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All Aboard… Ride the IPAC Rapids with the Grey Bruce Health Unit

IPAC SWO Meeting – London, ONFriday, September 16th 2016Presenters: Christina Milani B.Sc, CPHI(C),CICAbsent: Adel Coulter RPN, CIC

Grey Bruce Health Unit – IPAC Geographic Area

• Populations 158,670 (Grey Bruce Health Unit 2012b)

• 8601 square kilometers (Statistics Canada 2012b)

• 17 Municipalities

• 2 Counties (Grey and Bruce)

• 2 First Nations Communities

• Multiple Plain Clothes Communities

• 3 Hospitals Corporations (11 sites)

• 19 Long Term Care Homes

• 22 Retirement Homes

• 249 Personal Services Settings

• 66 Daycare settings

Vision: A healthier future for all

Mission Statement: Working with Grey Bruce communities to protect and promote health

Value: Equitable opportunities that support health and well being

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Health Unit Program Professionals

Dental Dental Hygienists

Dental Health Educators

Family Health Registered Nurses

Parent Support Workers

Food Safety, Rabies, Safe water, Tobacco Public Health Inspectors, tobacco enforcers

Health Promotion Health Promoters, Dieticians

Infectious Disease

Personal Service Settings

Public Health Inspectors,

Registered Nurses, Registered Practical Nurse

Needle Exchange Registered Nurses

Registered Practical Nurses

Sexual Health, Vaccine Preventable Diseases Registered Nurses

Registered Practical Nurses

Speech and Language – Speech and Language Pathologists (no longer

with the Health Unit as of summer 2016)

** May be similar in other Public Health Units.

Grey Bruce Health Unit - Programs and Professionals

Grey Conventional Settings

Consult roomDental – clinic Sexual Health – clinic

l

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Grey Unconventional Settings

Speech & Language

Early Years Centre

Vaccine

School – Health room

Dental

Salvation Army

Public Health Act,1882 Department of Health,1925 Ministry of Health and Long-term Care,1971

IPAC Canada formally known as CHICA Canada

18

82

20

04

20

07

20

08

20

14

20

11

20

16

20

17

20

03

20

05

19

76

IPAC Canada Local Chapter - HUPIC

Provincial Infectious Diseases Advisory Committee (PIDAC)

PIDAC Best Practice Documents

Ontario Agency for Health Protection and Promotion (OAHPP), Act was passed in 2007

Regional Infection Control Networks, transitioned to PHO in 2010

Just Clean Your Hands Program

Ministry of Health and Long-term Care IPCN Funding

OAHPP Adopted the operating name of Public Health Ontario

(PHO)

PHO Online Learning Opportunities

External Infection Prevention and Control History

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91

SA

RS

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External Consultation with LTCH, Retirement Homes, Hospitals, Daycares

Accreditation Canada Preparation and Evaluation

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90

20

11

20

12

20

13

20

14

20

15

20

16

20

17

Respirator Fit Testing

20

09

Staff Education

MOHLTC Funding for Infection Prevention and Control Nurse (CIC)

IPAC Canada (formally CHICA Canada) Audit Tools Implemented

Internal assessment of IPAC Practices and the development of P&P

Accreditation Canada

Internal IPAC Committee

CIC Certified Staff (1 PHI, 1 BScN, 1 RPN)

Development and Implementation of Hand Hygiene Program

TDG Program and Training / Spill Kits

IPAC Lapse

Grey Bruce Health Unit IPAC History

Accredited with

Exemplary Standing under the Qmentum

accreditation program by Accreditation Canada

-March 2014-

• 44 Customized IPAC Standards

• 2011 – 2014 evaluate internal process

• Adapt standards to fit the Health Unit setting

March 2014 Exemplary Standing IPAC Score 42/44 95.7%

• Continue to assess our current program

Accreditation Canada

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ID Staff – 2 BScN, 1 RPN, 4 PHI(3 CIC Certified Staff)

• Sporadic Reportable Disease Investigation

• Outbreak Management

• External Consultation• Help Desk• External Education• Liaison with LTCH, Hospitals,

Daycares (PHI), Retirement Homes

• Inspections (PHI)

• Vector borne diseases

• Sexual Health Investigation (Nurses)

• Professional Development

IPAC Nurse Role - RPNCIC Certified

• Internal Audit

• IPAC Policy and Procedure Development and Revisions

• Internal Education

• Internal IPAC and Occupational Health and Safety Committees

• Consultation

• Resource Development

• External Liaison with Family Health Team/Primary Care

GBHU IPAC Program External Program

• IPAC committee• Framework • Staff Education (Respirator fit testing & PPE training)• Hand hygiene program• Program and Service Audits• 49 IPAC Policies and Procedures

GBHU IPAC Program

• Employee Illness and Reporting

• Staff Influenza Immunization

• Eating and Drinking in a Clinic Area

• Hand Hygiene

• Risk Assessment, Routine Practices and

Additional Precautions

• Sharps Management

• Needle Stick Injury-Exposure to Blood and Other

Body Fluids

• Personal Protective Equipment (ADMIN-CP)

• Cleaning and Disposal of Blood, Body Fluids and

Waste

• Respirator Program and Control of Infectious

Diseases

• Cleaning and Maintenance of Toys and

Learning Props

• Collection and Transportation of Lab Specimens

• Cleaning and Disinfecting

• Infection Control for Dental Screening Clinics

On-Off Site

• Cleaning and Sterilization Instruments (SVC-OHS)

• IX-329 Dental Unit Water Lines

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GBHU Hand Hygiene Program

100% 100%

90%

94%96% 95%

100%

91% 97%

70%

75%

80%

85%

90%

95%

100%

2016 2015 2014 2013

Pe

rce

nta

ge

GBHU Hand Hygiene Audits

Dental Program

Vaccine Preventable

Diseases

Sexual Health Program

Speech and Language

Family Health

117

4

159

45

723

0

50

100

150

200

2016 2015 2014

Nu

mb

er

of O

bse

rva

tio

ns

GBHU Hand Hygiene Audits Number of

Observations

Dental Program

Vaccine Preventable

Diseases

Sexual Health Program

Speech and Language

Family Health

GBHU Audit Program

50%

60%

70%

80%

90%

100%

2012 2013 2014 2015

Re

sults

GBHU Dental Program Audits

Owen Sound

Walkerton

Wiarton

Markdale

Hanover

50%

60%

70%

80%

90%

100%

2013 2014 2015

Re

sults

GBHU Environmental Audits

All Areas (Clinic, Supply

room, Gym, Cleaning

Products)

Restrooms

Supply Rooms

Clinic

Reprocessing Room

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Our Challenges

• Adapting to the Health Unit Setting

• Cleaning Process

• Audit Process

• Diversity of staff knowledge

• Improved technology

Summary

Promotion

Public Safety

Protection

Prevention

Evaluate / assess

Innovate

Adapt / Create

Critical Thinking

Strategy

Experiment

Implement

Collaborate

EducationFoundation

Up-stream approach

Change

Evidence Based

Best Practice

Partnership