Download Prevention of Healthcare and Associated Infection in Surgery

POSITION PAPER
Royal Australasian College of Surgeons
PREVENTION OF HEALTHCARE ASSOCIATED INFECTION IN SURGERY
1.
PURPOSE AND SCOPE
This position paper outlines key principles with regard to the prevention of healthcare associated
infection in surgery. Supporting these principles are links to documents that the College has endorsed.
2.
BACKGROUND
The Royal Australasian College of Surgeons is committed to ensuring the highest standard of safe
and comprehensive surgical care for the community.
Healthcare associated infections (HAI) acquired in the hospital setting are a major cause of
preventable and sometimes serious harm to patients. The College has a role to engage with
government and external organisations on healthcare associated infections, to actively promote
principles of infection control and to ensure that effective work practices are maintained by surgeons,
trainees and support staff.
Prevention of healthcare associated infections is an essential part of good healthcare practice and
requires regular monitoring and review. A coordinated approach to the prevention and control of
health care associated infections is essential for improving patient safety.
3.
ENDORSEMENT OF GUIDELINES
The College has decided that rather than writing its own Infection Control Manual, it will endorse the
“Commonwealth Infection Control Guidelines – For the Prevention of Transmission of Infectious
Diseases In The Healthcare Setting”
(http://www.health.gov.au/internet/main/publishing.nsf/Content/icg-guidelines-index.htm). These
guidelines have been well researched by experts and covers and updates the material in the existing
College Policy on Infection Control in Surgery (2001).
The College also endorses the Royal Australian College of General Practitioners’ (RACGP) “Infection
Control Standards for Office Based Practices”. This publication has detailed guidelines in the areas of
cleaning the practice environment and sterilization of equipment. It will be of value to the surgeon
undertaking office based procedures:
http://www.racgp.org.au/AM/Template.cfm?Section=Pandemic_resources_for_general_practices&Te
mplate=/CM/ContentDisplay.cfm&ContentID=28165
4.
SURVEILLANCE
The College supports surveillance of Hospital Acquired Infections . Surveillance has been shown to be
a proven method of reducing infection rates when local data collection results in timely feedback.
Whilst the College supports publication of infection rates in a deidentified manner and recognizes that
comparing data between hospitals can have a positive effect, it does not support publication of
infection rates of individual hospitals or surgeons (so-called League Ladder).
In the surgical context surveillance should cover surgical site infections of selected procedures,
bloodstream infections, hand hygiene and antimicrobial usage. The College supports the Australian
Commission on Safety and Quality in Health Care (ACSQHC) Paper on this topic:
http://www.health.gov.au/internet/safety/publishing.nsf/Content/202C676D8BA38757CA25748D007FC
3DC/$File/FullFinal-ReducingHarm.PDF
Division:
Division of Fellowship and Standards
Document Owner: Director, Fellowship and Standards
Page 1 of 2
Ref No.
FES_PST_009
Version:
1
Approval Date:
February 2010
Review Date:
February 2012
POSITION PAPER
5.
Royal Australasian College of Surgeons
OFFICE BASED PRACTICE
Many surgeons undertake minor procedures in their rooms. It is important that the general principles
of infection control are complied with. It is recommended that each practice should have a manual of
protocols regarding infection control. Guidelines to assist in this area can be found in Ch 34 of
“Commonwealth Infection Control Guidelines – For the Prevention of Transmission of Infectious
Diseases In The Healthcare Setting”
(http://www.health.gov.au/internet/main/publishing.nsf/Content/icg-guidelines-index.htm) and in the
RACGP “Infection Control Standards for Office Based Practices”
(http://www.racgp.org.au/AM/Template.cfm?Section=Pandemic_resources_for_general_practices&Te
mplate=/CM/ContentDisplay.cfm&ContentID=28165).
6.
HAND HYGIENE
Improving hand hygiene among health care workers is currently the single most effective intervention
to reduce the risk of HAI. Changes in attitude and behaviour with regard to hand hygiene in Australia
has been shown to result in a significant reduction in the rates of HAI’s due to Methicillin Resistant
Staphyloccus Aureus (MRSA).
The College endorses the National Hand Hygiene initiative and in particular supports the World Health
Organisation “5 Moments” program and the use of alcohol based hand rubs. The College
recommends all surgeons and trainees to become familiar with this program. (www.hha.org.au).
7.
SURGEONS WITH BLOOD BORNE VIRUSES
The College supports the policy outlined in the Commonwealth Infection Control Guidelines – Chapter
24.
8.
TEACHING AND TRAINING
The College believes that Infection Control matters should be included in the syllabus of all specialties.
Training and educational material should also be provided to all Fellows.
Approver:
Authoriser:
Director, Fellowship and Standards
Council
Division:
Division of Fellowship and Standards
Document Owner: Director, Fellowship and Standards
Page 2 of 2
Ref No.
FES_PST_009
Version:
1
Approval Date:
February 2010
Review Date:
February 2012