2021 ORAL AND POSTER PRESENTATIONS - ABSTRACT SUMMARIES A Supplement to the Canadian Journal of Infection Control - IPAC Canada
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
2021 ORAL AND POSTER PRESENTATIONS
ABSTRACT SUMMARIES
A Supplement to the Canadian Journal of Infection Control
Spring 2021, Volume 36, No. 1VIROX TECHNOLOGIES INC
WEBBER TRAINING
AWARDS
1. One (1) Best First-Time Abstracts as chosen by the Abstract Review
Committee. This is an abstract whose lead author has never before
submitted an abstract to IPAC Canada or CHICA-Canada. The award
of $500 each is sponsored by 3M Canada. Award winners will be
acknowledged at the Closing Ceremonies on May 5. In the event of
unavoidable delays, the award will be announced post-conference.
2. One (1) oral presentation will be announced as Best Oral Presentation
and receive an award of $500 sponsored by 3M Canada. The award will
be announced at the Closing Ceremonies on May 5. In the event of
unavoidable delays, the award will be announced post-conference.
3. Best Poster Presentation as chosen by attendees will receive an award
of $500 sponsored by 3M Canada. The award will be announced at the
Closing Ceremonies on May 5. In the event of unavoidable delays, the
award will be announced post-conference.
CONFERENCE ATTENDEES WILL VOTE FOR BEST ORAL PRESENTATION AND
BEST POSTER PRESENTATION THROUGH THE CONFERENCE APP.
DEADLINE FOR SUBMISSION: 4 p.m.,
Wednesday, May 5.VIRTUAL: IPAC 2021 National Education Conference ORAL PRESENTATIONS
May 3-5, 2021
ORAL PRESENTATIONS
Unless specifically named as a co-author, no reviewers were directly involved
in the research or publications cited in any of the abstracts.
Reviewers recuse themselves if they have co-authored an abstract.
Each presenter will have 11 minutes for presentation and two minutes
for Q&A. Recorded sessions will be available post-conference.
TUESDAY, MAY 4, 2021 – AROs
1335-1348 Eastern
1335-1348 Eastern 1350-1403 Eastern
DISCONTINUING ARO SCREENING IN MENTAL CANDIDA AURIS: PROSPECTIVE IDENTIFICATION
HEALTH SETTINGS: A CHANGE MANAGEMENT PROJECT AND MANAGEMENT: JOURNEY TO DATE
Jennifer Happe¹, Natasha Usher-Hameluck¹, Joan Osbourne Townsend¹, Seema Boodoosingh¹, Andrea Morillo¹,
Tameika Green-Crane¹, Shauna Meyerson¹ Annetta Neil¹, Nataly Farshait¹, Lillian Kariko¹, Joanna Widla¹
¹Alberta Health Services ¹Humber River Hospital
Background/Objectives: Screening patients on admission to mental health units Background/Objectives: Candida auris (C. auris) is an emerging fungus that
for antibiotic-resistant organisms (ARO) is problematic. Patients may not have the presents a serious global health threat. C. auris is highly communicable and
capacity to answer risk assessment questions accurately on admission. Staff may causes severe illness in hospitalized patients. Patients can remain colonized with
not be able to safely collect specimens within the first 24 hours, as required by the C. auris for a long time and C. auris persists on surfaces in healthcare
Alberta Health Services (AHS) protocol. Collection delays can lead to poor-quality environments. In April 2019, Humber River Hospital – a large community hospital
surveillance data because it is not clear if the patient had an ARO on arrival, in Toronto, Canada – identified the first prospective case of C. auris in Ontario.
or acquired it after admission. Further, in 2018, AHS refocused transmission Project: Humber River Hospital implemented a screening protocol for high-risk
prevention efforts on routine practices and moved away from contact precautions patients based on PIDAC’s Interim Guide for Infection Prevention and Control
for most ARO-positive patients on mental health units. This change makes the of Candida auris issued in January 2019. Screening criteria include patients
value of continuing ARO admission screening questionable. However, cessation coming from areas where C. auris is endemic, or where transmission has been
of ARO screening must be carefully considered because practice changes can be documented, travel history to the Indian subcontinent, known colonization or
difficult to implement and sustain. infection with CPE, and history of intrusive antifungal use. The first patient to
Project: The Prosci Change Management process and tools were used to support be identified in Ontario was screened for C. auris on admission based on the
Infection Control Professionals (ICPs) and unit staff on AHS mental health units in aforementioned criteria. C. auris is known to be a resilient organism that can
the Central Zone to prepare for, implement and sustain discontinuation of ARO survive for prolonged periods of time in surfaces and can resist routine cleaning
admission screening. Face-to-face and teleconference meetings were organized with common hospital-grade disinfectants. In consequence, the patient was
with staff. The purpose was to engage staff and explain what was going to change placed in a private room on enhanced droplet and contact precautions, with
and why, identify strategies to successfully implement change on each unit, controlled traffic into the room using an ante-room, and dedicated equipment.
establish mitigation strategies for predictable barriers, and to celebrate successes. Disinfection protocol includes twice-a-day environmental cleaning and
Local clinical educators were recruited to assist with implementation and disinfection with bleach-based disinfectant, as well as double cleaning, ultraviolet
reinforcement going forward. light irradiation, and quarantine for all medical equipment that needs to be
Results: There was a 94% reduction in methicillin-resistant Staphylococcus aureus removed from the room. Transmission was monitored through screening all ward
screening swabs sent to the lab from mental health units and a corresponding mates upon discharge from the unit at days 0, 7 and 21, with all patients remaining
$21,360 reduction in annual lab-processing costs. There was an annual savings of on contact precautions until results were confirmed negative. Education to staff
$5,400 for the infection control program because of a reduction in time spent to was delivered through rapid PDSA cycles to support validation and promotion
educate staff on use of the screening tool and audit compliance. of learning; practices were promptly documented in policies/procedures for
A qualitative analysis of staff experience revealed staff had a positive experience screening, testing and identification of patients at risk and/or colonized with
with the change, including before, during, and after implementation. Leadership C. auris; microbiology methodology for accurate identification of the organism
appreciated the use of statistical data to demonstrate the need for change and the was conducted; and patient and family information resources were developed.
positive impact the change had on the organization. Results: HRH realized zero hospital acquired transition over the nine-month
Lessons learned: A structured change management approach helped build admission, with over 600 ward mates screened to date. Rapid “theory burst”
awareness and desire for change. Early meetings with staff helped identify in-services were well received by staff; engaging patients and families in the design
concerns about how the change would impact them and ways to successfully of information resources and protocols created investment.
implement the change on their unit. Proactive engagement supported staff to Lessons Learned: 1. Multidisciplinary approach is necessary to prevent and
take ownership of the change, which resulted in reduced resistance and increased control transmission of Candida auris within the healthcare setting. 2. Resources
adoption. Leaning on unit-based clinical educators, who staff trusted and ought to align with best practices 3. Communication with senior management
respected as practice experts to roll out the change, contributed to the project’s is essential.
success. Finally, through a structured change management approach, ICPs shifted
from their usual role of leading a change to supporting others to lead and own
the change.
2021 IPAC CANADA NATIONAL CONFERENCE 5VIRTUAL: IPAC 2021 National Education Conference
ORAL PRESENTATIONS May 3-5, 2021
1405-1418 Eastern Project: In triage, coloured stickers corresponding to the three types of additional
precautions were added to the printout as a stronger visual cue to enter the
DISCONTINUATION OF CONTACT PRECAUTIONS FOR PATIENTS
precautions into EMR. Education was provided during daily unit safety huddles
COLONIZED WITH METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS:
regarding the use of stickers for additional precaution initiation in EMR (with a
A PROVINCIAL PRACTICE CHANGE IN A SEA OF UNCERTAINTY!
four-week implementation phase allowing two weeks to disseminate changes).
Lola Gushue¹, Donna Moralejo², Jennifer Phillips³, Natalie Pickett4, Jasmine Day5, Laboratory-confirmed exposures were reported to management using the
Brenda Earles¹, Natalie Bridger³, Marion Yetman, Gina Elliott ¹DHCS, electronic incident reporting system so that follow up could occur with the
²Memorial University of Newfoundland, ³Eastern Health, 4Western Health, involved staff. The exposures were also presented to the department during
5
Labrador Grenfell Health daily safety huddles. The importance of triage in identifying potential infectious
diseases was emphasized during the IPAC module of the educational professional
Background/Objectives: In Newfoundland Labrador, patients previously development days. Emerging infectious diseases were also discussed and
flagged or identified as having MRSA colonization have been placed on contact emphasized the IPAC resources available to triage. The proportions of patients
precautions (CP). Many jurisdictions have successfully discontinued this practice triaged with febrile respiratory illness (FRI) and diarrhea 12 weeks pre- and
without an increase in MRSA infections. This change in practice had been post-intervention, were measured along with the number of incidents
discussed provincially over the past year, but the current COVID-19 crisis provided reported electronically.
an opportunity for moving forward quickly with such an initiative. Healthcare Results: The proportion of isolated patients with FRI and diarrhea increased
workers (HCWs) may fear an increase in MRSA transmission, therefore, before (51.9% to 61.9% for patients with FRI, and 41.0% to 44.4% for patients with
implementing such a change, we evaluated HCWs’ concerns so they could diarrhea). Based on the number of incidents reported, confirmed exposures were
be addressed. further reduced (from 13 to 7 incidents seven months pre- and post-intervention).
Project: This is a multi-phase project: 1) staff survey, with all staff in all regional Lessons Learned: Education efforts in addition to the quality improvement
health authorities invited to participate in an online survey; 2) education; initiatives clarified the triage process in identifying infectious diseases. By
3) implementation of the change in practice; and, 4) evaluation of the change. discussing common and emerging infectious diseases with the intent to raise
Results: A total of 856 staff participated, from a variety of disciplines and settings. awareness of the importance of the triage process, IPAC took a more active role
Overall, 82.9% agreed with the change of practice and 85.5% agreed that in the department in order to minimize exposures to all infectious diseases within
Routine Practices (RP) and point-of-care risk assessment (PCRA) are sufficient to the department. Adding visual cues to enter isolations in the EMR further aided in
prevent transmission of MRSA from those colonized. They were able to identify reducing exposures.
advantages of discontinuing CP for patients/families (e.g., reduced sense of
isolation), for HCWs (e.g., reduced workload, improved patient flow) and for
the healthcare system (e.g., personal protective equipment (PPE) savings). Some WEDNESDAY, MAY 5, 2021 – COVID-19
respondents identified concerns that current levels of hand hygiene and RP may 1400-1413 Eastern
not be sufficient, while others reported fear of transmission. Key knowledge gaps Winner of the 2021 BEST FIRST-TIME ABSTRACT
identified related to transmission, difference between colonization and infection, (Sponsored by 3M Canada)
and PCRA. An online learning module was developed for all staff, which covered ADDRESSING PANDEMIC PRESSURES WITH AN
the change in practice and the rationale and evidence for the change, also the OPERATIONAL PREPAREDNESS AND RESPONSE TOOL
topics where knowledge gaps existed. The education was completed prior to
Rachael Smith-Tryon¹, Damiano Loricchio¹, Renate Ilse¹, Heather Candon¹
the implementation of the policy change. We will be monitoring the impact
¹Kingston Health Sciences Centre
on MRSA infections and PPE use. A second survey is planned to follow up on
HCW concerns.
Lessons Learned: The results of the survey guided the content of the planned Background/Objectives: The COVID-19 pandemic has put novel and
education; more emphasis was placed on transmission, colonization versus unprecedented pressures on hospital operations, including personal protective
infection, and PCRA than would have otherwise been included without this equipment (PPE) shortages, staffing shortages and redeployments, changing local
assessment of learning needs and concerns. It also focused on reinforcing the and national epidemiology, and outbreaks within hospital walls. The existing
role of RP in preventing transmission of all infectious agents, not just MRSA. Incident Command structure at Kingston Health Sciences Centre (KHSC) was
Participating in the survey allowed staff to share their concerns; providing required to incorporate and address these pressures within their mitigation,
education and ongoing monitoring to address their concerns will demonstrate that preparedness, and response plan. A need was identified for determination of
their voices were heard. This approach can facilitate the change process. While external and internal influencing factors, with objective triggers specific to KHSC.
the follow-up survey will help us evaluate the change process, ongoing monitoring Project: The development of the Operational Preparedness and Response Tool
will help us evaluate the change itself. We learned the value of gaining feedback identified and weighted external and internal influences and pressures specific
from staff about their concerns and learning needs was worth the effort involved to COVID-19 to produce a severity level and corresponding response. External
in conducting a large-scale survey and implementing a change in practice. factors and pressures identified were provincial prevalence of COVID-19, as well
as local epidemiology and active regional outbreaks. Internal pressures consisted
1420-1433 Eastern of PPE shortages, staffing shortages, and hospital capacity. In order to accurately
plan for effect on KHSC operations, local prevalence, staffing needs, provision
REDUCING INFECTIOUS DISEASE EXPOSURES IN THE EMERGENCY of critical care, hospital occupancy, and healthcare worker infections were
DEPARTMENT THROUGH PROCESS IMPROVEMENT MEASURES IN TRIAGE identified as weighted categories. Increasing pressures in one of these weighted
Erica Susky¹, Brittany Jenkins¹, Stephen Casey¹, Sherri Broome¹ categories have higher impact on hospital operations. Categories were assigned
¹University Health Network a score weekly on a scale of 1 to 5, with 1 having the least severe pressure on
hospital operations. Each program within the hospital was encouraged to produce
Background/Objectives: An effective screening process for infectious diseases a mitigation and preparedness plan with most responsible persons identified for
is required in the triage area of emergency departments so that patients with ramping up and tapering off based on the weekly severity level.
suspicion for transmissible infections can be promptly placed on additional Results: The scoring algorithm was designed to be an objective classification of
precautions. Appropriate triaging of patients includes querying them for infective external and internal pressures. Assumptions were made that the hospital would
symptoms, which help dictate the need for certain types of precautions. Though operate on a level of moderate severity for the majority of the pandemic, with
the triage nurses enter the answers to these questions into the electronic medical severity levels 1 and 5 being outlying extremes. After a three-month period of
record (EMR), the precautions are not automatically initiated. Instead, a printout adjustment, the result was a user-friendly tool that is completed bi-weekly and
is generated with an indication to start additional precautions, which are manually presented to Incident Command for review and response. While the tool was
entered into the EMR by nursing staff within the department. This step was prone developed as a result of COVID-19 pressures, it is important to note that this tool
to error and resulted in staff being exposed to various infectious diseases. will continue to be applicable to Incident Command operations in the future.
A process improvement project was undertaken to facilitate triage communication, Lessons Learned: There were several challenges over the course of development
the initiation of additional precautions, and to minimize infectious exposures. and implementation. Guidelines and recommendations on a municipal,
6 2021 IPAC CANADA NATIONAL CONFERENCEVIRTUAL: IPAC 2021 National Education Conference ORAL PRESENTATIONS
May 3-5, 2021
provincial, and federal level continue to change over the course of the pandemic, they may use, if they feel more confident in their ability to apply the learning, and
rendering various response plans outdated. By identifying most preparedness if they plan to make any changes in their practice based on what they learned.
plans, including most responsible person(s) for various levels of pandemic-related Results: Five documents were developed to support the series, including a
pressures, the hospital gained valuable vision of potential operational obstacles. description of the series and its organization, a CoP template to introduce the
series to stakeholders at the first session, a CoP presentation template to be
1415-1428 Eastern used for sessions following the introductory CoP, content slides that provide the
content to add into the CoP template, and finally, a series of case scenarios to
CHARACTERISTICS OF HEALTHCARE PERSONNEL HOSPITALIZED be incorporated into the CoP. In total, 27 CoP sessions were held across all five
WITH LABORATORY-CONFIRMED COVID-19 IN A NETWORK OF regions from October to December 2020, with 1,346 attendees in total. Further
CANADIAN ACUTE-CARE HOSPITALS, MARCH 1 TO NOVEMBER 30, 2020 results will be discussed (in the presentation) and will include: the average number
Robyn Mitchell¹, CNISP COVID-19, Working Group2 of sessions per region; the average number of attendees per session; the overall
¹,²Public Health Agency of Canada rating of sessions by attendees, and the post-session survey results.
Conclusion: CoPs are an excellent way to deliver guidance and information to
Background/Objectives: To describe the epidemiology of a subset of healthcare IPAC stakeholders, and to provide a venue for sharing implementation strategies
personnel (HCP) hospitalized with laboratory-confirmed COVID-19 in a network of IPAC best practices. The data collected from this initiative can be applied to
of Canadian acute-care hospitals between March 1 and November 30, 2020. inform future CoP design and decision making.
Methods: HCP hospitalized with laboratory-confirmed COVID-19 were
identified through surveillance conducted by the Canadian Nosocomial Infection 1445-1458 Eastern
Surveillance Program in 55 acute-care hospitals in 10 provinces and one territory
between March 1 and November 30, 2020. HCP were defined as any individual THE CHRONICLES OF COVID-19: IPC, THE NOVEL
working in a healthcare setting (acute or long-term care). Demographics, clinical CORONAVIRUS AND VULNERABLE POPULATIONS
characteristics, interventions and outcomes among hospitalized HCP were Melody Cordoviz1, Kathryn Mombourquette², William Banh², Francesco Mosaico3,
described and compared to non-HCP hospitalized with COVID-19. Chi-square Aruna Uma Chandran², Stephanie Smith4, Gloria Keays4
tests were used to compare proportions and missing data were excluded from ¹AHS, ²Alberta Health Services, ³Boyle McCauley Health Centre/Edmonton Isolation
the analysis. Facility, University of Alberta, 4Alberta Health Services, University of Alberta
Results: Among all in-patients aged 18-65 years hospitalized with COVID-19,
97/1,024 (9.5%) were HCP and, where data were available, 33/42 (78.6%) were Background/Objectives: The COVID-19 pandemic has disproportionately
identified as providing direct care to COVID-19 patients. Hospitalized HCP were affected Vulnerable Populations (VPs). A multidisciplinary team consisting of
more likely to be female (61/97, 62.9% vs. 394/920, 42.8%, p=0.0002) and less community supports, the Boyle McCaulay Health Centre, the City of Edmonton
likely to have an underlying medical condition (64/96, 66.7% vs. 712/921, 77.3%, and Alberta Health Services were tasked with the development and management
p=0.02) when compared to hospitalized non-HCP, but were similar with respect of a mass care site for VPs who were experiencing homelessness, unstable
to age (median 52 years for both groups), ICU admission (35/95, 36.8% housing, or living in shelters. In Edmonton, the Edmonton Expo Centre was
vs. 280/918, 30.5%, p=0.2) and 30-day all-cause mortality (3/96, 3.1% vs. 44/926, used to isolate VPs. There were many competing priorities, which needed to be
4.8%, p=0.5). Among HCP with COVID-19, the most commonly reported medical incorporated into the planning of the site. IPC was challenged to create a hybrid of
conditions were chronic heart disease (includes hypertension) (30/97, 30.9%), a non-clinical site and a clinical site with outbreak measures in place, challenging
diabetes (23/97, 23.7%), chronic lung disease (15/97, 15.5%) and obesity (7/89, the boundaries and traditional practices of Infection Prevention and Control (IPC).
7.9%), with similar proportions reported among non-HCP hospitalized Project: The site required a triage area and several halls dedicated to isolated
with COVID-19. clients. Halls were divided into four areas: asymptomatic, close contacts isolating
Conclusion: HCP hospitalized with COVID-19 were similar to non-HCP for 14 days, symptomatic clients with COVID-19 tests pending, symptomatic
COVID-19 patients with respect to severe outcomes associated with COVID-19. COVID-19 positive clients, COVID-19 negative symptomatic clients. All clients
Provision of health care to a COVID-19 patient does not in itself indicate source were on additional precautions. Each hall had a nursing desk, treatment area,
of infection, further study is needed to ascertain whether infection is acquired clean supply, pharmacy area, safe consumption site, portable washrooms, and a
occupationally, or in the community. smoking area. Additionally, each hall had dedicated isolation beds and washrooms
in case of a gastrointestinal outbreak. Barriers could not be used to separate bed
spaces, instead a 2-metre radius was used to separate clients. All meals were
1430-1443 Eastern
served individually and consumed at the client bed space. Personal protective
SUPPORTING LONG-TERM CARE HOMES DURING WAVE II equipment (PPE) use was directed by task performed. This site too was affected
OF THE COVID-19 PANDEMIC THROUGH COMMUNITIES OF PRACTICE by worldwide supply shortages and IPC had to implement practices not typically
Kasey Gambeta¹, Kasey Gambeta¹, Jacquelyn Quirk¹ approved in optimal times.
¹Public Health Ontario Results: All medical procedures were done in a treatment area, where contact
and droplet PPE were required. However, staff continually interacted with
Background/Objectives: Communities of practice are a common approach used clients in their bed space. With this interaction, only mask and eye protection
by Public Health Ontario (PHO) to support healthcare stakeholders. PHO has were required. Isolation was voluntary and challenges arose as clients had to be
five regional teams supporting stakeholders in different regions across Ontario. encouraged to stay and adhere to isolation practices. Non-conventional measures
A community of practice (CoP) series was developed as one part of PHO’s action were required to ensure clients stayed for the duration of their quarantine. There
plan to support long-term care homes (LTCH) during Wave II of the COVID-19 were no identified issues with transmission at the site. Due to low numbers, clients
pandemic. A series template was developed to create a consistent approach for were allocated to one hall and then the site was decommissioned. A new site was
the CoP offerings across the province. The CoP series focused on seven priority chosen requiring IPC to alter recommendations.
topics identified as gaps during Wave I of the COVID-19 pandemic. Lessons Learned: A site command post structure helped to expedite efficient
Method: An analysis of 140 LTCH IPAC assessments, conducted during Wave decision making. IPC education to all staff was a significant part of the IPC role.
I of the pandemic identified seven priority topics for ongoing supports. IPAC IPC practices can be applied to the specialized needs of VP, while maintaining
Specialists were assigned to lead each of these priority topics, as well as the client safety. Collaborating with a non-acute care multidisciplinary team for VP
development of a CoP series, case scenario exercises, and a standard regional introduced a whole new world to the acute care IPC team.
process for prioritizing long-term care homes for one-to-one support. Several
sources of information were used to guide the development of the CoP series,
including best practices for communities of practice, an assessment of current
resources and supports, and consultation with topic leads. CoP series attendees
were surveyed at the end of each session to identify the overall rating of the
session, if they felt they learned something new, if they discovered a new resource
2021 IPAC CANADA NATIONAL CONFERENCE 7VIRTUAL: IPAC 2021 National Education Conference
POSTER PRESENTATION May 3-5, 2021
POSTER PRESENTATIONS
Unless specifically named as a co-author, no reviewers were directly involved in the research
or publications cited in any of the abstracts.
Reviewers recuse themselves if they have co-authored an abstract.
Attendees may view the digital poster and a video presentation at any time during the
conference. Presenters will be available for Q&A during the poster presentation session.
WEDNESDAY, MAY 5, 2021
1155-1255 Eastern
this, date of prophylaxis initiation, and test-positive date. We investigated for
LACK OF HIV PRE-EXPOSURE PROPHYLAXIS AWARENESS REPRESENTS
potential epidemiological links with other confirmed PJP cases using temporal
A MAJOR KNOWLEDGE GAP AMONG GAY AND OTHER MEN WHO
and geographic mapping. We also established a baseline number of cases and
HAVE SEX WITH MEN IN ONTARIO
tests ordered for this organism. Organisms, which were identified using PCR on
Piragas Puveendran¹, Sahar Razmjou², Michael Dans², bronchoalveolar lavage specimens, were genotyped by MLST (CYB, Mt26S and
Patrick O’Byrne³, Paul MacPherson² SOD targets sequenced) along with a control case not suspected in
¹St. Michael’s Hospital/Li Ka Shing Knowledge Institute, ² the potential outbreak.
Ottawa Hospital Research Institute, ³University of Ottawa Results: Five patients in the liver transplant population (four liver transplant and
one pre-transplant) developed PJP within one month and none of the patients
Background/Objectives: While clinical and observational data have had received PJP prophylaxis at the time of symptom onset. The increase in cases
demonstrated that HIV Pre-Exposure Prophylaxis (PrEP) reduces the risk of was not related to an increase in testing for P. jirovecii based on baseline testing
HIV transmission, most gay, bisexual and other men who have sex with men over the past three years. Four cases were genotyped by MLST; one was not able
(gbMSM) may be unaware of this highly effective option for HIV prevention. to be typed, and three had mixed genotypes. One case had a mixed genotype
According to 2016 national HIV estimates, over half (52%) of all new HIV comprising of genotypes from two other patients, but no epidemiological links
infections in Ontario occur among gbMSM. Yet, limited research exists to assess existed between these cases were found (defined as being on the same floor on
PrEP awareness and uptake as a prevention tool among this population. the same day). Only two instances of potential epidemiological links were found,
Project: To address this knowledge gap, we conducted a questionnaire from however, the genotyping did not substantiate transmission.
June 2018 to March 2019 among gbMSM living across Ontario. Conclusion: An increase in PJP cases was found over a period of one month that
Results: A total of 1,560 HIV-negative gbMSM completed the questionnaire. The could not be due to an increase in testing. Epidemiological and molecular data
mean age was 37.3 years (SD = 14.7). The majority (95%) reported sex with only concluded that nosocomial transmission did not occur. This investigation highlights
or mostly men and the remainder were bisexual. With respect to PrEP use, only the need to conduct investigations of PJP cases when increased incidences are
10% reported they were currently taking PrEP. Toronto (21%) and Ottawa (13%) discovered and that both epidemiological and molecular data are needed to make
had the highest uptake of PrEP, whereas northern (4%) and eastern Ontario (3%) conclusions regarding transmission. The IPAC program is now line-listing cases of
had the lowest. Over half of respondents that live in northern (59%) and southern PJP and a single potential nosocomial case is considered a sentinel event meriting
(56%) Ontario had never heard of PrEP, or knew very little about it. Not knowing documenting and investigating.
what PrEP is, or how to access it were significant barriers for younger gbMSM, with
lack of awareness being as high as 60% in many regions of Ontario. EVALUATION OF AN INFECTION PREVENTION AND CONTROL
Lesson Learned: To advance a culture committed to infection prevention PATIENT EDUCATION INITIATIVE: THE PATIENT’S PERSPECTIVE
and control, future educational efforts should address how to increase PrEP
awareness and access among this most at-risk population. Tiberius Stanescu¹, Vydia Nankoosingh¹, Karen Campbell¹,
Dechen Chhakpa¹, Jayvee Guerrero¹, Ronny Leung¹, Senthuri Paramalingam¹,
Nelia Pena¹, Katherine Perkin¹
PNEUMOCYSTIS JIROVECII PNEUMONIA IN HEALTHCARE SETTINGS: ¹Scarborough Health Network
INVESTIGATIONS ARE RECOMMENDED IF THERE IS A PERCEIVED
“INCREASE IN CASES AND WHEN THERE IS SUSPICION OF Background/Objectives: The purpose of this initiative was to promote patient
NOSOCOMIAL ACQUISITION health education for all newly identified antibiotic-resistant organisms (ARO) to
expand patient involvement in quality of care at SHN. Increased awareness will
Erica Susky¹, Sarah Zanchettin¹, Krista Marquis¹, Philippe Dufresne², help the patient, family and public to have better experiences and health outcomes
Alon Vaisman¹, Susy Hota¹ when they are fully engaged in the program and service design and delivery of care.
¹University Health Network, ²Laboratoire de santé publique de Québec Project: Patient education was based on a questionnaire and ARO pamphlets
developed with the professional knowledge of the infection control practitioners
Background/Objectives: Pneumocystis jirovecii is a fungus implicated in causing (ICPs) and constant feedback from the patient and family advisors to reflect the
pneumonia in immune-compromised hosts, and is associated with a high needs of the patients in a language easy to understand. Education was provided 1:1
mortality rate. Outbreaks of P. jirovecii pneumonia (PJP) have been reported within the 72 hours from the diagnosis. Project evaluation data were collected by
in inpatient and outpatient settings where person-to-person transmission is interviewing patients after they had received education.
thought to have occurred. However, the exact mode of transmission, incubation Results: Out of 123 eligible patients, 98 received education and 34 were evaluated
period, and distinction between colonization and infection status makes post-education. The discussions with patients provided valuable feedback on how
outbreak investigations challenging. Here, we describe an investigation of a ICPs can improve our process in providing 1:1 education and the pamphlets.
potential PJP outbreak in a solid organ transplant program at a quaternary Lessons Learned: ARO education helped patients to understand the reason
inpatient setting. for being quarantined and acquire new skills to take care of themselves in the
Methods: Once notified by the transplant team of a potential increase in PJP hospital and at home. Patient involvement is equally important in preventing the
cases, the Infection Prevention and Control (IPAC) department conducted chart transmission of AROs.
reviews of each suspected case, which included the admission date, symptom
onset, and prior inpatient and outpatient visits up to six months preceding
8 2021 IPAC CANADA NATIONAL CONFERENCEVIRTUAL: IPAC 2021 National Education Conference POSTER PRESENTATION
May 3-5, 2021
SAFE INTRA-FACILITY TRANSPORT 3) Occupational Health & Workplace Safety: a multidisciplinary, interdepartmental
OF PATIENTS ON ADDITIONAL PRECAUTIONS team, which included Infection Prevention and Control, provided early exposure
Jennifer Happe¹, Nathan Maskowitz¹, assessments and contact tracing, functional testing and training of facilities and
Transportation Workgroup Transportation Workgroup¹ equipment, respirator fit-testing, redeployment and critical absence adjudication, and
¹Alberta Health Services wellness needs; 4) Human Resources & Staffing: workforce planning, recruitment,
and redeployment strategies were implemented to accommodate in-hospital,
Background/Objectives: Preventing transmission of communicable diseases field hospital, and community partner (e.g., long-term care facilities) needs; 5)
during patient transportation in-hospital requires clear communication, a common Personal Protective Equipment (PPE): shortages of PPE supplies required proactive
understanding of preventive measures among staff, and consistent application sourcing from traditional and non-traditional suppliers; 6) Community Response:
of these measures. Units sending patients must communicate the need for local community partnerships established through pre-existing pandemic plans
precautions with transportation staff and the receiving unit. Patients must be were activated to address COVID-19 through a non-referral-based assessment and
prepared prior to transportation in a way that contains pathogens on their person. treatment centre, drive-through testing clinic, and a 70-bed field hospital; and 7)
Staff must employ established infection control measures when interacting Corporate Communication: a robust crisis communication strategy was established
with the patient and keep transportation equipment, such as wheelchairs and to provide timely and transparent access to rapidly evolving information, including
stretchers, clean. Deficits in understanding and consistently applying these institutional policies, clinical updates, government directives, supports, and feedback.
measures were identified at a central Alberta hospital. Lessons Learned: Though RVH experienced the first COVID-19 death in Ontario,
Project: Infection Control and Clinical Quality Improvement departments the hospital benefited from a decentralized command structure that focused on
partnered to lead a team of staff from medical and surgical units, outpatient interoperability and communication. Recognizing the importance of early, decisive
departments, porters and clinical educators to build and employ an effective action, emphasis was placed on supporting inter-departmental and community
solution. The Min(imum) Specs Liberating Structures facilitation technique partnerships to identify and resolve gaps in pandemic responsiveness. As of
was used to identify what absolutely must be done, and not done, for safe December 8, 2020, RVH has not experienced any hospital-acquired infections
transportation. A focus on cleanliness and hand hygiene were identified. Core among staff or patients after caring for 51 COVID-19-positive inpatients and
elements included: a visual flag on the patient’s chart, incorporating a verbal identifying 569 COVID-19-positive outpatients.
hand-off between sending and receiving units and porters, disinfecting the Acknowledgements: The authors would like to thank the RVH Foundation and RVH
handles of wheelchairs and stretchers, preparing patients with clean hands and Executive Leadership Team for their support.
clothes, and a mask if the patient has a respiratory illness, and staff adherence
to the Hand Hygiene Moments. Porters are not required to don gloves, masks ASSESSMENT OF MICROBIAL REMOVAL
or gowns during transportation. These core elements actually align with the AND RINSE ABILITY OF NON-ANTIBACTERIAL SOAPS
original process. Thus, the barrier to safe transport was staff knowledge and Kristen Green¹, Amanda Copeland¹, Todd Cartner¹, Rachel Leslie¹, James Bingham¹
consistent implementation of the process. A toolkit was prepared with flow maps, ¹GOJO Industries, Inc.
instructional videos, pocket reference cards, and What’s in It For Me and FAQ
sheets to address common questions. A single process was initially prepared that
Background/Objectives: Hand hygiene (HH) is instrumental in preventing the
was later adapted by Emergency and Intensive Care Unit, based on local needs, to
transmission of pathogens. Handwashing is a frequent HH practice to remove or kill
improve adoption. Workgroup members, clinical educators and local champions
microbes on the skin. Both non-antibacterial (NAB) and antibacterial (AB) soaps are
were recruited to teach and reinforce the process on their unit. Porter staff are
acceptable for healthcare use. Studies have shown AB soaps to be more effective
involved in each patient transfer and tracked process compliance before and after
than NAB soaps in microbe reduction, however, recent regulatory actions have
the education intervention.
encouraged the reduction or elimination of AB use. There is a need to understand
Results: Compliance with safe transportation practices increased overall by 23%.
the formula characteristics that drive microbial removal enabling the development of
In a qualitative survey of staff experience, 85% were aware of the process and 87%
more effective NAB soaps.
understood their role in the process.
Methods: A commercially available NAB test soap, optimized for microbial removal,
Lessons Learned: Forging strong interdisciplinary relationships was beneficial
was compared to a commercially available NAB reference soap in a series of studies.
to identifying knowledge gaps and developing a set of practice tools for use by
Interfacial tension (IFT), a measure of the interaction between soap and skin,
all disciplines. Early involvement, active collaboration, stakeholder engagement,
was measured on the skin to quantify wetting and spread ability. The soaps were
and adaptability to different practice settings are essential to the successful
evaluated for microbial removal by ASTM E2755. Using Serratia marcescens, 12
implementation and uptake of a patient management process.
volunteers applied 5.0 mL of each soap to dry hands, lathered and rinsed, each for 30
seconds. In a second study, Staphylococcus aureus was used in which 12 volunteers
NAVIGATING PANDEMIC RESPONSIVENESS IN AN ACUTE-CARE SETTING: applied 1.8 mL soap to dry hands, lathered for 30 seconds, and rinsed for 10 seconds.
A COMMUNITY HOSPITAL’S OPERATIONAL EXPERIENCE WITH COVID-19 To understand the relationship of IFT and rinse ability, a blinded, observational study
Aidan McKee², Cathy Clark¹, Suzanne Kings¹, Suzanne Legue¹, Wendy Barner¹, was conducted to quantify rinse ability of each soap under different flow rates; 0.50,
Jane Cocking¹, Amanda Lamarche¹, Sarah Morris¹, Corey McKee¹, Jamie Borland¹, 0.35, and 0.25 gallons per minute (GPM). Subjects (n=59) participated in the study
Pamela Oertel¹, Kristal Kennedy¹, Leigh Gross¹, Matt Forder¹, Andrew Broeren¹, where 0.9 mL of a soap was used under varying water outputs. Time to complete
Chris Tebbutt¹, Giulio DiDiodato³, Jesse McLean¹ rinsing of their hands was documented for each subject. Rinsing time (min) and water
¹Royal Victoria Regional Health Centre, ²Royal College of Surgeons in Ireland, consumption (gallons (G)) were calculated.
³McMaster University Results: The test soap had a significantly lower IFT (1.55 mN/m) compared to the
reference soap (2.27 mN/m) (p=0.01) indicating improved wetting (i.e., spreading)
Background/Objectives: The COVID-19 pandemic has placed unprecedented and coverage of the hands. The test soap removed significantly more microbes for
demands on healthcare systems. To ensure continuity of services, acute-care both ASTM E2755 studies. S. marcescens: test soap = 2.26 log10 CFU reduction,
hospitals must make operational adjustments to manage growing patient volumes reference soap = 1.70 log10 CFU reduction (pVIRTUAL: IPAC 2021 National Education Conference
POSTER PRESENTATION May 3-5, 2021
EBOLA PREPAREDNESS: COLLABORATIVE APPROACH MANAGER/CHARGE NURSE QUICK-REFERENCE GUIDE
IN CREATING A STATE OF READINESS CENTRAL ZONE INFECTION CONTROL PROGRAM
Joan Osbourne Townsend¹, Andrea Matte¹, Nataly Farshait¹, Rosa Spataro-Sherman¹ Betty Soanes¹, Alberta Central Zone Infection Control Team¹
¹Humber River Hospital ¹Alberta Health Services
Background/Objectives: The Ebola outbreak in Democratic Republic of Congo Background/Objectives: There are approximately 80 acute-care, continuing-care,
began in August 2018. To date, there has been over 3,000 confirmed cases and and home-care sites, plus a large regional hospital and large psychiatric and brain
over 2,000 deaths. This outbreak is the second largest in history, second only to injury facility across central Alberta. Sites have a site manager, unit manager and
the West Africa outbreak of 2014 that caused over 11,000 deaths. Global travel charge nurse for each unit. Staff in leadership positions, responsible for patient
has heightened the threat of spreading communicable diseases from one region to care and patient flow, frequently change, and infection prevention and control
another. Located 10 minutes from Toronto Pearson International Airport, Humber (IPC) information is not passed on to the next generation of leaders. Educating
River Hospital will likely be the first to receive patients with potential exposure to new leaders to the IPC practices, protocols, and resources is important to create
Ebola Virus Disease upon their arrival in the city. an awareness of IPC and the role of IPC in patient safety and the prevention of
Project: A multidisciplinary working group collaborated to implement a state healthcare-associated infections.
of readiness; this included the use of PDSA cycles to ensure the frontline staff Project: I developed the initial guide as a tool for consistent messaging when
training was well received; list and type of supplies and personal protective orientating leaders to the resources and services that IPC provides. The resource
equipment (PPE); and alignment/implementation of policy and procedures based was shared with the Central Zone IPC team and deemed a useful tool. Hence, the
on best available evidence. information was reviewed by ICPs for relevancy and accuracy, edited by the zone
Results: Registered Respiratory Therapists trained in the use of the PPE, and IPC editing working group, appropriate AHS branding tools applied and reviewed
utilizing Powered Air-Purifying Respirator (PAPR) devices, trained emergency staff by communications personnel prior to posting on the website.
and physicians. Fully equipped ready-to-use Ebola carts containing all the personal Results: Having a standardized guide is an opportunity for the infection control
protective equipment required, PAPR devices and charge stations, as well as visual professional (ICP) to provide consistent messaging when orientating staff in new
guides on donning and doffing procedures have been stored in the Emergency leadership roles. Key information conveyed in the tool includes web links to zone
Department and other critical outpatient locations throughout the hospital. All and provincial information, ICP contact information, communicable disease
training, equipment and educational materials are supported by policies and management resources, posters, resources on hand hygiene, personal protective
procedures, which in turn are aligned to CDC and WHO recommendations on equipment, and outbreak management. Revisions to the guide are communicated
Ebola containment and response strategies. to leaders via email, site leadership meetings, and newsletters. Some leaders
Lessons Learned: By 2015 alone, six other countries had reported an imported choose to print a copy for the nurse station as a quick reference. As well, the guide
Ebola case or cases (Mali, Senegal, Nigeria, Spain, the United States of America, provides leaders with a document to share with new staff, provides an opportunity
and the United Kingdom). These have now been controlled. All of these examples for “just-in-time” education, directs staff to current IPC practice resources, and
confirm that a rapid and strong response to an Ebola outbreak is not only essential, promotes patient safety. Additionally, orientating staff to the tool enables the ICP
but possible, and is the most important factor in controlling the disease and to become familiar with the staff.
consequently stopping its spread. As the number continues to grow, maintaining a Lessons Learned: A centralized online resource provides ease of access
state of readiness has proven to be a dynamic process which requires continuous regardless of geographic location and ensures leaders have current and consistent
monitoring, coordination, and improvement. information which supports best practices that affect patient safety. The Quick
Reference Guide provides a standardized process and consistent messaging for
ICPs when orientating site leaders and those directly responsible for patient safety,
FACILITATING ADDITIONAL PRECAUTIONS IN THE OPERATING ROOM to the resources. Updates and revisions to the guide are easy to facilitate, but
Jennifer Happe¹, Betty Soanes¹ there can be challenges for timely posting on the website. Face-to-face orientation
¹Alberta Health Services of staff by an ICP is an opportunity to introduce oneself and establish a baseline
for the professional relationship. There is an opportunity to orientate site-assigned
Background/Objectives: Operating rooms (ORs) in central Alberta have proven to educators to the guide.
be unique settings which require guidance when applying routine practices
and additional precautions to prevent transmission of microorganisms and
the development of surgical site infections. Further, once an operation is NORTHERN SASKATCHEWAN FIRST NATIONS
underway, it is problematic to consult the infection control department about HEALTH CENTRES EXPERIENCE: IMPACT OF SUPPORT
questions that arise. VISITS ON INFECTION PREVENTION AND CONTROL PRACTICES
Project: The infection control team collaborated with OR clinical educators Adeshola Abati¹
to prepare a quick reference tabular tool outlining how to apply routine ¹Northern Inter-Tribal Health Authority (NITHA)
practices and additional precautions broken down by Contact, Droplet and
Airborne Precautions. The tool directs staff in applying these measures during Background/Objectives: The incidence of Healthcare-Associated Infections
each step of the OR process from booking cases and preparing the theatre to has been increasing gradually over the years in First Nations health centres in
patient transportation and pre-operation, intra-operation and post-operation Northern Saskatchewan. Compliance with Infection Prevention and Control
management of the patient and environment. With staff feedback, the tool was (IPAC) best practices is recommended to prevent the spread of infections in
refined to fit on a single, laminated sheet. Quick Response (QR) codes were also healthcare settings. Yet, this remains a challenge in many Northern Saskatchewan
added to facilitate electronic access to complete reference material if required to First Nations health centres. Access to hand-washing products, high turnover
guide just-in-time decisions. The tool was first implemented in the OR department of staff, concerns about the potential misuse of alcohol-based hand rubs,
at the largest facility in central Alberta. Following an education campaign, a copy competing priorities, and limited educational opportunities are factors that
of the tool was placed in each theatre for reference. Subsequently, the tool was contribute to this challenge.
rolled out to 14 OR departments across central Alberta. Project: This project started in 2017 and is ongoing. Before its commencement,
Results: A qualitative survey was conducted with OR managers, nurses and the IPAC working group members examined different ways to improve IPAC
surgeons across central Alberta. Staff were quizzed about their awareness of the practices in health centres and nursing stations under the jurisdiction of the
tool, how often they used the tool, and if QR codes were helpful. Staff consistently Northern Inter-Tribal Health Authority (NITHA). Support visits with an educational
deemed the tool a valuable resource in guiding their infection control practice. session were identified as the most appropriate intervention. To guide these visits,
Lessons Learned: An accessible, standardized tool with links to current resources a checklist was developed to assess IPC practices in four major areas, namely;
provides ease of access regardless of geographic location. The tool also ensures Administrative practices and surveillance, Environment of care, Hand hygiene
OR staff and physicians have current and consistent information which supports practices, and Reprocessing of medical equipment. During each visit, the checklist
best practices that affect patient safety. The addition of QR codes means staff can was used to initiate discussion and identify areas for improvement. Each visit
access necessary information through both a paper tool and electronically. concluded with an educational session, which was tailored to address the areas
10 2021 IPAC CANADA NATIONAL CONFERENCEVIRTUAL: IPAC 2021 National Education Conference POSTER PRESENTATION
May 3-5, 2021
for improvement identified. After each visit, the IPC Advisor sends feedback of control professionals (ICPs) were informed of spotting on repossessed MDs in
the support visit to the facility’s health directors/nurse managers, and the partner’s a rural central Alberta hospital by the medical device reprocessing (MDR)
health director for action on areas that require attention. staff in May 2019.
Results: The support visits have led to increased hand hygiene compliance rate, Project: Diagnosing the cause(s) of MD spotting can be challenging.
adequate knowledge of how to prevent infection in the healthcare settings, A multidisciplinary team (MDT) of ICPs, MDR staff, facility maintenance and
enhanced relationships between the IPC program and health services in the engineering staff, the medical officer of health and a public health inspector was
communities, change in IPC practices such as switching from the use of non- established to manage the issue. The team confirmed that they were dealing
alcohol-based hand rubs to the use of alcohol-based hand rubs in their clinics, with spotting caused by a residue as opposed to staining. The vendor of the
increase in the number of consults or requests to the IPC program for information automated washer disinfector (WD) machine was consulted. Water quality testing,
or resources, and increased collaboration between the IPC Advisor and the IPC preventive maintenance on the WD and recalibration of the detergent delivery
Working group in the partnership. Also, healthcare personnel have adequate was carried out. This did not resolve the issue. The MDT then recommended that
knowledge of the component of routine practices. Furthermore, the NITHA all operational aspects of MDR be carefully reviewed and preventive maintenance
infection control manual is now available in most of the health facilities. done on the reverse osmosis (RO) water system prior to any repeat water testing.
Lessons Learned: Face-to-face communication through support visits is a The team met five times between July 30 and October 30, 2019, to successfully
cost-effective way to prevent and control the spread of infection and also improve complete the investigation. On October 18, 2019, maintenance of the WD and
IPC practices within existing resource levels. The IPC Advisor will continue to RO system was done, the detergent delivery rate halved, the rinse cycle doubled
engage the community health centres through the support visit initiative in order and the RO rinse time decreased from two minutes to 1.5 minutes.
to further improve IPAC practices in northern Saskatchewan. Results: The above actions successfully stopped the spotting on the MD. The
vendors posited that decreasing the detergent delivery rate to half played a
ADENOSINE TRIPHOSPHATE TESTING TO IMPROVE significant rule in resolving the spotting. Two months after, there continues to be
HEALTHCARE FACILITY CLEANLINESS AND OBSERVED no instrument spotting.
REDUCTION IN HEALTHCARE-ASSOCIATED INFECTIONS Lessons Learned: Recognizing that no two MDs are the same and following
manufacturer instruction for use for any automated WD is advisable at all times.
Kelly Smith, Jennifer Phillips¹, Jalene Molloy¹
Setting up clear communication guidelines between the various departments
¹Eastern Health
within a rural healthcare site will ensure a well-coordinated and effective
interdepartmental collaboration. Most importantly, acceptable levels of change
Introduction: The cleanliness strategy was established based on feedback
in calibration of detergents, lubricants and other products used in automated
from the Experience of Care survey in 2016. Results of the survey highlighted a
washer disinfectors may resolve issues such as spotting on MDs. Vendors of these
dissatisfaction and concern from clients and families in relation to the cleanliness
machines can provide and assist in acceptable calibration in product measures.
and condition of our facilities; upon review it was discovered that there was not
Consistent communication between the vendors and the MDR team regarding
a standardized approach to the delivery of environmental services. Discrepancies
reprocessing of MD is important in making accurate, timely diagnosis of problems.
existed regionally in managerial oversight, chemicals, equipment, policies and
procedures, and education and training for environmental services staff. As a
result, the cleanliness strategy was undertaken to standardize the delivery of PROVINCIAL ROUTINE PRACTICES PROJECT: AN EVALUATION OF AN
environmental services across Eastern Health. INITIATIVE TO PROMOTE USE OF ROUTINE PRACTICES IN CANCER CARE
Methodology: Six pilot sites representing acute and long-term care were chosen AND AMBULATORY CARE AREAS LOCATED IN ACUTE CARE FACILITIES
across the region. Adenosine Triphosphate (ATP) swabbing is used as an indicator
Gwyneth Meyers¹, Heather Gagnon¹, Maureen Buchannan-Chell¹, Jennifer Happe¹,
of whether the swabbed item was clean. ATP was then converted into relative
Melody Cordoviz¹, Melissa Beck¹, Linda Kamhuka¹, Ericka Oates¹
light units for the item. Once an item is swabbed, the swab is inserted in the
¹Alberta Health Services
monitor and is analyzed. For this pilot, an RLU of 30 and under was considered a
pass. The surfaces selected were swabbed monthly. Positive microbiology reports
Background/Objectives: A horizontal approach that includes a focus on routine
of the following organisms were included in the analysis of healthcare-associated
practices is fundamental to an Infection Prevention and Control (IPAC) program
infections: Acinetobacter’s, Citrobacter’s, Clostridium difficile, methicillin-resistant
and is of increasing importance with global travel and the emergence of various
Staphylococcus Aureus, etc. These organisms were chosen as they are commonly
antibiotic-resistant organisms and infectious diseases. In 2016 and 2017, the
associated with healthcare.
Alberta Health Services IPAC program implemented two initiatives to promote
Results: At baseline 26.3% of items passed after the first clean. During the pilot,
the application of routine practices in place of contact precautions to manage
the percent of items that passed after the first clean increased to as high as 70.5%.
patients with an antibiotic-resistant organism in ambulatory cancer care areas and
Healthcare-associated infections were also monitored at pilot sites. A decrease in
ambulatory care areas located at acute care facilities in the province of Alberta.
the rate of healthcare-associated infections was noted from baseline compared to
Method: In late 2019, a working group of infection control professionals (ICPs)
the pilot.
designed, planned and implemented an evaluation of the sustainability of the
Conclusion: Overall, based on ATP testing, the cleanliness of the pilot areas
two initiatives. An interview tool with nine open-ended questions was developed
improved. In addition, the rate of healthcare-associated infections decreased.
and piloted. ICPs performed in-person structured interviews with a minimum
Fewer healthcare-associated infections can lead to a more positive patient
of one frontline staff member from a sample of areas involved in the initiatives.
experience, decreased acuity and improved patient flow. Due to the success of
Responses from the interviews were coded using a data dictionary, entered into
the pilot, the project will continue with the goal of moving the broader strategy to
an Excel® 2013 database and analyzed using descriptive statistics. A focus group
other sites in the region.
interview with ICPs was conducted to understand the successes and challenges
of the initiatives. Responses were analyzed by two independent reviewers using
INVESTIGATION OF REPROCESSED INSTRUMENTS SPOTTING thematic analysis.
Tiffany Herrick¹, Alison Devine¹ Results: Interviews were performed in 20% (67/313) of areas and included 115
¹Alberta Health Services frontline staff. Overall, the use of routine practices was sustained in 42% (28/67)
of the areas sampled. In ambulatory cancer care, routine practices were sustained
Background/Objectives: Reusable medical devices (MDs) need proper in 67% (8/12) of areas. In ambulatory care, routine practices were sustained in
reprocessing to ensure they perform as intended and are safe for reuse. 36% (20/55) of areas. Key themes that emerged from the focus group included:
Inadequate reprocessing may be caused by factors such as a failure in cleaning, differences in the approach and focus of the initiatives; engagement at various
disinfection, sterilization, or rinsing of MDs, by water quality, type and amount levels, which impacted the ability of the ICPs to encourage participation in and
of detergent, or additives. Any of these may be associated with visible water-like implement of designed interventions; importance of champions and educators
spotting on MDs. Spotting can interfere with sterilization and functioning of MD in areas to act as supports for both frontline staff and ICPs; consideration for the
and should be managed in real time to eliminate any risks to patients’ safety. types of resources developed; and importance of project management to provide
Close monitoring of the reprocessing of MDs leads to early identification of clarity on and structure to the initiatives.
spotting and the initiation of appropriate steps in addressing the cause(s). Infection Conclusion: Sustainability differed between the two initiatives. Explanations for
2021 IPAC CANADA NATIONAL CONFERENCE 11You can also read
