1. Benefits for using a standardised risk management framework to risk assess Infection Prevention and Control
Sue Greig
Senior Project Officer
National HAI Prevention Program
1 October 2014

2. Who might benefit from this presentation?
Organisation governance – improve their understanding of their role in infection prevention and control and risk management
Quality and safety managers or departments
Infection prevention and control professionals

3. Key message – infection control is everybody’s business
To make this message meaningful it requires a governance structure and key people to drive and direct the infection prevention and control programme and all staff to have a basic understanding of:
Effective governance to support implementation, monitoring, reporting activities
Effective work practices to minimise risk of transmission of infectious agents
Modes of transmission of infectious agents
Legislation, regulation and standards to be applied

4. A risk management framework
Provides a nationally consistent approach that is robust enough to be applied across the health continuum
How do we use risk assessment and management principles for Infection Prevention and Control?
Infection should not be considered an unpredictable complication but a potentially preventable adverse event

5. The risk assessment and management flowchart Source: Australian Guidelines for the Prevention and Control of Infections in Health Care (NHMRC 2010) - Adapted
Collaboration

6. A risk matrix Source: Australian Guidelines for the Prevention and Control of Infections in Health Care (NHMRC 2010)

7. Who owns the risk? Governance of the organisation or service
From where can risks come?
the system
the organisation
the team who are delivering the care
the individual

8. Who is at risk?
Patients – some patients more than others, e.g. elderly, surgical patients, neonates, patients with indwelling devices
HCWs – they are health consumers as well and they have extensive exposure to the risk
The organisation

9. Firstly, we need to understand the principles of risk management
Avoid risk – if a risk cannot be eliminated then it must be managed
Identify risk – what is the risk and who is involved?
Analyse risks – how did it occur , what is the likelihood and what are the consequences?
Evaluate risk – can the risk be reduced or eliminated?
Treat risks – who will do this, how and when will it be monitored?

10. What do we do to minimise risk
We need to identify:
Who is at risk?
What infectious agent is involved?
How is the agent transmitted?
Why can it happen?
How likely is it?
What are the consequences?
What can be done?
How is it applied to the situation?

11. Successful risk management includes
A range of strategies that will be influenced by
a base-line review or gap analysis
review of the current governance arrangements, systems, processes, practices and their effectiveness
Development of an action plan to prioritise response strategies and resources

12. A risk assessment tool - example

15. To find out more, go to:
The Healthcare Associated Infection (HAI) Prevention Program 
Accreditation and the NSQHS Standards
Accreditation Advice Line:
Phone
Standard 3
Preventing and
Controlling Healthcare
Associated Infections

17. Risk Management and NSQHS Standards, Standard 3 – Preventing and Controlling Healthcare Associated Infections
Sue Greig
Senior Project Officer
National HAI Prevention Program
25September 2014

18. Risk Management and NSQHS Standard 3
This presentation outlines how the principles of risk management will support an organisations response to NSQHS Standard 3
For each element of risk management discussed in this presentation, relevant examples from NSQHS Standard 3 have been included

19. IP&C and Governance (3.1, 3.3, 3.4, 3.14, 3.16)
Policies and procedures should utilise a risk management approach and
Demonstrate evidence of regular review, monitoring, audit and assessment of infection prevention and control activities
Determine priorities based on risk assessment
Evaluate effectiveness at least annually
Minimise risks to patients of HAIs

20. Prioritising risk (3.8, 3.9, 3.10)
Scope of activity and services offered will influence risk
Is the origin of the risk internal or external or both?
What are the risks and opportunities for transmission?
What existing controls are in place?
Identify the opportunities for transmission
Identify those risks that are high so they can be prioritised both for likelihood and consequence

21. Collaboration to reduce risk (3.7, 3.18, 3.19)
Recognition of how infection prevention and control risks impacts upon other areas – WH&S, HR, education, consumers and clinicians
Utilising a standardised tool for identification and analysis of risk
Evaluation of risk management strategies will require collaboration
Minimise duplication

22. Evaluating the risks (3.12, 3.13, 3.17)
To identify how this can happen in your organisation
When evaluating the risk how are you going to prioritise activities?
identify where the risks are high
the simplest intervention
greatest impact in the shortest time period.
What is the balance between
likelihood and consequences?

23. How will we know how likely it is to happen?
From the risk assessment - are the risks
common or rare
severe or mild
How likely will risk occur?
monitoring and audit results
surveillance
complaints
observation
Establish a context for the clinical environment

24. Establishing a context – what do we need to consider?
The scope of the services provided
Availability of policies and procedures relevant to the intended audience?
Consultation with HCW during development and review?
Literacy issues and comprehension of risk
Do HCW understand what the risks are and what actions will minimise those risks?

25. Communication and consultation
Be proactive when developing protocols and procedures.
Identify regular intervals for revision and updating – this can also be a reactive response.
Consider clinicians, managers and non-clinical staff when communicating how policies, procedures and protocols apply to them.
Target the audience when providing information on the risk of infectious agents

26. How can communication and consultation support the risk management process?
Provide a plan and systems for risk notification, assessment, management and resolution
Celebrate achievements
Encourage and facilitate collaboration
Utilise appropriate message media including signage, websites, posters, charts, agenda items
Provide patient and consumer information in areas where it is accessible
Education is provided for
HCW on infectious agents, means
of transmission and interventions
that need to be applied

27. Monitor and review
Are the interventions making a difference to the corporate and/or clinical risk?
Is risk being reduced?
How do we know?
mechanisms are implemented to ensure identification of risks
methods of demonstrating how good the care is including surveillance, quality
improvement activity results, audit
results, education

28. In Summary Infection prevention and control needs:
effective governance
resources
risk management to ensure a safe environment for both HCW and patients
Prevent preventable infections
Success can be measured by addressing risks with a standardised framework
“Breaking the chain of infection transmission”

29. To find out more, go to:
The Healthcare Associated Infection (HAI) Prevention Program 
Accreditation and the NSQHS Standards
Accreditation Advice Line:
Phone
Standard 3
Preventing and
Controlling Healthcare
Associated Infections