HAI. A Framework for Mandatory Induction Training in Healthcare Associated Infection (HAI) for NHSScotland. Education for Prevention & Control

Transcription

1 HAI Healthcare Associated Infection Education for Prevention & Control A Framework for Mandatory Induction Training in Healthcare Associated Infection (HAI) for NHSScotland Working Together for a Healthy Caring Scotland

2 Contents 1. Introduction 2 2. Learning Outcomes 4 3. Using the Framework 6 R e f e r e n c e s 7 HAI Healthcare Associated Infection Education for Prevention & Control Published on behalf of the Scottish Executive by NHS Education for Scotland, Design and Production// A Framework for Mandator y Induction Training in HAI for NHSScotland 1

3 1. Introduction Origins of the Framework 1.1 The introduction of mandatory induction training in HAI for healthcare workers in Scotland is one of the key priorities outlined in the Scottish Ministerial HAI Action Plan, Preventing infections acquired while receiving healthcare (October 2002) (1). The Action Plan laid out a major three year programme of work to improve the prevention and control of HAI across NHSScotland. In January 2003, The HAI Task Force was established under the leadership of the Chief Medical Officer. The HAI Task Force s remit is to co-ordinate the development and implementation of the Action Plan, to monitor progress in its implementation across NHSScotland, to monitor levels of HAI and to report on progress to the Minister. 1.2 The concept of creating a Framework for Mandatory Induction Training in Healthcare Associated Infection (HAI) for NHSScotland emerged from a Scottish Executive-initiated symposium held in Glasgow in June An invited audience of key experts in HAI from the UK and abroad attended the symposium, participating in workshops focusing on specific areas of HAI practice. 1.3 One of the key focus areas was training in HAI for healthcare workers. Aspects of the current approach to induction training in NHSScotland were identified and discussed, including lack of consensus on the content of training programmes and lack of clarity on eligible participants. It was felt that the most effective way to make training in HAI more consistent and robust was to ensure that it became an element of standard induction training for all employees. How the Framework was developed 1.4 The Framework draws on wide-ranging activity on HAI in Scotland and has been agreed following a process of consultation involving key stakeholders. Existing standards, guidelines, policies, procedures and initiatives have informed its progress, including: The Scottish Ministerial HAI Action Plan (1) The NHSScotland Code of Practice for the Local Management of Hygiene and HAI (2) The HAI Cleanliness Champion initiative (3) Standard Infection Control Precautions (SICPs) (4) The Scottish Infection Manual (5) NHS Quality Improvement Scotland (NHS QIS) standards on HAI (see, for instance, 6,7) National Cleaning Services Specification (8) NHS QIS draft standards on healthcare governance (9) Local NHSScotland policies, procedures, guidelines and standards. A Framework for HAI Education in Scotalnd (NES) (under development) Particular attention is drawn to The NHSS Code of Practice for the Local Management of Hygiene and Healthcare Associated Infection (Section 2, Staff Education) (2). 1.5 The Partnership Information Network (PIN) guidelines on induction training for all NHSScotland staff (10) have also had a significant influence on the Framework s development. 2 A Framework for Mandator y Induction Training in HAI for NHSScotland

4 Aims of the Framework 1.6 The Framework sets out to maximise the relatively limited opportunities offered during generic induction programmes to emphasise the importance of HAI and the key role individual healthcare workers can make to reducing its incidence. Defining the Framework 1.7 It is important to emphasise that the Framework does not attempt to replace the components of current HAI education and practice within NHSScotland. Rather, it complements, supports and strengthens a range of initiatives already in place, such as: the work of infection control teams (ICTs) the work of link personnel for infection control the work of HAI Cleanliness Champions HAI-focused content of many professional healthcare initial preparation programmes and postregistration education initiatives local policies, procedures, guidelines, standards and training programmes on HAI designed to accommodate the specific needs of groups of healthcare workers the foundation materials on HAI in induction programmes for all NHSScotland staff (10). 1.8 The Framework provides a foundation for good practice and helps to ensure consistency of approach to mandatory induction training in HAI throughout NHSScotland. It does NOT, however, provide the structure or content of a course in HAI. Any courses or training initiatives based on the Framework will need to be developed at local level to meet local needs. 1.9 Instead, it sets out a framework of guidance on development of mandatory induction training in HAI. Personnel within NHSScotland organisations who have responsibility for developing and delivering mandatory induction training in HAI will be able to use it to: map existing provision of induction training in HAI audit current resources for induction training in HAI, including personnel with specific expertise, teaching accommodation and equipment and provision of suitable clinical areas with adequate supervision to facilitate work-based competency development design training initiatives to develop selected healthcare workers competencies in delivering good HAI practice It is also important to stress that while knowledge acquisition and theoretical preparation are important elements of mandatory induction training, the application of theory in practice is paramount. Target groups for mandatory induction training in HAI All hands-on clinical staff who have input to direct patient care Staff with minimal patient contact Staff who have contact with patient-related equipment Contracted/voluntary staff engaged in any of the three categories above. A Framework for Mandator y Induction Training in HAI for NHSScotland 3

5 2. L e a r n i n g O u tc om e s 2.1 The Framework has two elements: Foundation The overarching foundation on which the Framework is based is the Standard Infection Control Precautions (SICPs) (4). Learning outcomes Mandatory induction training programmes should aim to ensure that healthcare workers achieve the learning outcomes selected to best meet their needs. FOUNDATION: Standard Infection Control Precautions (SICPs) 2.2 The SICPs consist of nine key elements: hand hygiene personal protective equipment prevention of occupational exposure to infection management of blood and body-fluid spillages management of care equipment environmental control safe disposal of waste, including sharps safe handling, transport and processing of linen appropriate patient placement. 2.3 Mandatory induction training in HAI is based on the principle that the greater the number of healthcare workers with direct or indirect patient contact who have an understanding of the SICPs, the greater the chance of promoting high personal standards and behaviours and reducing the prevalence of HAI within NHSScotland. 4 A Framework for Mandator y Induction Training in HAI for NHSScotland

6 LEARNING OUTCOMES 2.4 The learning outcomes are offered as a framework on which the HAI training elements of induction programmes can be placed. Organisations will be able to select the learning outcomes best designed to meet the needs of differing healthcare workers undertaking induction training. 2.5 The learning outcomes are based on the premise that, following mandatory induction training, the healthcare worker will be able to: a) Understand the infrastructure for infection control within the organisation, including the function of infection control teams, microbiology services and HAI Cleanliness Champions. b) Describe ways of preventing the transmission of micro-organisms, with particular reference to hand hygiene. c) Define what is meant by the chain of infection (11). 1 d) Discuss the importance of personal vigilance and high standards of care in breaking the chain of infection. e) Outline factors that increase patients /clients susceptibility to infection. f) Describe and give examples of a range of conditions that allow micro-organisms to multiply. g) Give an account of the means by which micro-organisms can be transmitted to a susceptible host (patient, member of staff or visitor). h) Discuss the rationale for the need for isolation in certain circumstances. i) Understand local/national policy and statutory requirements relating to: prevention of occupational exposure to infection management of blood and body fluid spillages management of care equipment safe disposal of waste, including sharps safe handling, transport and processing of linen environmental control. j) Discuss the need for staff/visitor/patient compliance with set policies and NHS QIS standards relating to HAI. k) Be aware of the rights of members of the public to information relating to prevention and control of HAI. 1 The six links in the chain of infection are described as: infectious agent (micro-organism); reservoir, where the micro-organism can reproduce; portal of exit from the reservoir; mode of transmission by which the microorganism transports from one site to another; portal of entry to the host; susceptible host, whose ability to combat infection may be compromised (11). A Framework for Mandator y Induction Training in HAI for NHSScotland 5

7 3. Using the Framework NHSScotalnd personnel who have responsibility for developing and delivering mandatory induction training in HAI should work in close partnership with colleagues in, for instance, human resources departments and specialist teams in designing and delivering induction training programmes for healthcare workers. Principles for managing mandatory induction training in HAI within NHSScotland induction programmes 3.2 Some principles to assist NHSScotland personnel who have responsibility for developing and delivering induction training on planning, delivering and evaluating the HAI elements of their programmes are set out below. HAI training initiatives within induction programmes should have a multidisciplinary focus. Flexible methods of delivering the HAI elements of the programme should be pursued, ensuring that healthcare workers have the opportunity to direct their own learning, in consultation with their line managers/supervisors. Healthcare workers should be able to access core education materials through all resources at the organisation s disposal. This should include libraries, key policy and procedure documents, information on appropriate statutory requirements, colleagues with particular expertise, and IT resources (including, where appropriate, the NHS e-library). Innovative approaches to self assessment should be employed, built on the principle that healthcare workers should be enabled to verify their own competency acquisition. The personal development planning (PDP) process offers an appropriate medium for this function. Induction training initiatives on HAI should have explicit learning outcomes. Mechanisms for recording attendance at induction training should be employed at organisational and individual levels. Adequate quality assurance and auditing processes should be in place to ensure the ongoing fitness for purpose of HAI elements of induction training programmes. 2 NHS Education for Scotland is currently developing an educational resource pack to support the Framework. The resource pack will include: a training video, Reading the Signs; a self-directed pack for consolidation of the HAI induction training in practice; a web-based stand-alone unit on hand hygiene; information on the HAI specialist portal of the e-library (to be launched early 2005). For further information, contact Liz Gillies, Director, HAI Initiative, NES at: liz.gillies@nes.scot.nhs.uk or phone A Framework for Mandator y Induction Training in HAI for NHSScotland

8 References 1. Scottish HAI Taskforce. Preventing Infections Acquired while Receiving Healthcare. The Scottish Executive s Action Plan to reduce the risk to patients, staff and visitors. Edinburgh: Scottish HAI Taskforce. October Scottish HAI Taskforce. A Code of Practice for the Local Management of Hygiene and Healthcare Associated Infection (HAI) Edinburgh: Scottish HAI Taskforce. September NHS Education for Scotland. Information Resource to Support the Introduction of Assigned Staff to Champion Infection Prevention and Control. Edinburgh: NES Standard Infection Control Precautions The Scottish Office (1998) Scottish Infection Manual. Guidance on core standards for the control of infection in hospitals, health care premises and the community interface. Edinburgh: The Scottish Office. April Clinical Standards Board for Scotland. Standards: Healthcare Associated Infection (HAI) Cleaning Services. Edinburgh: CSBS. June NHS Quality Improvement Scotland. National Overview: Improving Clinical Care in Scotland. Healthcare Associated Infection (HAI); Infection Control. Edinburgh: NHS QIS. January National Cleaning Services Specification NHS Quality Improvement Scotland. Draft Standards for Healthcare Governance. Edinburgh: NHS QIS. January Partnership Information Network Guideline Development Group. Induction Training NHS Education for Scotland. Promoting the Prevention and Control of Infection through Cleanliness Champions: programme workbook. Edinburgh: NES A Framework for Mandator y Induction Training in HAI for NHSScotland 7

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