compliance observed. Hospitals must meet minimum average scores in each standard, chapter, and overall to receive NABH accreditation.
Hand hygiene knowledge & practices among healthcare providers in a tertiary h...MASUM BILLAH
This study assessed hand hygiene knowledge, attitudes, and practices among healthcare providers at a tertiary hospital in Nigeria. A cross-sectional survey was administered to 500 doctors and nurses to understand their handwashing behaviors and identify barriers. While most providers had good knowledge and positive attitudes, actual handwashing compliance before and after patient contact was only around 60-70%. Factors like heavy workloads, lack of water/soap access, and inadequate training were found to influence practices. The researchers concluded hand hygiene promotion programs addressing these barriers could help reduce hospital-acquired infections.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
National Patient Safety Implementation_Dr Ruchi Kushwaha.pptxDr Ruchi Kushwaha
This document outlines the National Patient Safety Implementation Framework (NPSIF) for India from 2018-2025. The key points are:
1. The NPSIF aims to improve patient safety across all levels of healthcare in India to progress toward universal health coverage. Its goals are to establish structural systems and a competent workforce to support patient safety.
2. Strategic objectives include improving safety systems at national and facility levels, establishing adverse event reporting, ensuring a trained workforce, preventing infections, implementing safety campaigns, and promoting research.
3. Action plans and principles focus on strengthening legislation, accreditation, communication, and patient-centered care to establish a culture of safety in Indian healthcare.
1. The document discusses the changes required for Meaningful Use Stage 2, including additional core and menu objectives providers must meet compared to Stage 1.
2. It also covers the Value-Based Payment Modifier and Physician Quality Reporting System, noting groups must avoid penalties by having at least 50% of eligible professionals report quality measures individually in 2016.
3. The final topic is ICD-10, which will take effect on October 1, 2015. The document compares ICD-9 and ICD-10 coding formats and provides an example of coding multiple chalazia excisions.
Survey On Machine Learning Based Patient Monitoring Algorithm Using Oxygen Sa...IRJET Journal
This document describes a study on developing a machine learning-based patient monitoring algorithm using oxygen saturation (SpO2) levels. The proposed system would continuously monitor a patient's temperature and SpO2 using IoT devices and sensors. It would then construct a machine learning model to predict patient severity and regularly upload the data to a private server. This would allow doctors to remotely monitor patients' conditions without them needing to stay in the hospital. The system aims to reduce risks to patients' lives and limit healthcare worker exposure by enabling early detection and monitoring of health issues.
Similar to Hospital organisation, management and structure for prevention of HAI. Walter Zingg (UK) (20)
Carbapenem-resistant Acinetobacter baumannii poses a significant threat in healthcare settings across Europe. It can cause serious infections that are difficult to treat due to limited antibiotic options. The number of countries reporting spread and endemicity of carbapenem-resistant A. baumannii has increased in recent years. Increased detection and control efforts are needed to prevent it from becoming endemic in more European regions and healthcare facilities.
The document discusses the global spread of the mcr-1 gene, which confers plasmid-mediated colistin resistance in Enterobacteriaceae. This poses a substantial public health risk as it limits treatment options for multidrug-resistant infections. Options for response include improved detection of mcr-1 via laboratory methods like PCR and whole genome sequencing, enhanced surveillance programs, infection control measures in healthcare settings, antimicrobial stewardship, and reducing colistin use in animals to prevent further spread. A One Health approach combining human and veterinary medicine is needed to monitor mcr-1 in food and the environment.
Presentation from the ECDC expert consultation on Whole Genome Sequencing organised by the European Centre of Disease Prevention and Control - Stockholm, 19 November 2015
Presentation from the ECDC expert consultation on Whole Genome Sequencing organised by the European Centre of Disease Prevention and Control - Stockholm, 19 November 2015
Dag Harmsen presented on the evolvement and challenges of cgMLST for the harmonization of bacterial genome sequencing and analysis. Key points include:
- cgMLST (core genome multilocus sequence typing) involves identifying and comparing alleles across a fixed set of core genome genes and has been applied to outbreak investigation and global pathogen nomenclature.
- Tools for cgMLST analysis have been developed and improved to work on read, draft, and complete genome levels and allow scalable, additive analysis of single genes to whole genomes.
- Standardizing a hierarchical cgMLST-based approach and developing common nomenclature poses challenges but is important for microbial genotypic surveillance across laboratories and countries.
Presentation from the ECDC expert consultation on Whole Genome Sequencing organised by the European Centre of Disease Prevention and Control - Stockholm, 19 November 2015
Presentation from the ECDC expert consultation on Whole Genome Sequencing organised by the European Centre of Disease Prevention and Control - Stockholm, 19 November 2015
Presentation from the ECDC expert consultation on Whole Genome Sequencing organised by the European Centre of Disease Prevention and Control - Stockholm, 19 November 2015
This document summarizes discussions from several sessions of a meeting on antimicrobial resistance and healthcare-associated infections. Key points include:
- Most countries submit antimicrobial consumption data close to the deadline, and there are specific rules for who can access and publish the data.
- It is important but challenging to compare hospital antimicrobial consumption data between countries due to differences in how data is collected. Both defined daily doses and packages are needed for comparison.
- A pilot hospital-based antimicrobial consumption survey was proposed to collect additional data starting in late 2015, but the protocol requires further review and clarification before implementation.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Validation studies are essential to accurately assess the sensitivity, specificity, and predictive values of point prevalence surveys (PPS) of healthcare-associated infections (HAI). Previous validation studies of PPS have shown varied results, underscoring the need for formal evaluations. Without validation, true HAI prevalence is unknown and differences between locations cannot be properly investigated. International organizations can help support national validation efforts to improve HAI surveillance.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
This document contains forms and instructions for conducting a point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals. The forms collect data at the hospital, ward, patient, and national/regional level. Hospital data includes bed numbers, staffing levels, infection control activities and organizational culture. Ward data includes bed numbers, hand hygiene infrastructure. Patient data collects infection details, antimicrobial use, and patient characteristics for those with infections or receiving antibiotics. National data provides healthcare system context. The forms standardize data collection to allow prevalence comparisons across settings.
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Hospital organisation, management and structure for prevention of HAI. Walter Zingg (UK)
1. 3rd Joint Meeting of the ARHAI-Networks
ECDC Point prevalence survey, 2016-2017
Indicators
Carl Suetens (ECDC), Walter Zingg (UK)
2. 3rd Joint Meeting of the ARHAI Networks, Stockholm
Evidence and expert opinion for
infection control measures in
Europe (SIGHT project)
Walter Zingg, MD
Imperial College London
3. • Overall goal: identify the most effective and generally
applicable elements of hospital infection prevention and
control programmes to support the broadest possible
implementation across Europe
• 1st objectives: collect, review and appraise in a systematic
manner the best available evidence of effectiveness at
local/national level of selected components of programmes
• 2nd objectives: develop expert guidance on key
components, put them into perspective and define
structure and process indicators
4. Number of records
identified through
database searching
N = 47,948
Additional records
identified through
other sources
N = 131
Duplicates from different databases removed: 8362
Articles for title and abstract evaluation: 39,717
Removed after title and abstract evaluation: 37,487
Articles for full text evaluation: 2230
Articles excluded: 1397
- Selection criteria not met: 1040
- Full text inaccessible: 357
Articles for quality assessment: 833
Total records identified: 48,079
Articles included for data analysis and synthesis: 92
[RCT (3), CBA (5), ITS (4), CCS (4), NCBA (34), NCC
(22), Qualitative (16), Mixed-methods (4)]
Duplicates from different dimensions removed: 226
Removed due to insufficient quality: 515
Zingg W. Lancet Infect Dis 2015;15:212
5. WP1:SystematicreviewWP2:Elaborationofkeycomponents
andprocessandstructureindicators
2ndexpert
meeting
Dimension 1
[Organisation, structure]
Dimension 2
[Surveillance, feedback]
Dimension 3
[Education, training]
Dimension 4
[Multimodal strategies,
behavioural change]
Dimension 5
[Policies/resources on
isolation precautions]
Allocation of indicators to
the key components
Additional
systematic review
[auditing, target setting,
patient participation,
knowledge management]
Definition of the search strategy; inclusion/exclusion criteria
Elements (14) Elements (5) Elements (11) Elements (4)
Final set of key components (10)
Elements (11)
1stexpert
meeting
2nd set of key components
Creation of list of indicators3rd set of key components
1st set of key components
8. o Clear and concise
o Action focused (should lead to action)
o Important (stakeholders agree that the indicator makes a relevant
contribution to respond to a problem)
o Measurable (collecting meaningful and credible data)
o Simple
o Acceptable (to stakeholders)
o Valid (accurately measure what they claim to measure)
o Reliable (consistent over space and time)
o Sensitive for change (detects change over time and across settings)
o Free from bias (no systematic errors)
→ Provides strategic insight required for effective planning and sound
decision-making
Campbell SM. BMJ 2003;326:816
Buyle FM. Eur J Clin Microbiol Infect Dis 2013;32:1161
10. Organisation of infection control (IC) at
hospital level
Key component
An effective infection control
programme in an acute care
hospital must include at least:
one full-time specifically trained
IC-nurse ≤ 250 beds; a dedicated
physician trained infection
control; microbiological support;
data management support
o Detailed infection control activities: number
of ongoing surveillance and prevention
programmes, outbreaks, number of
performed audits - longitudinal
o Established infection control (Organisation):
appropriate staffing, IC committee in place,
defined goals for IC, identified IC budget, IC
on the agenda of the hospital
administration, defined outbreak
management, vaccination programmes for
health-care workers - transversal
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
11. SIGHT-Indicators (KC 1)
o Detailed infection control activities:
number of ongoing surveillance and
prevention programmes, outbreaks,
number of performed audits –
longitudinal
o Established infection control
(Organisation): appropriate staffing, IC
committee in place, defined goals for
IC, identified IC budget, IC on the
agenda of the hospital administration,
defined outbreak management,
vaccination programmes for health-care
workers - transversal
ECDC PPS
IPC programme components
o Is there an annual IPC plan, approved/
signed off by the hospital CEO?
Yes No
o Is there an annual IPC report, approved/
signed off by the hospital CEO?
Yes No
o Number of FTE infection control nurses
o Number of FTE infection control doctors
o Number of blood culture sets/year
o Number of stool tests for CDI/year
o At weekends, can clinicians request
routine microbiological tests and receive
back results?
On Saturdays: yes no
On Sundays: yes no
Organisation of infection control (IC) at
hospital level
12. TATFAR
SIGHT-Indicators (KC 1)
o TATFAR core indicator 6: “Does your
facility provide any salary support for
dedicated time for antimicrobial
stewardship activities
o TATFAR core indicator 12: “Is there a
formal procedure for a physician,
pharmacist, or other staff member to
review the appropriateness of an
antimicrobial after 48 hours from the
initial order (post-prescription
review)?”
ECDC PPS
Antimicrobial Stewardship
o Number of FTE antimicrobial
stewardship
o Start date/indication of antibiotics
o Antibiotics reviewed after 48-72 hours
Organisation of infection control (IC) at
hospital level
13. Isolation capacity
[SIGHT-Indicators (KC 1)]
ECDC PPS
o Number of beds in ward
o Number of patient rooms in ward
o N of single rooms in ward
o N of single rooms with individual
toilet and shower
Organisation of infection control (IC) at
hospital level
14. Ward occupancy and workload
To make sure that the ward
occupancy does not exceed the
capacity for which it is designed
and staffed; staffing and
workload of frontline health-care
workers must be adapted to
acuity of care; and the number of
pool/agency nurses and
physicians minimized
Key component
o Average bed occupancy (85%) at midnight
o Average staffing of frontline workers
o Average proportion of pool/agency
professionals
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
15. SIGHT-Indicators (KC 2)
o Average bed occupancy (85%) at
midnight
o Average staffing of frontline workers
o Average proportion of pool/agency
professionals
ECDC PPS
Staffing/Occupancy
o Number of FTE registered nurses
o Number of FTE nurses aides
o Number of FTE registered nurses in
ICU
o Number of FTE nurses aids in ICU
o Number of FTE antimicrobial
stewardship
o N of beds occupied at 00:01 on the
day of PPS
(Nurse-patient ratio: hospitalwide & ICU)
Ward occupancy and workload
16. Materials, equipment, and ergonomics
Sufficient availability of and easy
access to material and
equipment and optimized
ergonomics
Key component
o Alcohol-based handrub at the point of care
(proportion)
o Sinks stocked with soap and single-use
towels (proportion)
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
17. SIGHT-Indicators (KC 3)
o Alcohol-based handrub at the point
of care (proportion)
o Sinks stocked with soap and single-use
towels (proportion)
ECDC PPS
Alcohol-based handrub (ABHR) at the
point of care
o Alcohol hand rub consumption in
ward (L/year)
o Number of beds in ward
o N of beds in ward with ABHR
dispensers at point of care
o Percentage of HCWs on ward with
ABHR dispensers in pocket
Materials, equipment, and ergonomics
18. Use of guidelines, education, and training
Use of guidelines in combination
with practical education and
training
Key component
o Guidelines locally adapted (written)
o Number of new staff trained using the
local guidelines
o Teaching programmes are based on local
guidelines
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
19. Team-oriented and task-oriented education
and training
Education and training involves
frontline staff, and is team- and
task-oriented
Key component
o Audit of education and training
programmes
o Results of knowledge tests and competency
assessments
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
20. Standardisation of audits
Organizing audits as a
standardized (scored) and
systematic review of practice with
timely feedback
Key component
o Number of audits (overall, and stratified by
departments/units and topics) for
specified time period – Yes/No
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
21. SIGHT-Indicators (KC 6)
o Organizing audits as a standardized
(scored) and systematic review of
practice with timely feedback
ECDC PPS
IPC programme components
o N observed hand hygiene
opportunities per year
o Vascular and/or or urinary catheter
insertion, and/or intubation care
o Use of PPE (i.e. one opportunity for
correct use of gloves, masks, aprons
etc)
Standardisation of audits
22. Prospective surveillance, feedback, and
networks
Participating in prospective
surveillance and offering active
feedback, preferably as part of a
network
Key component
o Participation of (inter-) national
surveillance initiatives
o Number and type of wards with a
surveillance
o Hospitalwide/selected wards
o Regular review of the feedback strategy –
Timely feedback
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
23. SIGHT-Indicators (KC 7)
o Participation of (inter-) national
surveillance initiatives
o Number and type of wards with a
surveillance
o Hospitalwide/selected wards
o Regular review of the feedback
strategy – Timely feedback
ECDC PPS
Participation in surveillance networks
In the previous year, which surveillance
networks did your hospital participate in
?
SSI
ICU
CDI
Antimicrobial resistance
Antimicrobial consumption
Prospective surveillance, feedback, and
networks
24. Development of multimodal strategies and
tools
Implementing infection control
programmes follow a multimodal
strategy including tools such as
bundles and checklists developed
by multidisciplinary teams and
taking into account local
conditions
Key component
o Verification that established prevention
programmes follow a multimodal strategy
o Process indicators: hand hygiene
compliance, compliance with medical/care
procedures by checklists, compliance with
cleaning/disinfection procedures
o Outcome indicators: standardized rates for
HAI, infections with MDROs, transmission of
MDROs
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
25. SIGHT-Indicators (KC 8)
o Verification that established prevention programmes follow a multimodal strategy
o Process indicators: hand hygiene compliance, compliance with medical/care procedures
by checklists, compliance with cleaning/disinfection procedures
o Outcome indicators: standardized rates for HAI, infections with MDROs, transmission of
MDROs
Development of multimodal strategies and
tools
ECDC PPS
Guideline
Education&
Training
Audit
Surveillance
Feedback
Pneumonia (healthcare- or ventilator-associated)
Bloodstream infections (HA- or catheter-associated)
Surgical site infections
Urinary tract infections (HA- or catheter-associated)
26. Identification and engagement of strategy
champions
Identifying and engaging
champions in the promotion of a
multimodal intervention strategy
Key component
o Interviews with frontline staff and
infection control professionals
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
27. Creating a positive organisational culture
A positive organizational culture
by fostering working relationships
and communication across units
and staff groups
Key component
o Questionnaires about work satisfaction
o Crisis management
o Human resource indicators: absenteeism,
health-care worker turnover
Indicators
Zingg W. Lancet Infect Dis 2015;15:212
28. SIGHT-Indicators (KC 10)
o Questionnaires about work
satisfaction
o Crisis management
o Human resource indicators:
absenteeism, health-care worker
turnover
ECDC PPS
Organisational culture
Total % absenteeism [total absenteeism
days] / [total working days per year] in
previous 5 years:
Year-1 [___]%
Year-2 [___]%
Year-3 [___]%
Year-4 [___]%
Year-5 [___]%
Creating a positive organisational culture
29. 3rd Joint Meeting of the ARHAI-Networks
ECDC Point prevalence survey, 2016-2017
Indicators
Carl Suetens (ECDC), Walter Zingg (UK)