635 Saving 1000 Lives Campaign

Saturday, March 20, 2010
Grand Hall (Hyatt Regency Atlanta)
Dafydd Williams , Welsh Healthcare Associated Infection Programme, Public Health Wales NHS Trust, Cardiff, United Kingdom
Eleri Davies, MBBCh, Wales , Welsh Healthcare Associated Infection Programme, Public Health Wales NHS Trust, Cardiff, United Kingdom
Alan Wilson , National Leadership & Innovation Agency for Healthcare NHS Wales, Llanharan, United Kingdom
Background: 1000 Lives campaign was launched in April 2008 as the Patient Safety campaignfor Wales.  The campaign is built around seven content areas aim to reduce harm to patient in primary and secondary care in Wales.  Reducing healthcare associated infection is a specific content area of the campaign in Wales.
Objective: The Healthcare AssociatedInfection (HCAI) content areaaims to reduce all healthcare associated infections through a series of evidence based interventions coupled with monitoring of outcome measure throughout the healthcare community in Wales fom primmary through to secondary and teritary care.  The involvement of primmary careas well as the acute sector of healthcare in the patient safety work was an unique feature of the campaign in Wales.  An overview of the work of the HCAI content area is provided.
Methods: Nine key interventions,
  1. implementing the recomendations of HCAI strategy for Wales,
  2. standard precutions,
  3. isolation precautions,
  4. decontamination of enviroment & equipment,
  5. antimicrobial stewardship,
  6. manegment of medical device,
  7. central line bunsle,
  8. ventilator bundle,
  9. preventions of surgical site infection
  10. early detection and rsponse system

were identified as the drivers for the prevention and transmission of healthcare associated infection.  For each intervention, compliance with specific process measures data was collected and reported to the campaign hand hygiene observational audits, antimicrobial usage and compliance with CVC and VAP care bundles, as well as key outcome measure of reducing healthcare associated infection.
Results: Results from each organisation have varied, with some organisation managing to spread the different intervention to a number of wards.  A hand hygiene compliance observational audit has been widely successful with an average rate of 89% and median of 93.89% for Wales. Other measures such as antimicrobial adherence to formulary 97.14%, central venous catheter maintenance bundle 98% as well customised process measures decontamination of medical equipment.  The engagment of the primary care sector was groun breaking and posed very different challenges to those encountered in the acute sector, success has been seen in improving awareness of HCAI through teaching programmes and the hand hygiene interventions and care bundles for managing urinary catheter have been succesful

Conclusions: The 1000 Lives Campaign aims to save 1000 lives and 50,000episodes of harm in Wales during the 2 years of the Campaign.  A key area within the campaign is the content area devoted to reducing HCAI.  The emphasis withinthe HCAI content area has been on reducing all types of HCAi not just MRSA and Clostridium difficile through evidence based interventions.  Success has been seen in increasing compliance with hand hygiene across the healthcare community.  reduction in Cl.difficile infecions, Central venous catheter infectins on critical care units and urinary catheter related infectins has been seen.