| AREA | ACTION NEEDED | WHO | WHEN |
|---|
| Management of Outbreak |
- Set up Outbreak Control Team to develop and implement an effective strategy to manage outbreak.
|
|
- Outbreak Control Team with supporting subgroups established in Jan 2008. Meet weekly.
|
|---|
| Communication Communication (continued) |
- Notification of CDAD Outbreak to DHSSPS and NHSSB
- Reports to CEO, Medical Director, Outbreak Control Team, Infection Prevention and Environmental Hygiene Committee, Drug and Therapeutic Committee, NAPF.
- Monthly Report to Trust Board
- Weekly Updates to SMT
- Communicate the necessity of reducing the incidence of CDAD in the NHSCT to all clinical and senior managers
- Communicate to all Health Care Workers the duty of care to comply with Trusts CDAD reduction plan
- Issue CDAD information sheet to all clinical staff
- Inform GPs of outbreak and encourage them to try to avoid hospital admission of patients with diarrhoea
Updated information CDAD leaflets for Patients/Visitors
- Information sheet for visitors in English and translated into relevant languages.
|
|
- 8th Jan onwards
- Discussed at SMT and Clinical Directors meetings from December 2007 onwards
- Included in Chief Executive’s letter January and February 2008. In Trust Newspaper in February 2008
- Regular contact with all relevant clinical staff on an ongoing basis
|
|---|
| Education |
- Infection Control Training for all staff. Medical, Nursing, Allied Health Professionals and Hotel Services staff
- Education re death certification for medical staff.
|
- Medical Educational Officer. Senior Nurse Infection Control. Clinical Directors. Ward Managers. Hotel Services Managers. Head of Nursing Education and Development.
|
|
|---|
| Incident Reporting |
- Report any delays or failure to isolate patient as a clinical incident
- Report non-compliance with infection control policies as a clinical incident
- Medical staff to complete a proforma for each death associated with CDAD
|
|
|
|---|
| Collect Surveillance Data |
- Clinical staff monitor occurrence of diarrhoea in wards and report any increase above expected level to line manager and infection control
- Continue alert organism surveillance by 1.C Nurse
- Develop ICT programme for data collection on all CDAD patients for analysis with feedback of information to wards
|
- Ward clinical team (medical, nursing and pharmacist)
- Dr P Kearney and Dr E Davies
|
|
|---|
| Infection Control |
- Monitor adherence to infection control policies to include dress code and hand hygiene
- Review need for additional infection control measures in light of changing circumstances and new best practice evidence
- Patients with suspected CDAD isolated and/or cohorted immediately
- The bodies of patients who have died with CDAD should be transferred to the mortuary in a body bag
|
- Ward Managers
- Link Nurses
- Outbreak Control Team with supporting subgroups
|
- Ongoing
- Cohort isolation ward opened in A1, Antrim Hospital in January 2008
- Scrubs for medical staff at Antrim Hospital introduced 6 February 2008
- Letter to relevant Directors issued January 2008
|
|---|
| Microbiological Testing |
- Lab Toxins for C Difficile toxin testing 24/7
- Store all toxin positive samples for 1 year
- All toxin positive test samples are cultured and sent for PCR Ribotyping
|
- Medical Microbiologists
- General Managers/Service Manager Microbiology
|
|
|---|
| Antibiotic Guidelines |
- Review antibiotic guidelines for primary and secondary care (to minimise use of Fluroquinolones)
- Develop and circulate to all clinical staff an aide memoir for antibiotic prescribing
- Produce guidance on Penicillin hypersensitivity
- Produce a list of restricted antibiotics which will require completion of a policy exemption form
|
|
- January 2008
- December 2007
|
|---|
| Enhanced Environmental cleaning for patients in isolation |
- Use of chlorine based disinfectant to reduce environmental contamination
- Enhanced environmental cleaning
- Development of Rapid Response Cleaning Teams
- Decontamination of affected areas by Hydrogen Peroxide
|
|
- January 2008
- FE Bid developed February 2008
|
|---|
| Monitoring of implementation of CDAD action plan |
- Completion of performance indicators to evidence that various aspects of action plan have been carried out
|
- Relevant staff as per performance indicator table
|
|
|---|
