All Victorian health services can apply a range of strategies to maintain standards and generate improvements in healthcare-associated infection (HAI) prevention.
Health services should have clear objectives for undertaking healthcare-associated infection surveillance, with defined links to internal quality and risk management systems.
An effective surveillance plan should include:
- adherence to relevant statutory requirements, safety standards and guidelines
- laboratory-based surveillance and clinical ward rounds to identify infections
- monitoring of significant organisms such as antibiotic resistant bacteria
- hospital-wide surveillance
- feedback of surveillance data analysis to health services.
VICNISS - HAI monitoring and surveillance
VICNISS Coordinating Centre analyses and collates targeted infection surveillance data from Victorian health services. The centre provides data to health services and the department.
Health service monitoring and control
The department works collaboratively with health services to drive improvements in quality and safety.
The Victorian health services performance monitoring framework sets out the range of measures for health services to promote consistent monitoring and control practices across the sector.
A number of indicators support ongoing improvement in relation to patient safety and quality of care, including healthcare-associated infections.
Design and maintenance guidelines for hospitals
The department has developed guidelines to ensure that health services will be designed, constructed, furnished and equipped in keeping with the principles of infection control.
Requirements as specified by the guidelines include, but are not limited to, the following:
- sufficient storage space for personal protective equipment to minimise the transfer of micro-organisms from person to person
- installation of hand-washing facilities in all patient care areas and in other areas where hygiene is essential, such as kitchens, laundries, pharmacies, laboratories and staff amenities
- consideration of air-conditioning or ventilation systems, floor coverings, and waste management in the construction and fit-out of healthcare facilities
- provision for ease of cleaning and sterilisation and disinfection of equipment and instruments
- provision for the isolation of infectious patients as required.
Mycobacterial infections associated with heater cooler units
It has been found that heater cooler units, medical devices used in cardiac surgery, may be contaminated with Mycobacterium chimaera, a species of non-tuberculous mycobacteria. There is a small risk that patients exposed to the exhaust from these units in the operating theatre may develop a serious infection up to several years post-surgery.
The department has been working closely with health services to minimise risk and maximise safety for cardiac surgery patients. The following guidance documents have been developed to support Victorian clinicians and health services responding to this issue:
- Guidance for health services operating and maintaining heater cooler units.
- Testing and sampling guidance, including the testing schedule for Victorian hospitals.
- General practitioner information.
- Consumer information, available from the Better Health Channel website www.betterhealth.vic.gov.au.