CDI case checklist and standard assessment tool. Liz Stokle, AMRS and HCAI Programme Lead, Nurse Epidemiologist, PHE

Transcription

1 CDI case checklist and standard assessment tool Liz Stokle, AMRS and HCAI Programme Lead, Nurse Epidemiologist, PHE

2 Background to work December 2013, Working Group set up to address concerns about: whether arrangements for testing and reporting of CDI, and regulatory actions that result, remain fully aligned with supporting best clinical practice. changes in epidemiology of Clostridium difficile infection (CDI) not reflected in current management variations in practice across healthcare sector 2 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

3 Aim and ambition Ultimate aim, for which responsibility should be accepted across the whole health economy, is to prevent all avoidable harm from C. difficile infection (CDI), recognising that there may be cases of unavoidable infection There ambition to achieve the best possible prevention and control of CDI that, to maintain a balanced focus, this work would be embedded into the wider context of prevention and control of healthcare associated infections (HCAI). 3 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

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5 Positive Incentives which are successful in eliciting best practice and which motivate the whole health economy to take responsibility together for the prevention and control of CDI need to apply to the current epidemiology as opposed to past understanding relating to the distribution and transmission of CDI in the UK need to optimise the detection and reporting of CDI to improve our understanding of its epidemiology in both the hospital and community settings 5 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

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7 Promotion of learning NHS England: examine their infection cases to learn any lessons necessary to continuously improve the safety of patients, be focussed on clinical learning and not an attempt to avoid contractual sanctions. Assessing what went wrong, if anything, commissioner and provider together Informing effective interventions, by understanding the problem(s) Not all are collecting or assessing Currently no official collection of data on the outcomes of lapse in care assessments 7 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

8 Assessing whether a CDI case was associated with a lapse in care A lapse in care would be indicated by evidence that policies and procedures consistent with local guidance, written in line with national guidance1 and standards, were not followed by the relevant provider. 8 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

9 Clostridium difficile case checklist To guide local assessment of Clostridium difficile cases so that the minimum information needed can be captured to determine the learning required to prevent Clostridium difficile cases To provide a single approach to assessing whether a lapse in care has taken place; help with understanding themes A step towards consistency of assessment to level the playing field Trusts should be aiming to be compliant with all items on the checklist. 9 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

10 A lapse in what care? Before and after diagnosis When presenting with diarrhoea: Accurate clinical assessment The right tests/early diagnosis Optimising opportunity for treatment Early isolation preventing transmission After diagnosis: Effective management of infection Good antimicrobial stewardship Use of TARGET and Start Smart Then Focus Effective management of diarrhoea 10 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

11 Clostridium difficile Assessment Tool 11 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

12 Whole healthcare economy problem It is hoped that the checklist will open a dialogue about CDI cases between CCG and Trusts across the healthcare economy To seek assurance of the precision of assessments Move away from blame culture rather learn lessons and put them right 12 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

13 Evaluation Plans to evaluate: use of the checklist and whether assessments are being undertaken consistency of approach to assessment and outcome 13 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015

14 THANK YOU 14 Health Economy approach to the detection, management and prevention of CDI - Birmingham 12 March 2015