Day 1 - 2019 CNO Summit

1. Leading safety improvements in IPC:
National hand hygiene policy for
England
Linda Dempster, Head of Infection Prevention and Control, NHS Improvement
Dr Lisa Ritchie, NHS Improvement IIPC Fellow and Nurse Consultant IPC, Health Protection Scotland
Craig Bradley, Associate Chief Nurse/Deputy DIPC, Gloucestershire Hospitals NHS Foundation Trust
@Lindajdempster @CraigBradleyRN @Lisaritchie111
#improveIPC

2. New national hand hygiene policy

3. ‘I am really pleased that a group of our IPC staff has come
together to develop a single hand hygiene policy for England.
This national policy should make it easier for all our healthcare
staff to receive the same information on hand hygiene no matter
where they are delivering care and should hopefully free up
our IPC teams from policy writing.
This is the start of our national IPC policy journey, and I look
forward to you working with us as this national work progresses
in the coming months’.
#improveIPC

4. Is our hand
hygiene
to
commissioners?
monitoring
providing
assurance
to my
organisation?
Or is it just
giving
reassurance?
#improveIPC

5. National hand hygiene policy
Responsibilities for the content of this policy
• NHS Improvement in collaboration with Health
Protection Scotland must ensure the content of this
policy remains evidence based
Responsibilities for adopting and
implementing this policy
• All registered providers must demonstrate compliance
with the Health and Social Care Act 2008: Code of
practice on the prevention and control of infections
and related guidance. Specific criteria for hand hygiene
are 2, 4, 9 and 10
• This requires input at an organisational level, managers
of services, staff providing care and Infection
Prevention and Control Teams
#improveIPC

6. National hand hygiene policy

7. National Hand Hygiene Policy
(once for England)
• Support a common understanding: making the right
thing easy to do for every patient, every time
• Reduce variation in practice and standardise care
processes
• Improve how knowledge and skills are applied in
infection prevention and control
• Help reduce the risk of healthcare associated
infection (HAI)
• Help align practice, education, monitoring, quality
improvement and scrutiny.
Evidence based practice guide intended for use by frontline healthcare staff

8. ...the NHS will work hand
in hand with the
voluntary sector and
local authority...
#improveIPC

9. London Midlands North South
Emma Baker Carrie Felgate Julie Dziobon Tracey Doolan
Amanda Bateman Helen Forrest Liz Grogan Ashley Flores
Martina Cummins Amanda Hemsley Patty Hempshall Samantha Matthews
Tracey Galletly Karl McGilligan Peter Ingram Angela Powell
Amita Sharma Taran Saluja Jacqueline Mains Amanda Walker
Neil Wigglesworth Lynda Stockwell Joanne Reynard Lisa White
Natalie Vaughn Linda Swanson
#improveIPC Gary Thirkell
National Policy and Guidance Consensus Group Members

10. ‘Lowering the burden of human
infection will lead to fewer
antimicrobials being used and
less risk of resistance. That puts
preventing and managing
infections firmly at the core of
any AMR strategy...’
#improveIPC
‘England will adopt the Scottish national
IPC manual and care standards.’

11. National IPC Policy and Guidance
• Evidence based guidance
• Expert consensus
• Real time update
#improveIPC

13. Does this data give
you assurance?
#improveIPC

14. What’s the reality?
1.Kingston L, et al. Hand hygiene-related clinical trials reported since 2010: a systematic review. J Hosp Infect 2016;92:309e320.
2. World Health Organization. WHO guidelines on hand hygiene in healthcare. Geneva: WHO; 2009
3. Bradley, C.W. et al. Hand hygiene compliance targets: what are we actually targeting? Journal of Hospital Infection , Volume 95 , Issue 4 , 359 - 360
• Strong evidence from a systematic review indicating best hand
hygiene is around 56%1
• We know that compliance audits are only part of a hand
hygiene improvement programme2
• We know we only measure one element of our programmes3
• Audits are not necessarily false just wrong due to a lack of
training in audit methodology

15. Hand hygiene

17. Hand hygiene monitoring and assurance
• What hand hygiene monitoring is currently being undertaken and reported
in my organisation?
• Is our organisation hand hygiene monitoring providing assurance of safe
care?
• Do my organisation and the commissioners of services have a shared
understanding of our hand hygiene quality measures and a common aim(s)
on improving patient safety?
• Is there a way of presenting the data differently e.g. triangulation of data
with evidence of improved outcomes in relation to safety, effectiveness
and patient experience?

18. https://eoeleadership.hee.nhs.uk/sites/default/files/Patient%20Safety%20First%20How%20To%20Guide%20measurement%20for%20improvement.pdf
#improveIPC

19. #improveIPC

20. WHO Hand Hygiene day 5th May 2019
• NHS Improvement is promoting this survey for
England; NHS Trusts can register at
https://www.who-ipc-survey.org/?from=CINRsbe5Qg
where you will be directed to the two assessment
tools to complete for your organisation
• The two assessment tools can assist organisations to
identify key hand hygiene issues requiring attention
and improvement and assist in facilitating
development of an action plan for hand hygiene
promotion

21. Improving hand hygiene practice survey
• Sharing of resources in a central
repository would be useful
• There is no one-way to measure
and report on hand hygiene
• Existing hand hygiene campaign
messaging remains current
#improveIPC

22. ‘Effective clinical practice: when the
right person does:
The right thing
In the right way
At the right time’
The ward leaders handbook, Oct 2018
#improveIPC

23. Thanks for listening
Linda Dempster
ldempster@nhs.net
@Lindajdempster
Craig Bradley
craig.bradley@nhs.net
@CraigBradleyRN
Dr Lisa Ritchie
lisaritchie@nhs.net
@Lisaritchie111#improveIPC