January 2008 Alberta Infection Prevention and Control Strategy
For further information For additional copies of this document contact: 22nd floor, 10025 Jasper Avenue Edmonton, Alberta T5J 1S6 Phone: 780-427-7164 Fax: 780-427-1171 E-mail: ahinform@health.gov.ab.ca You can find this document on the website www.health.alberta.ca ISBN 987-0-7785-6627-4; PDF Version
TABLE OF CONTENTS Page INTRODUCTION... 1 THE ALBERTA INFECTION PREVENTION AND CONTROL STRATEGY... 2 1. Leadership and Accountability... 3 2. Provincial Standards and Monitoring... 4 3. Province-wide Surveillance... 5 4. Human Resource Requirements... 6 5. Physical Infrastructure... 7 6. Public Awareness and Education... 8 IMPLEMENTATION... 9
INTRODUCTION The Alberta Infection Prevention and Control Strategy outlines actions to improve infection prevention and control across Alberta s health system and in Alberta communities. The Strategy has implications for all sectors but the initial focus will be on the health care system. The environment in which health care is delivered and where people live is continually changing. Health care associated-infections are a significant cause of death and increased illness among hospitalized patients. Albertans want assurance of the safety and quality of the health care system. Health care is increasingly provided in community settings and people are being discharged earlier from hospital. In addition, micro-organisms have grown resistant to antibiotics. These factors create risks for the transmission of infections in community settings. New diseases such as SARS, and reemerging diseases such as whooping cough, continue to threaten the health of the public. All of these issues reinforce the importance of effective infection prevention and control (IPC)., health authorities and Alberta health professional regulatory bodies all have important roles in IPC. is responsible for setting direction and standards for the health care system and monitoring compliance with standards. Health Authorities are responsible for assessing needs, promoting and protecting the health of their population, preventing disease and injury and delivering safe, quality health care services. Health professional regulatory bodies are responsible for governing their regulated members in a manner that protects and serves the public interest. This Strategy describes the actions that will be taken by, health authorities and health professional regulatory bodies to improve infection prevention and control. It was developed with input from the Alberta Infection Prevention and Control Advisory Committee, which is comprised of many nationally recognized experts who live and work in Alberta. Alberta Infection Prevention and Control Strategy 1
THE ALBERTA INFECTION PREVENTION AND CONTROL STRATEGY VISION The vision of Alberta s Infection Prevention and Control Strategy is: GOALS The goals of the Strategy are to: Working together to prevent and control infections everyone has a role Protect the health of Albertans by preventing and controlling the transmission of infections Assure Albertans of the quality of infection prevention and control in Alberta STRATEGIC DIRECTIONS 1. Leadership and accountability 2. Provincial standards and monitoring 3. Province-wide surveillance 4. Human resource requirements 5. Physical infrastructure 6. Public awareness and education The following section outlines objectives and actions for each of these strategic directions. Actions are described for, health authorities and health professional regulatory bodies with the expectation that much of the work described will be undertaken collaboratively. Actions will align with relevant initiatives such as the Alberta Patient Safety Framework being developed by. Some of the actions described will require collaboration with other levels of government (e.g. First Nations and Inuit Health Branch, Health Canada-Alberta Region) and various government ministries including: Advanced Education and Technology; Children s Services; Education; Employment, Immigration and Industry; Infrastructure and Transportation; Municipal Affairs and Housing; Seniors and Community Supports; and Solicitor General and Public Security. Partnerships with academic and training institutions and other organizations such as the Health Quality Council of Alberta and the Canadian Patient Safety Institute will also be required. Alberta Infection Prevention and Control Strategy 2
1. Leadership and Accountability Objectives: Strengthen leadership for IPC at senior levels of the health system. Clarify and implement accountability for IPC among, health authorities, and health professional regulatory bodies. Proposed Actions: Enact legislative and policy changes to clarify governance, accountability, and responsibilities for IPC to support patient safety and quality care in the health system. Clarify the authority of regional medical officers of health for patient and public safety in matters of IPC and build upon the existing linkages between regional medical officers of health and the province s chief medical officer of health. Identify IPC reporting requirements for health authorities and health professional regulatory bodies. Develop strategies to enhance patient and worker safety, in collaboration with relevant government ministries, academic training institutions, the Health Quality Council of Alberta and other organizations. Health Authorities Designate a senior executive with overall responsibility for IPC in the region. Develop, implement, and sustain effective and comprehensive IPC programs and services across the region. Report on IPC activities and outcomes to staff, managers, senior executives, the Health Authority Board,, and communities served by the health authority. Health Professional Regulatory Bodies Address IPC in all relevant aspects of a regulatory bodies regulatory activity, including professional guidelines, practice standards, continuing competency programs, and where applicable, accreditation. Ensure that professional bylaws and standards of practice are consistent with the reporting requirements for risks to patient safety under the Health Professions Act and the Public Health Act. Alberta Infection Prevention and Control Strategy 3
2. Provincial Standards and Monitoring Objectives: Strengthen the development and consistent application of IPC standards across the continuum of health care and community settings. Monitor compliance with IPC standards. Proposed Actions: Develop provincial IPC standards. Initial priorities are standards for: IPC accountability and reporting structures for health authorities Cleaning, disinfection, and sterilization of medical devices Single-use medical devices Immunization of all health care workers Methicillin-Resistant Staphylococcus aureus (MRSA) prevention and management IPC training, certification and staff Health facility design, construction, renovation, and maintenance. Implement mechanisms for monitoring compliance with provincial IPC standards. Monitor and publish reports on compliance with provincial standards. Establish an approach to respond to compliance issues. In consultation with partners including the health authorities, health professional regulatory bodies and the Health Quality Council of Alberta, identify mechanisms for measuring and monitoring effectiveness of infection prevention and control strategies and practices. Health Authorities Implement provincial IPC standards across the continuum of health care and community settings. Monitor and report on compliance of the health authority, including contracted services, with provincial IPC standards. Remediate identified deficiencies to protect patient and worker safety. Health Professional Regulatory Bodies Establish and communicate expectations and responsibilities of regulated members with regard to IPC. Adopt provincial IPC standards as applicable and monitor compliance of members with standards. Alberta Infection Prevention and Control Strategy 4
3. Province-wide Surveillance Objectives: Implement a province-wide IPC surveillance system. Proposed Actions: Establish a population-based, timely, and responsive surveillance system to monitor IPC-related processes and outcomes. Provide information management and epidemiological expertise to support consistent data collection, analysis and reporting, and to achieve maximal use of collected data. Report surveillance information on health care associated-infections, antimicrobial resistance and other IPC-related issues as needed. Use surveillance data to plan, evaluate and improve provincial IPC strategy activities. Health Authorities Develop and implement structures and processes for data collection, analysis, and reporting. Use surveillance information to plan, evaluate and improve regional IPC activities. Prepare and submit surveillance reports on IPC issues, as required. Alberta Infection Prevention and Control Strategy 5
4. Human Resource Requirements Objectives: Strengthen supports to professionals responsible for IPC. Strengthen education and training of all workers in IPC principles and practices. Protect workers from work-associated infection transmission. Proposed Actions: Develop a strategy to create surge capacity for regions requiring additional expertise to resolve critical IPC incidents. Facilitate the availability of support and consultation services to infection control professionals. Identify IPC competencies for health care workers. Facilitate the development of education and certification requirements for all IPC professionals. Facilitate the implementation of training activities and materials for IPC. Facilitate awareness of individual and organizational roles and responsibilities with respect to IPC and occupational health and safety practices and relevant legislation including the: Occupational Health and Safety Act, Health Professions Act, Public Health Act, Medical Profession Act, Regional Health Authorities Act, etc. Health Authorities Achieve and sustain required staffing levels and resources for IPC. Ensure that all workers receive orientation, and ongoing training and education in IPC. Develop and maintain health care workers competence in IPC practices. Minimize opportunities for work-associated infection transmission. Health Professional Regulatory Bodies Provide professional leadership to facilitate IPC training and education among members. Monitor and reinforce continuing competence of members with regard to IPC. Alberta Infection Prevention and Control Strategy 6
5. Physical Infrastructure Objectives: Integrate IPC principles into the design, construction, renovation and maintenance of health care facilities. Proposed Actions: Identify IPC standards for health care facility design, construction, renovation, and maintenance. Facilitate incorporation of IPC standards into building codes and designs. Implement the Alberta Hand Hygiene Strategy * across all sectors to improve accessibility to hand hygiene facilities. Health Authorities Apply and integrate IPC standards in the design, construction, renovation, and maintenance of health care facilities. Provide health care workers with the physical environment and equipment to practice effective IPC. Improve availability of and accessibility to hand hygiene facilities. * The Alberta Hand Hygiene Strategy is a broad 10-year plan designed to improve hand hygiene behaviours in Alberta. It details actions to improve accessibility to hand hygiene facilities, and improve hand hygiene knowledge beliefs, attitudes and behaviours. Alberta Infection Prevention and Control Strategy 7
6. Public Awareness and Education Objectives: Increase IPC awareness, knowledge, and practices in the general public. Increase public awareness about antimicrobial resistance and health care associated-infections. Proposed Actions: Implement the Alberta Hand Hygiene Strategy across all sectors to improve knowledge, beliefs, attitudes and behaviours regarding hand hygiene. Promote and encourage the development of collaborative and coordinated approaches toward increasing public awareness, and practice of infection prevention and control practices. In partnership with the Health Quality Council of Alberta, assess public knowledge of and satisfaction with respect to infection prevention control. Health Authorities Collaborate with AHW in the development and implementation of targeted public education. Alberta Infection Prevention and Control Strategy 8
IMPLEMENTATION Implementation will include introducing, developing and evaluating these strategic directions over the next ten years. Detailed action plans will stem from these strategic directions and be implemented in conjunction with the Alberta Hand Hygiene Strategy and the provincial IPC standards. Alberta Infection Prevention and Control Strategy 9