{"id":3800,"date":"2014-01-31T05:37:43","date_gmt":"2014-01-30T18:37:43","guid":{"rendered":"https:\/\/blogs.rch.org.au\/news\/?p=3800"},"modified":"2015-04-29T12:06:22","modified_gmt":"2015-04-29T02:06:22","slug":"infections-are-going-down","status":"publish","type":"post","link":"https:\/\/blogs.rch.org.au\/news\/infections-are-going-down\/","title":{"rendered":"Infections are going down"},"content":{"rendered":"

\"pano_fb\"<\/a>Single rooms provide patients and families added privacy and space during their stay at the RCH, but it’s the added extras patients don’t receive that also improve their experience in hospital.<\/strong><\/p>\n

Hospital acquired infections are inconvenient and devastating for patients and their families. Infections, such as gastroenteritis and enterococcal septicaemia, are spread in hospitals where patients\u2019 immune systems are already weak due to illness.<\/p>\n

Associate Professor Andrew Daley, RCH Infection Control Physician, said planning for the new RCH provided a once-in-a-lifetime opportunity to evaluate every aspect of infection control from the ground up.<\/p>\n

\u201cThe Infection Control team played a key role in determining the location and layout of clinical areas before the new hospital was constructed,\u201d Andrew said.<\/p>\n

\u201cOur ultimate objective was to improve the hospital experience for patients and families by reducing hospital acquired infection rates, reducing morbidity and mortality associated with these infections, and to shorten length of stay,\u201d he said.<\/p>\n

During the planning stage for the new hospital, the team collected infection data in the old hospital for both hospital acquired viral infections and central line infections.<\/p>\n

After the move, the monitoring has continued, and the results for 2012\u201313 have been outstanding.<\/p>\n

\u201cWe\u2019ve seen significant reductions in the rate of hospital acquired infections, which is fantastic for patients and families, and a huge morale boost for our staff,\u201d Andrew said.<\/p>\n

For the three years prior to the move, central line associated infections remained unchanged at 2.7 per 1,000 line days.\u00a0 In 2012, the rate dropped to 1.8 per 1,000 line days.<\/p>\n

Hospital acquired gastroenteritis rates also plummeted, by 40 per cent, while hospital acquired respiratory viral infections reduced by 10 per cent.<\/p>\n

A key concern for clinicians is when infection-causing organisms develop a resistance to antibiotic treatments.\u00a0 Before the move, 9 per cent of invasive staphylococcus aureus<\/i> bloodstream infections in the RCH were methicillin (antibiotic) resistant, but since the move none of these infections have been methicillin resistant.<\/p>\n

Similarly, the number of enterococcal septicaemia cases that are vancomycin resistant has fallen from 50 per cent to just eight per cent after the move.<\/p>\n

Single rooms \u2013 not sharing is caring<\/strong><\/p>\n

A major contributor to the reduction in infections has been the introduction of 85 per cent single occupancy patient rooms in the new RCH.<\/p>\n

After researching the designs of many hospitals around the world, the RCH concluded single rooms represented best practice in many ways, particularly in reducing hospital acquired infections.<\/p>\n

RCH Infection Control Coordinator, Sue Scott, said parent focus groups shared the desire for single rooms, and their decision is paying off.<\/p>\n

\u201cFamilies will tell you that single rooms provide greater space and privacy, which is always valued when a child is unwell in hospital.\u00a0 What families may not realise is that single rooms also help protect their children from infections.<\/p>\n

\u201cAll single rooms in our hospital have ensuites, which means there is less opportunity for organisms to transmit to other patients from the contaminated environment. Parents can eat meals safely with their children in their own \u2018family zone\u2019, away from the \u2018clinical zone\u2019 where staff are able to practice safely,\u201d Sue said.<\/p>\n

Isolation rooms on every ward<\/strong><\/p>\n

Each ward in the new hospital has two negative pressure rooms to isolate patients with airborne transmitted infections.\u00a0 This means patients can be isolated on the most appropriate ward for their underlying condition, rather than being moved to a separate \u2018isolation ward\u2019.<\/p>\n

\u201cThis is great, because now cardiology and cancer patients with an airborne transmitted infection can remain on the cardiology and cancer wards with the staff they know, and who know them and their conditions well.\u00a0 It\u2019s also helping to reduce parent anxiety about their child\u2019s care,\u201d Sue said.<\/p>\n

Infection precautions tailored to each patient<\/strong><\/p>\n

RCH clinicians regularly evaluate the infection transmission risks of each patient.\u00a0 Rather than taking a one-size-fits-all approach to applying precautions to reduce infection transmission, staff now assess each patient\u2019s individual risks, taking into consideration their age, developmental stage and social needs.<\/p>\n

For example, a patient who is not toilet trained may require extra precautions (such as remaining in their room with staff using protective barriers like gloves and gowns) than a patient who is continent, cooperative and has good personal hygiene.<\/p>\n

Infection Control has also developed information sheets in conjunction with the RCH Family Advisory Council (FAC) to help parents and carers understand the precautions they can take to reduce the chance of infection transmission.\u00a0 Some of these sheets have been translated into multiple languages, and are provided to parents of patients who are on the wards, are being managed by RCH Hospital in the Home, or have been discharged into the community.<\/p>\n

Hand hygiene family auditing in Specialist Clinics<\/strong><\/p>\n

While the RCH has conducted monthly staff hand hygiene auditing in all clinical areas since January 2012, outpatient services were not involved in the process.<\/p>\n

Hand hygiene compliance in outpatient areas had previously been raised as a concern by the FAC and so, in 2013, the Infection Control team took a unique approach to auditing Specialist Clinics. On World Hand Hygiene Day, 6 May, families attending RCH Specialist Clinics were invited to participate in surveying staff compliance with hand hygiene.<\/p>\n

Around 300 surveys in six languages (English, Simplified Chinese, Vietnamese, Somali, Turkish and Arabic) were distributed to families throughout the day while a variety of specialist clinics were in progress.<\/p>\n

Meanwhile staff from Infection Control, Volunteers, Educational Play Therapy and the FAC promoted the event through colouring activities and stickers for children.<\/p>\n

Sue said the findings have highlight improvements that need to occur in staff hand hygiene practices.<\/p>\n

\u201cThe results demonstrated that staff didn\u2019t always perform hand hygiene both before and after significant patient contact,\u201d Sue said.<\/p>\n

\u201cThe results have prompted us to reinforce hand hygiene in the outpatient setting to permanent and visiting health care workers.\u00a0 We\u2019ll be repeating the survey to measure ongoing improvements,\u201d she said.<\/p>\n

Sibling participation<\/strong><\/p>\n

Nurses on the Kookaburra Ward (cancer care) Sarah Egan, Kristen Roberts and Ella Borello, facilitated an infection control session at the ward\u2019s annual \u2018Sibling Day\u2019 for children who have a sister or brother undergoing cancer treatment.<\/p>\n

Sibling Day is designed to familiarise children with the hospital environment and some of the procedures that may occur. Siblings have a chance to meet other siblings who are dealing with similar issues. The children have the opportunity to ask questions of both medical and nursing staff as well as have their temperature, pulse, blood pressure and oxygen saturations measured.<\/p>\n

The infection control session explained the importance of hand hygiene. Children took delight in playing with a special \u201cglow germ\u201d fluorescence cream to understand how to correctly wash hands.<\/p>\n

This story was produced for the RCH Quality of Care Report 2012-13.\u00a0Click here<\/a>\u00a0to view the full report.<\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Single rooms provide patients and families added privacy and space during their stay at the RCH, but it’s the added extras patients don’t receive that also improve their experience in hospital.<\/p>\n","protected":false},"author":41,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[6],"tags":[],"class_list":["post-3800","post","type-post","status-publish","format-standard","hentry","category-in-the-news"],"acf":[],"_links":{"self":[{"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/posts\/3800","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/users\/41"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/comments?post=3800"}],"version-history":[{"count":8,"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/posts\/3800\/revisions"}],"predecessor-version":[{"id":3878,"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/posts\/3800\/revisions\/3878"}],"wp:attachment":[{"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/media?parent=3800"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/categories?post=3800"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.rch.org.au\/news\/wp-json\/wp\/v2\/tags?post=3800"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}