Peer reviewed article he National Health Service (NHS) in England continues to experience ongoing change in order to complete the transition to the new delivery system outlined in Liberating the NHS (Department of Health, 2010a). Treating and caring for patients in a safe environment and protecting them from acquiring avoidable infections remains a high priority and a central quality improvement component within the outcome Indicator set for 2013/14 (NHS Commissioning Board, 2012a). Infection prevention and control practitioners will be required to use a range of innovative quality improvement strategies to facilitate engagement with clinicians and meet the challenges that lie ahead for the NHS. The purpose of this paper is to report on the implementation of an infection prevention and control self-audit (IPCSA) project within general practice. The aim of the project was to empower practice staff to become actively involved with an infection prevention and control (IPC) audit in order to support the development of an IPC quality improvement culture within general practice teams. The paper outlines the methodology used to implement self-audit. The findings suggest that IPCSA can be used as an effective alternative to an IPC nurse-led infection prevention and control audit. IntroductionThe new structure of the NHS is set out within a framework agreement between the Department of Health and the NHS Commissioning Board Authority (Department of Health, 2012). It outlines the role of the NHS Commissioning Board as an executive non-departmental public body of the Department of Health and places a duty on the board and Clinical Commissioning Groups (CCG) under the Health and Social Care Act (Department of Health, 2010b) to improve quality and outcomes (NHS Commissioning Board, 2012b).Achieving and maintaining high standards of infection prevention and control (IPC) remains fundamental in order to ensure that patients experience a safe environment and are protected from acquiring avoidable infections. Despite conflicting evidence about the efficacy of various types of audit, it continues to be widely used as a quality improvement technique (Millward et al, 1993; Bowie et al, 2010). This paper outlines the implementation of an infection prevention and control self-audit (IPCSA) in a general practice setting. The rationale for implementing self-audit and its application in practice are discussed. The findings suggest that IPCSA can be used as an effective alternative to a nurse-led infection prevention and control audit. BackgroundThe history and proliferation of audit is well documented (Power, 1994;Holden, 1999; Bowerman et al, 2000;Humphrey and Owen, 2000; Bowie et al, 2009;Levy and Rockall, 2009). The role of audit within the National Health Service (NHS) in England was outlined as part of the government white paper 'Working for Patients' (Department of Health, 1989a). Working paper 6 (Department of Health, 1989b) specifically defined medical audit, but subsequent policy initiatives (Department of Health, 1998Health, ...
Michelle Gorrell summarizes new guidance on infection prevention and control and looks at the role practice nurses play in implementing these standards
The National Health Service (NHS) in England is facing significant challenges ahead as a result of the government’s plans to reduce national debt. The challenge for infection control practitioners will be to continue to support the development and delivery of high quality clinical services without the level of funding previously experienced over the last decade. In order to achieve this all healthcare professionals will be required to embrace improvement strategies. The purpose of this paper is therefore to report on a review of a clinical reporting and root cause analysis (CRRCA) process coordinated by a community-based infection prevention and control team. The paper outlines the issues surrounding the current CRRCA process and analyses the process using lean concepts. A series of change options are put forward in order to illustrate how a failure to effectively scope improvement project boundaries can constrain change thereby limiting the potential for productivity and quality improvement.
As personal care wipes become increasingly popular, inappropriate disposal to the sewage system is raising significant environmental and economic concerns. Many common brands, while marketed as “flushable,” do not degrade appreciably in the plumbing and piping fixtures that the sewage transits. As such, these wipes can cause a myriad of problems including sewer blockage and destruction of pumps and grinders. This work sought to better understand key factors influencing the onset of such problems, including the volume of wipes present in the sewer and the degradation rates associated with a variety of personal wipe products, both “flushable” and nonflushable. The results suggest no correlation between the quantity of wipes in sewage and either the preceding precipitation or the sewage flow rate. To examine their degradability within a sewer system, we evaluated the degradation over time for six commercially available wipes under four conditions: static, kinetic, tap water, and sewage water. Five of the six wipe types were greater than 93% intact after 48 h of exposure to sewer‐like conditions and only one wipe type degraded to less than 14% of its initial volume after 48 h, which is similar to the degradation performance of tested toilet paper. Degradation rates were highest in tap water under kinetic conditions and lowest in raw sewage water under static conditions.
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