National program to reduce healthcare infections in Australian patients

Background: Australian efforts in HAI surveillance and prevention are primarily coordinated at state or regional level. Consequently Australia lacked a systematic approach to HAI (infection control, hand hygiene and antimicrobials) or data gathering and analysis. The resources invested in HAI and the scope of surveillance varied markedly across Australia

This fragmented state of HAI surveillance meant that information was scarce, unreliable and difficult to generalise from. No national program existed to draw together data on the incidence and prevalence of HAI in Australia.
Objective: : The primary objective of the national HAI program was to develop a national strategy to deliver sustained reductions in the incidence of HAI 

Methods: A collaborative strategy was developed including:
Ø       Engagement with clinicians, policy makers, medical and nursing colleges
Ø       Issues identified and prioritised
Ø       Five key national projects developed.
·         National surveillance
·         National Infection Control Guidelines
·         National Hand Hygiene Initiative
·         Antimicrobial Stewardship
·         Capacity building for Infection Control Professionals (ICPs)
Ø       3 publications on surveillance, antimicrobial stewardship and infection prevention programs included:
·         Identification of key experts
·         Targeted recommendations prioritised for action
·         Endorsement by state/territory health ministers
·         Inclusion in national safety and quality indicators for accreditation
Results: In 2 years the National HAI program has delivered:
Ø       Consensus definitions, data dictionary and data collections endorsed for national surveillance; aligned with indicators for National Health Care Agreement funding
Ø       Education modules for novice and rural ICPs
Ø       Strategy for national Antimicrobial Stewardship;
Ø       Evidence-based National Infection Control Guidelines developed around core practice principles;
Ø       National hand hygiene program rolled out across all jurisdictions and private sector
Ø       Elements of Australian infection control programs developed on basis of literature review and review of jurisdictions
Ø       Engagement of clinicians, policy makers and the private hospital sector
Ø       Uptake and implementation of initiatives by jurisdictions and the private hospital sector
Conclusions: Despite widespread activity in most jurisdictions, many individual initiatives and the publication of a number of national reports, including endorsement by the Australian Health Ministers there was considerable variation in resources with work undertaken by many disparate specialist groups across the country. An innovative approach to improve Australian efforts to prevent HAIs has involved substantial collaboration with national policy stakeholders and clinical experts. Careful review and adaptation of previous relevant national work has resulted in a national HAI program with common definitions, standardised hand hygiene and guidelines successfully adopted across the country