Developing And Implementing An Infection Prevention And Control Program In The Ambulatory Dialysis Care Setting: The Singapore Experience

Background:  

The promotion of infection prevention and control is a key brief of the Healthcare Performance Group of the Ministry of Health (MOH), Singapore. In April 2007, in collaboration with the Practice Leader on Infection Control of the Joint Commission International (JCI), MOH conducted training and workshop for the Infection Control Nurses and Nurse Administrators of Dialysis Centers in Singapore. This paper describes the development and implementation of the infection prevention and control program for the ambulatory dialysis centers (DCs) in Singapore.

Objective:

Infections involving vascular access sites are a major cause of morbidity and mortality amongst hemodialysis patients.[1] Hence an effective infection prevention and control program is a critical component of the patient safety programme of DCs.
Methods:

To effect the implementation of what was learned during the educational program, the primary author facilitated the development of effective infection prevention and control program and provided on-site coaching and mentorship of the dialysis centre Infection Control Nurse (ICN).
 

Results:

In September 2007, an Infection Control (IC) Unit was formed. This unit developed IC policies and procedures specific to the DCs’ setting. Audit tools and checklists were developed and tested in the 23 DCs of the ambulatory setting.  Educational sessions on IC were conducted on-site over six months and surveillance activities for access sites infection, sharps related injuries were concurrently developed. In January 2008, a Nursing Infection Control Task Group (NICTG) was formed to continue to inculcate the culture of infection prevention and control through education, communication and research throughout the DCs.

Conclusions:

The development and implementation of IC Program in DCs is vital in improving the safety and quality of dialysis care. Implementation of patient safety is facilitated when educational programmes that are coordinated at a national level are complemented with on-site facilitation of the development of institutional Infection Prevention and Control Programs.