Jane Barnett

National Infection Prevention and Control Programme Lead, Southern Cross Hospitals Limited

No bluff – this is for real: the revised Infection Prevention and Antimicrobial Stewardship Standard
The Health and Disability Services (Safety) Act 2001 requires all providers of health services to be certified against relevant standards.  A process began in March 2019 to scope the existing Health and Disability Sector standards NZ 8134:2008 for review.  The process involved amalgamation of several standards to avoid duplication (Health and Disability Sector Standards, Fertility Services Standard and Home and Community Sector Standards).  The NZNO IPC College provided representation on the subsequent working group and Standards Committee.  The revised Standard reflects the shift towards person and whanau-centered health and disability services.

The IPC standard has undergone significant changes, incorporating a stronger governance section and a set of criteria for antimicrobial stewardship and the environment.  The final draft for consultation was issued in December 2020 and following further amendment has now been ratified by the Standards NZ.  This presentation will provide an overview of the journey undertaken for the standards review and an overview of the content of the new Infection Prevention and Antimicrobial Stewardship Standard.
Jane Barnett, NZNO IPC College representative on HDSS Standards Committee.

Enhanced Standard precautions – we need ESP during a pandemic
Concurrent session:  The Covid-19 pandemic in 2020 highlighted how important it is that clinical staff know and practice the fundamentals of infection prevention routinely and to a good standard providing them with the security of knowing they are protecting themselves and their patients from infection.
The elective nature of services in the Southern Cross Healthcare network and the need to remain ‘green stream’ in order to relieve pressure from the acute DHB services, resulted in a need for a Covid-19 risk assessment of all patient admissions.  This resulted in deferral of any patients with symptoms or a high risk contact or travel history.   Nevertheless, despite the advice from the Ministry of Health and international bodies, it became clear that Standard Precautions for asymptomatic individuals were not considered sufficient.  There was a perception that additional precautions and personal protective equipment (including N95 masks) were required for all patient interactions.  The heightened anxiety was resulting in excessive use of PPE with minimal application of Infection Prevention principles.
The concept of Enhanced Standard Precautions was developed.  These were to be used only in close contact of less than 2 metres for 15 minutes or more.  When physical distancing was in place, normal standard precautions were to be observed i.e. hand hygiene and gloves if handling body fluids.    The main difference between the approaches was the use of a surgical mask or visors for admitting and anaesthetic staff as these were already in use by those in operating theatres and post anaesthetic care.
These precautions rationalised and standardised the approach to be taken by the teams throughout our hospitals and helped to reinforce the fundamentals in IPC practice.  It also gave reassurance to staff that we were still providing protection but this was based on rationale approaches.   As Alert Levels changed, our approach remained consistent.

Jane Barnett has worked in the field of Infection Prevention and Control for 33 years.   Her experience spans three NHS trusts in the UK and both District Health Board and private surgical hospital settings here in NZ.  She is passionate about this area of practice and believes that we need to use our influence in this field to improve patient safety and outcomes.  Jane has published a number of articles on Infection Prevention and is still a reviewer for the UK Journal of Infection Prevention.  She has held a number of positions with the NZNO IPC Nursing College including most recently representing the college on the New Zealand Health and Disability Standards review committee.  She currently works as the National IPC Programme Lead for Southern Cross Healthcare and is based in Auckland (but remains a Cantabrian at heart!)

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