infection clinical network strategy day · 2018-09-03 · this is a rapidly evolving space with...
TRANSCRIPT
Infection Clinical Network – Strategy day 21 August 2018
Twitter: #ICN2018
Dr. Brett Sutton
Position title: Deputy Chief Health Officer (Communicable Diseases)
Organisation: Department of Health and Human Services
A few words from the Chair… I believe the Infection Clinical Network represents a genuine opportunity to advance important work in infectious disease management and infection prevention and control.
The membership and its broader engagement with stakeholders means we can use the very best of our passion, experience, wisdom (and influence!) to address several key challenges, and perhaps even some wicked problems.
This is a rapidly evolving space with emergent and re-emergent threats. But we also have new technologies, new evidence and ‘big data’ to inform action.
I sincerely hope today is a productive and engaging one with new ideas and energy. I very much look forward to the ongoing work with all of you.
Infection Clinical Network – Strategy day 21 August 2018
Today’s program
Meet the team Current state of Emergency Care in Victoria Our goals Defining our priorities – Sli.Do polling Next steps TBC – panel session Twitter: #ICN2018 Sli.Do meeting ID: #1934
Purpose
To define the 3-5 priority areas for ICN work over
the next 3 years, pending endorsement by Safer
Care Victoria
Housekeeping
Exits
Table arrangements
Breaks (Morning Tea 11:00-11.20, Lunch 12.50 – 13.30)
Dietary requirement table
Phones, pagers
‘Sli.Do [link] (instructions on table)
MCEC WiFi Access [link] (instructions on table)
Welcome
Robyn Hudson Director Clinicians as Partners
Safer Care Victoria
Infection Clinical Network
Strategy Day
Our mission To ensure outstanding health care for all Victorians. Always. Our purpose To enable all health services to deliver safe, high quality care and experiences for patients, staff and clinicians.
Safer Care Victoria
Targeting Zero
The Healthcare Associated Infection Committee be absorbed by a newly formed Infection Clinical Network The Cleaning Standards process indicator be discontinued and replaced by a comparable patient reported cleanliness one Work toward Zero Central-Line Associated Bloodstream Infections
Other Activities
Better Care Victoria Sepsis Collaborative Emergency Care Clinical Network Sepsis bundle of care Sepsis Scaling Collaboration Regional Infection Control Programs
Where do we fit?
Our structure
Maternity and Newborn Stroke Critical Care Palliative
Paediatrics Cardiac Emergency Older People
Renal Infection
Clinical Networks
Clinical networks
Identify best practice in their relevant specialty
area and share and support implementation of best practice approaches
Identify mechanisms to decrease unwarranted
clinical practice variation when appropriate
Identify treatments or procedures for which
there is an evidence of a material volume-outcome
relationship
Develop clear and measureable statewide
safety and quality improvement goals
Provide advice on clinical quality measures for
statewide improvement and benchmarking work
Provide advice to Safer Care Victoria and the
DHHS on clinical quality and safety implications of
policy, planning and commissioning decisions.
Clinical networks
Identify best practice in their relevant specialty
area and share and support implementation of best practice approaches
Identify mechanisms to decrease unwarranted
clinical practice variation when appropriate
Identify treatments or procedures for which
there is an evidence of a material volume-outcome
relationship
Develop clear and measureable statewide
safety and quality improvement goals
Provide advice on clinical quality measures for
statewide improvement and benchmarking work
Provide advice to Safer Care Victoria and the
DHHS on clinical quality and safety implications of
policy, planning and commissioning decisions.
Improvement goals
Paediatric Clinical Network Renal Clinical Network Stroke Clinical Network Mental Health Clinical Network
Older Persons Clinical Network Critical Care Clinical Network Emergency Clinical Network Palliative Care Clinical Network
Approximately 1500 consumers, clinicians, academics and
advocacy groups have identified the priority areas for
improvement
Improvement goals
600 people will be screened for mood disturbance who have a stroke
1520 will receive care aligned to a stroke unit of care
3335 people will receive inotropes/vassopressors appropriately
1194 people will have improved care due to the application of the
clinical care guidelines in hip fracture
Improvement goals
261 children will not have a tonsillectomy
250 children will not be prescribed AST
177 women will not have a 3rd or 4th degree tear of their perineum
494 Victorians who start dialysis each year will have consent
Heading 1
Thank you
Central line-associated bloodstream infections in Victoria
A/Professor Leon Worth
VICNISS Coordinating Centre
Doherty Institute, Melbourne
CLABSI
• Bloodstream infection associated with an indwelling central venous catheter
• short-term devices e.g. non-tunnelled CVC
• medium and long-term devices e.g. Hickman, port, PICC
• Significant outcomes • prolonged hospitalisation (7-21 days)
• costs (US $12,000)
• mortality (OR 2.75; in-hospital mortality, ICU patients)
• Generally regarded as preventable
Ziegler MJ, et al. Infection 2014 Stevens V, et al. Clin Microbiol Infect 2014
Pronovost P, et al. N Engl J Med 2006
CLABSI: a look over time
2000 2018 2009 2003 2006 2012 2015
2002: Victorian ICU CLABSI surveillance commenced (VICNISS)
2008: Modified CLABSI case definition #1 (NHSN) ‘common commensals’
2013: Modified CLABSI case definition #2 (NHSN) ’mucosal barrier injury’
2012: National guidelines for CVC insertion & maintenance (ANZICS/ACSQHC)
2006: Validation of Victorian surveillance program (VICNISS)
2015/16: Target zero, Performance Monitoring Framework (DHHS)
Burden & pathogens
Paediatric ICU: 2.21/1000 CVC days Neonatal ICU: 2.20/1000 CVC days Haematology/oncology: 1.9/1000 CVC days
CVC insertion practices
2013-2018 • 21 clinical departments • total CVC insertions = 5453 • ‘Full bundle’ compliance
87.5-100%* *hand hygiene + maximum barriers + appropriate skin antisepsis + skin antisepsis dry before insertion
Preventability
• International, local experience
• Evolution of care bundles over time, extrapolation from ICU studies
Standard Additional
Insertion Insertion
Hand hygiene Antimicrobial-impregnated CVCs
Avoidance of femoral site Maintenance
Skin asepsis CHG-impregnated dressings
Removal of unnecessary devices CHG body washes
Maximal barrier precautions Antimicrobial locks
Maintenance
‘Scrub the hub’
Victorian prevention programs
Klintworth G, Stafford J, O'Connor M, Leong T, Hamley L, Watson K, Kennon J, Bass P, Cheng AC, Worth LJ
Am J Infect Control 2014
Setting: 700-bed tertiary hospital (2011-2012)
Implementation: multimodal, 20-month roll-out, hospital-wide, existing ICU bundle
Additional measures: CHG body washes, minocycline-rifampicin coated CVCs
Findings: Reduction in ICU CLABSI (2.3 to 0.9/1000 CVC days), reduced non-ICU CLABSI (2.5 to 1.3/10000 OBDs), median time to CLABSI onset 13 days
Lessons: CVC insertion checklist not practical, need for improved CVC maintenance.
Entesari-Tatafi D, Orford N, Bailey MJ, Chonghaile MN, Lamb-Jenkins J, Athan E
Med J Aust 2015
Setting: 19-bed adult ICU, tertiary hospital (2009)
Implementation: multimodal
Additional measures: Biopatch, CHG body washes, daily line review
Findings: reduction in ICU CLABSI (2.2 to 0.5/1000 CVC days), median dwell time 5 days
Lessons: challenge of standardised line insertion practices outside ICU
Summary
• CLABSI in adult ICUs • 10-year diminishing rates, currently ~0.7/1000 CVC days
• Non-ICU and paediatric/neonatal populations
• CVC insertion practices • compliance with best practice
• CVC maintenance and bundles of care • diversity, site-specific, resourcing implications
Clinicians as Partners
Monica Holdsworth Manager, Acute Care Cluster
Safer Care Victoria
Emergency Care, Infection, Critical Care Clinical Networks
Sepsis – are state wide initiatives
enough?
Current state wide initiatives • Better Care Victoria Sepsis Collaborative
• Emergency Care Clinical Network Sepsis: bundle of care
Professor Kaz Thursky,
Clinical Advisor
Better Care Victoria
Knox Private
John Fawkner
Cabrini
Epworth
SJOG Geelong
Epworth Geelong
Participating health services Implementing a sepsis bundle of care in ED and UCC project
SJOG Ballarat
ECCN ED/UCC project site
BCV whole of hospital
project site
Western Alfred
Eastern
Peninsula
Werribee Mercy
Collaborate with nearby health services
Safer Care Victoria Emergency Care Clinical Network • Since 2016 • Hybrid collaborative model
32 health services • Prof Anne Maree Kelly,
Emergency Physician, Clinical Advisor
• Emergency Departments
and Urgent Care Centres
Better Care Victoria • 2018 (first wave) • Collaborative model 11
health services • Professor Kaz Thursy,
Infectious Diseases Physician, Clinical Advisor
• Whole of hospital
Safer Care Victoria
Maternity & Newborn Clinical Network Maternity eHandbook (sepsis) Newborn eHandbook (sepsis)
Paediatric Clinical Network Collaborative model 11 health services Royal Children’s Hospital Whole of hospital
Gaps
• Paediatrics – a definition to accurately and consistently identify
children with sepsis
• Maternity – state wide bundle of care
• Urgent Care Centres – pharmacy and testing
• Emergency Departments – missed diagnosis
Opportunities
• Coordination
• Adjust for all settings
• Consistent state wide resources
• Minimise system related issues i.e. patient transfers
Monica Holdsworth Manager, Acute Care Cluster
Safer Care Victoria
Ph: 9096 5621
2018 Influenza Season – an
opportunity for colalboration
Dr Annaliese van Diemen
Communicable Disease Prevention & Control
2017 Influenza season
Lets be frank - it was awful
Hospitals
• Emergency department demand
• ICU admissions
• Isolation beds
• Patient flow
• Antiviral access
• Sick staff
Aged Care
• Outbreaks, sick and dying residents
• Unwell staff
• Unhappy families
• Commonwealth response
General Practice
• Huge demand
• Pressure for antibiotics
• Backlash re: vaccine
Public Health
• Hundreds of outbreaks
• Surveillance data backlogs
• Political pressure
• Unable to help with some requests – e.g.
sourcing antivirals
2018 Collaboration activities
Better data
• Coordinating health service, ambulance, community and
sentinal surveillance data for state wide picture for the first time
• Predicting demand across the system rather than in silos
Practical guidance
• Aged care, anti-viral usage and hospital outbreak guidelines
Connecting the dots
• Residential in-reach services
• RICPRAC
Opportunity #1 Practice makes perfect
2017 wasn’t actually that bad…..
• Poor vaccine match, not a pandemic or novel strain
• H3 predominant – generally higher morbidity and mortality
• Dual peak resulting in a longer season
We have an opportunity to practice, every year, for ‘the big one’
• We can’t create systems on the fly
• There are no disadvantages to optimising our systems
• In the world of advocacy, creating alliances (i.e. collaboration) is
how things stay on the radar
Opportunity #2 – Community & Hospital
How many primary care practitioners are in the room?
• Biggest opportunity for collaboration which is missing today and
in our overall influenza system management
• Most difficult one to do
• Rely on general practice for vaccination coverage, to keep
people out of hospital, to know when to send them in
• Will be even more reliant on them in the event of a pandemic
• Ideas? Thoughts for the session later in the day?
Opportunity #3 – Collaborative design
Collaboration ‘The action of working with someone to
produce something’
• Thus far ‘production’ has focussed on good outcomes and
systems
• We must have the right people at the table from the beginning
• More practically – advocate for clinical collaboration and
engagement in every level of service design – including the
buildings
• Isolation rooms, cohorting areas, building products which are
safe and durable
Thank you
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© State of Victoria, Department of Health and Human Services August 2018.
Except where otherwise indicated, the images in this publication show models and illustrative settings only, and do not necessarily depict actual
services, facilities or recipients of services. This publication may contain images of deceased Aboriginal and Torres Strait Islander peoples.
Where the term ‘Aboriginal’ is used it refers to both Aboriginal and Torres Strait Islander people. Indigenous is retained when it is part of the title of
a report, program or quotation.
Partnering with consumers in the
Infection Clinical Network
Infection Clinical Network Strategy Day
Belinda MacLeod-Smith, Consumer lead, Partnering in healthcare
project
Email: [email protected]
Twitter: @belmac_ic
Session outline
1. Consumers as Partners Branch
2. The ‘what and why’ of consumer participation
1. Consumer partnering in the ‘new’ Standard Three
(Healthcare associated infection prevention and
control)
2. The principles of partnering/engagement
3. Brief participation case studies
Consumer lead – Partnering in
healthcare framework • Lived experience as a carer for my husband through idiopathic
cardiomyopathy from 2015, three years on a LVAD (artificial
heart) then heart transplant in 2015 (also thyroidectomy, severe
sepsis, ECMO)
• 20+ years strategic communication, marketing and engagement
professional
• Moved to Melbourne 2012 – originally from Adelaide, where
complex cardiac care not possible
• Currently with Safer Care Victoria as consumer lead for
Partnering in healthcare project, and at Health Issue Centre as
Manager, Consumer engagement
• Former inaugural on-staff consumer advisor for Western Health
• Volunteer with Heart and Lung Transplant Trust (peer support)
• Committee member for Australian College of Emergency Medicine
FACEM, Victorian Agency for Health Information (VAHI) Advisory
Group, and VAHI PROMS/PREMS steering committee
• Steering committee member /research partner for #icuRESOLVE
Getting to know you Your health service works with health consumer representatives either
formally (structured, ongoing activities) or informally (one-off, sporadic
activities)
• on governance or steering committees
• on a Community Advisory Committee
• in co-design projects – as part of the steering group, potential research
partners or subjects
• as part of the investigating team in research and development projects
• to participate in training/professional development/orientation of staff
and volunteers
• in one-off participation in a focus group or round of focus groups on the
same subject
• to contribute to shortlisting and selection panels staff recruitment
• to co-present at forums and conferences
• in the process of awarding scholarships and grants
• as volunteers for quality activities (such as inpatient experience
interviews)
Summary 2017- 2018 Consumers as Partners’ Branch
Key Priorities
• Establish state approach
to Patient and Family
escalation of care
• Establish SCV Academy and
PEER network
• Sentinel events/ SENSE
events/ Incident reviews
and safety system
assessments
• Drive/ Support Patient
Safety Improvement
Projects e.g. Mesh
• Continue to support
Consumer engagement,
training and support
Patient Safety Culture
•Open communication
training (open
disclosure)
•Consumer focused
communication skills
training
•Patient Opinion pilot
Communication Breakdown
•Co-design capability building
•Expand use of PROMS & PREMS in improvement
•Consumers in re-design/ innovation & improvement
•Co- production pilot
Unwarranted variation in Practice
• Partnering in Healthcare Framework – development and implementation
• Inform the further development of VHES (keen to test alternative solutions for VHES)
• SCV Patient and Family Council
• Complaints Management & data linkage
• Patient stories
• Health Service CAC evaluation and investigation of a state wide CAC
Unwarranted variation in
Patient Experience
What is
participation/partnering?
Why is consumer participation
important?
National Safety and Quality Health
Service Standards (NSQHS)
Background: 1. Standards describe expected safe, high quality care
and systems needed to deliver it
2. Developed by the Australian commission on Safety and
Quality in Health Care in 2011
3. Developed with state and territory health
departments, health service organisations, consumers
and the private sector
4. First assessments were in 2013
5. Standards are a condition of funding for Victorian
public health services
6. Version 2 of NSQHS Standards released in November
2017
7. Assessment using the new standards will start
January 2019
What’s different?
How is patient-centred care
embedded in
the new standards?
Standard 3: Healthcare associated infection prevention and control
Action 3.3 Clinicians use organisational processes from the
Partnering with Consumers Standard when preventing and
managing healthcare-associated infections, and implementing
the antimicrobial stewardship program to:
a.Actively involve patients in their own care
b.Meet the patient’s information needs
c.Share decision-making
Are there foundation principles for
engagement?
• The great news is that the concept
of consumer (stakeholder)
participation has been around for
decades.
• Some of you may have heard of the
International Association of Public
Participation (IAP2) and their
conceptual ‘Spectrum of Public
Participation’
• The IAP2 concept is a great place
to start, but not the only approach
to participation
• It’s been adapted by organisations
world wide, including the majority
of local government entities in
Australia
Formal or informal? What’s your
cheese? • Different kinds of
participation suit
different kinds of
activities.
• The important thing
to remember is the
purpose, and the
promise you make to
consumers.
• Like a good cheese
platter, one size
does not fit all, and
sometimes a mix of
‘hard and soft’ gives
the best result.
How much influence does the consumer have on
decision-making?
Inform
•“We will keep you informed”
• Tactics can be about giving or gathering – flyers, brochures, newsletters, websites, public meetings or surveys, focus groups, suggestion boxes
Consult
• “We will listen to and acknowledge your concerns”
• Workshops, consumer reps on committees/advisory groups
• Online discussion groups
• Meetings/forums
• Circulation for comment
• Conferences/seminars
• Evaluation surveys
Involve or Partner
• “Your concerns/hopes will be directly reflected in decisions made”
• Strategic alliances are built using a combination of methods
• Workshops, consumer representatives on committees/advisory groups
• Roundtables
• Patient forums
• Surveys
• Focus groups
Collaborate or delegate
•“We will look to you for advice and innovation and incorporate this into decisions as much as possible”
• Shift some or all of the decision making to consumers – i.e. budget allocation, program management
Empower or Control
• “We will implement what you decide”
• Community appointed management committees i.e. Aboriginal community controlled health organisation
s.
Power - Lower Power - Medium Power - Higher
Inform: We will keep you
informed
Consult: We will listen to and
acknowledge your concerns
Involve: We will work with you to ensure your concerns
and aspirations are reflected in decisions made
Collaborate: We will look to you for advice and
innovation and incorporate this into decisions as
much as possible
Empower: We will implement what you
decide
Resources and contact details
"Know there isn’t a cookie cutter formula for engaging #pts. Always
ask your #pt partners what works best for them.“
https://sites.google.com/view/howtoengagepts/home
#howtoengagepatients:Global crowd-sourced site featuring research,
templates, tools and Tweetchat summaries.
https://www.iap2.org.au/Resources/IAP2-Published-Resources
The Australian branch of the International Association for Public
Participation (IAP2). Hit the ‘‘Resources“ tab.
https://www.mosaiclab.com.au/microskills/
Free tips for quality engagement and participation (great set of engagement
hints and tips)
Belinda Macleod-Smith (Twitter: @belmac_ic), Consumer Lead
T 03 9096 5484, E [email protected]
Exploring the Evidence Date: 21 August 2018
Chair: Associate Professor Caroline Marshall
Position title: Head of Infection Prevention and Control,
Infectious Disease Physician (VIDS)
Organisation: Melbourne Health
Welcome
The Five Hot Topics
• Multi-resistant organisms
• Antimicrobial stewardship
• Healthcare environment
• Infections associated with devices
• Healthcare worker
Professor Ben Howden
Position title: Director of Microbiological Diagnostic Unit(MDU)
Public Health Laboratory
Organisation: Doherty Institute
Why Multi-Resistant Organisms?
What are the gaps? • Reducing variation in microbiology reporting
• Ensuring effective/rapid susceptibility testing for new/uncommon
antimicrobials
• Effective surveillance for all relevant AMR pathogens
• Effective transmission prevention (PPE, isolation rooms)
• Hand hygiene
• Improving communication between facilities
• Staphylococcus aureus bloodstream infections (MRSA)
• Urinary tract infections/urosepsis ( ESBLs)
How can the Infection Clinical Network add value?
Consider AMR across the spectrum: • Integrated surveillance (what is happening, where, what is new) • Diagnostics (optimised, access to molecular diagnostics, extended
antibiograms, environmental microbiology) • Primary lab reporting (RCPA pathology stewardship etc) • Best practice empiric and directed therapy (community, hospitals) • Prevention (travel, transfers, screening, isolation, cleaning, HH)* • Outbreak detection and management (state-wide)* • Education (eg. UTI diagnostics and therapy in the community)
• Targeted issues (MRSA/MSSA bacteraemia; ESBL UTIs) *Communication between facilities
Associate Professor Kirsty Buising
Position title: Deputy Director of National Centre for
Antimicrobial Stewardship, Director of the
Guidance Group; Infectious Diseases Physician
Organisation: Doherty Institute
Why Antimicrobial Stewardship?
Critical for Patient Safety and Quality Critical for AMR control Failure to act will cost more money Guidelines need active implementation to effect change: resources/tools Generalizable - These conditions are common Equity - Sites without on site resources/ expertise Need - Data suggest some sites are doing poorly Cost effective - Duplication of effort Feasible - great examples of effective activities already exist
What are the gaps? Logistics
Drug shortages
- coordinate stock and advice
Last line /rare drug supply
- centralize access
Micro Testing
- When to test
- How to collect specimens
- How to interpret results
Common Resources
- UTI
- Pneumonia
- Surgical prophylaxis
- Cellulitis
- Influenza
- Clostridium difficile
- Fungal infections
Checklists, Posters, Pathways
Drug guidelines, Policies
Patient information
Staff information
How can the Infection Clinical Network add value? We are the only jurisdiction without a statewide AMS service Qld AMS, NSW CEC, SA RuralAMS, WA AMS, TICPU Coordination is cost effective – eg; ceftazidime-avibactam stock expiry Common resources/ tools – Reduce confusion, standardise advice Collaboration saves time and effort Build local staff capacity by building supportive networks - sustainable Clarify lines of responsibility, accountability – safer We cannot continue to measure poor performance without action
Donna Cameron
Position title: Infection Control Consultant
Organisation: Department of Health and Human Services
(Communicable Diseases)
Why the Healthcare Environment? • Cleaning compliance of hospitals is no longer reported to DHHS
• Victorian Hospital Experience Survey (VHES) data
• Complaints received
• Non-standardised cleaning methods and products
• Quite differing cleaning and disinfection protocols & methods between facilities
• Assessment of cleaning
• Increasing no’s contract cleaners => issues with training and accountability
• Green cleaning and sustainability
• Construction and renovation
• Commissioning standards and air sampling protocols
• Health care facility design
• Management of the built environment, e.g., water systems
• Increasing expectations to manage other risks, e.g. legionella
What are the gaps?
• Environmental cleaning
• Management of the built environment
How can the Infection Clinical Network add value? • Reduce variation in practice in cleaning and disinfection
• Assess evidence, influence development of multi-centre project with aim of developing a guideline to standardise ‘environmental hygiene’ practices
• Develop indicators for monitoring outcomes
• Health care facility Commissioning guideline
• Assess evidence and advise on development of a guideline
Associate Professor Craig Aboltins
Position title: Infection Disease Physician
Organisation: Northern Health
Topic: Infection associated with medical devices
Why infections associated with devices? 1. Staphylococcus aureus bacteraemia • Health care associated (HA-SAB)
• 1919 cases over 5 years in Victoria
• Number and rate decreased earlier this decade. Stable since.
• Community 2. Peripheral intravenous cannula (PIVC) infection
• 24%-35% HA-SAB caused by PIVC (up to 50% of PIVC not being used)
• Non-ICU CLABSI
3. Aseptic technique (ANTT) 4. Hand Hygiene
Ann Bull. VICNISS and contributors. Communication: 14.8.18
Sue Trenery. NH. Communication 14.8.18
Stuart et al. PIVC assoc SAB. MJA 2013
Rhodes et al. Reducing SAB assoc with PIVC. J Hosp Inf 2016
Worth et al. SAB in Australian hospitals: findings from VICNISS. MJA 2014
Infections associated with devices: what are the gaps? • Staphylococcus aureus bacteraemia
• Good reporting. Putting together detailed data. Interventions. Management.
• Peripheral intravenous cannula infections • Poor practice. State-wide data. Interventions
• CLABSI outside of ICU • State-wide data. Similar interventions as for ICU CLABSI?
• Aseptic technique (ANTT)
• Hand hygiene • Community health care
• Network of specialists • Gather data
• Assess evidence and prioritise
• Connections to implement interventions
• Examples of possible interventions • PIVC bundles (shown to improve PIVC care and reduce SAB)
• Role of CLABSI and CLIP monitoring for non-ICU central venous access
• Management of SAB
• Role of newer interventions: rifampicin impregnated cardiac device pockets
• ANTT and hand hygiene ?
How can the Infection Clinical Network add value?
Rhodes et al. Reducing SAB assoc with PIVC. J Hosp Inf 2016
Ray-Burruel. I-DECIDED tool. BMJ Open 2018
www.ausmed.com
www.ceramtec.com
Dr. Finn Romanes
Position title: Public Health Physician
Organisation: Department of Health and Human Services
(Communicable Diseases)
Why the healthcare worker?
• Our people are at risk of an exposure to vaccine-preventable diseases, and other infections
• Services need to protect healthcare workers, and healthcare workers need to protect patients
• Vaccination is an efficient, effective and safe intervention • Infection prevention and control is a frontline protection against
common and emerging pathogens in a world of increasing resistance
• Pandemics, whilst low probability, carry high risks and consequences and healthcare workers are central to the response
What are the gaps? • We lack high coverage against recommended vaccine-preventable
diseases in healthcare workers across the Victorian health sector • There is established evidence of HCW-patient transmissions, and vaccination is efficient and effective, but
we lack high coverage and good use of systems like the Australian Immunisation Register
• Voluntary programs are associated with poorer compliance, and counselling and education have failed to
achieve high coverage across the recommended seven VPDs (plus hepatitis A and BCG)
• There is room to improve skills and practical experience around
personal protective equipment and infection prevention • Infection prevention and control basics are critical for staff and patient safety and avoidable morbidity
• Pandemic preparedness needs ongoing attention • Modelling shows that a pandemic of severity similar to 1918 in today’s arrangements could lead to over
592,000 cases, 7000 deaths, up to 50% absenteeism and be drawn out of 7-10 months in Victoria
• Healthcare workers will be critical on the frontline – needing confidence around plans, stockpiles, roles
and actions
How can the Infection Clinical Network add value? Healthcare worker vaccination policy • Advise on, input to and influence emerging Victorian Government policy on HCW vaccination, including
incentives and mandates, in a time of policy movement
Infection prevention and control and personal protective equipment • Identify, select, design and oversee new tools, guidelines or training modules to strengthen knowledge
and practical skills in use of PPE
Pandemic preparedness • Influence and oversee health system awareness of obligations around equipment, knowledge and skills,
and plans for pandemic preparedness