Review - Reviewer's Assessment

1. Short summary / abstract
This strategy aims to support the reduction of healthcare associated infections in Wales and the main focus is in developing an infection control infrastructure emphasising the responsibilities of all healthcare workers.
The strategy uses a clinical governance and risk management approach that puts the emphasis firmly with clinical teams who must confront their own problems guided and supported by specialist in infection prevention and control.
The strategy recommends a package of tools which will help clinical teams to identify any problem areas, considers the requirements for specialist support, highlights the need for a safe physical environment, the importance of specialist and non specialist training in infection prevention and control and the importance of communication systems to underpin the whole process.
The document is divided into three parts: -
Part one
o the strategic objectives
o how the strategic objectives will be achieved
o the background structure, ‘Improving Health in Wales’
Part two is a summary of the key action points set out in a framework tables which outline the the Strategic objective; delivery framework; actions required; responsibility; monitoring framework and a timescale for completion for the following areas
o National Standards
o Infrastructure and Organisation
o Specialist Infection Control Support Specialist Epidemiological Support
o Facilities
o Training and Education
o Surveillance
o Audit
o Interventions and Performance Indicators
o Information Technology and Communications
Part three gives an overview of healthcare associated infections in hospitals and the supporting information on the key action points set out in part two.
The appendices include an example of a model infection control strategy statement, a table to demonstrate number of ICN’s to acute beds, tables and graphs demonstrating numbers of new MRSA bacteraemia reports via CoSurv from 1996-2002, data on hospital outbreak reporting 1997-2003, data on surgical site infection reporting and data demonstrating moving annual numbers of reports of sensitive staphylococcus aureus bacteraemia and MRSA bacteraemia rates in one hospital
Corporate responsibility will rest with chief executives and their boards to deliver the strategy for Wales

2. What question is the document addressing?
The document clearly outlines strategic objectives, a summary of the key action points, responsibilities and the supporting information necessary to enable all healthcare staff to prevent/control and sustain a reduction of healthcare associated infections in Wales.

3. Type of study

4. Methods valid & appropriate?

The approach was introduced in Improving Health in Wales – A Plan for the NHS and its partners and the National Audit Office document The management and Control of Hospital Acquired Infection in Acute NHS Trusts in England 2000.

5. Results / recommendations reliable?
Yes: Developed by the Welsh Healthcare Associated Infection sub group (WHAISG) of the Committee for the Control of Communicable Diseases and compliance with these national standards will be reviewed by the Welsh Risk Pool and Healthcare Inspectorate Wales.

6. Any major problems and biases?

7. Any other important / relevant studies which confirm or contradict?
1. National Assembly for Wales (2001) Improving Health for Wales – A Plan for the NHS and its partners. Cardiff: National Assembly for Wales
2. National Audit Office. (2000) The management and control of hospital acquired infection in acute NHS trusts in England
3. Department of Health. Health Service Guidance. Hospital infection control: guidance on the control of infection in hospitals. HSG(95)10
4. Welsh Assembly Government. Healthcare associated infection surveillance. WHC 2003(43) April 2003
5. Improving patient care by reducing the risk of hospital acquired infection: A progress report (A report by the Comptroller and Auditor General) National Audit Office HC 876 Session 2003-2004: 14 July 2004

8. Keywords
Healthcare associated infection infection prevention and control acute hospitals infectious diseases infectious diseases emergencies strategy national standards

Reviewer's Details:

Name:Sue Wiseman
Post:Nurse Consultant –Infection Control, DH
(Society / Organisation / Advisory Committee):
Member Advisory Committee on Dangerous Pathogens
Health Protection Adviser Royal College of Nursing P/T
Member Infection Control Nurses Association

*** Note: These are the views of a professional expert rather than an official statement from his or her society, organisation or advisory committee.

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