Hakizimana B
Background: Risk management is a process consisting of well-defined steps which, when taken in sequence, support better decision making by contributing to a greater insight into risks and their impacts. It is as much about identifying opportunity as is about avoiding losses. Effective prevention and control of infection must be part of everyday practice and be applied consistently by everyone. Methods: The study was conducted at Tygerberg Hospital in 8 clinical areas/wards during a period of 3 weeks from 23 November 2013 to 9 October 2013. Risk Assessment IPC Inspection Checklist for healthcare institutions provided by the Unit for Infection Prevention and Control (UIPC) at Stellenbosch University was used for data collection. A feedback report was shared with the unit managers and ward in-charges, and the improvement plan was developed in collaboration with them. The follow-up was done to evaluate the implementation of the improvement plan. Data was analysed using Ms Excel. Results: 6 out of 8 (75%) wards complied with ward design, hand hygiene facilities available in all wards, 5 out of 8 wards (62.5%) had inadequate and insufficient protective clothing, 7 out of 8 (87.5%) wards did not have suitable patient toilet facilities. 7 out of 8 wards (87.5%) had suitable sluice area, while 7 out of 8 wards (87.5%) had appropriate treatment area. Quality of maintenance of aseptic procedures improved from 64% (18/28) to 85% (22/26) in patients with indwelling urinary catheter. The similar improvement was noted in patients with peripheral IV lines, from 81% (57/70) to 86% (48/56) as well as in the patients with wound, from 92% (22/24) to 100% (21/21). Conclusion: 6 out of 8 (75%) assessed wards complied against IPC standards. Conducting regular IPC assessment in clinical areas in collaboration with clinical staff (unit managers and in-charges) is essential to improve the quality and safety of healthcare service delivery. Significant improvement was noted in 7 wards during follow up assessment conducted one week after the initial risk assessment, whereby urinary catheter care improved from 64% to 85% (a 21% improvement) and peripheral IV line care improved from 81% to 86% (a 5% improvement). IPC and clinical teams (nurses, doctors, etc) should work hand in hand to improve the quality and safety of healthcare service delivery.
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