NHS GRAMPIAN
Infection Control Committee
Minutes from meeting held on 11th September 2012
The Board Room, ARI
11.00 – 13.00
Present:
RSD - Dr Roelf Dijkhuizen, Medical Director
PEH – Pamela Harrison, Infection Prevention and Control Manager
JA - Jane Adam, Public Forum Representative
SR – Stewart Rogerson,Decontamination Lead for NHSG
VS – Vincent Shields, General Manager Acute Sector
EM - Eleanor Murray, Unit Nurse Manager, Acute Sector (deputising for Vince Shields)
ES – Elinor Smith, Nurse Director for NHS Grampian
FD – Frances Dunn, (deputising for Julie Fletcher)
AMK – Dr Anne Marie Karcher, Infection Control Doctor / Medical Microbiologist
RAB – Roy Browning, Infection Prevention & Control Senior Nurse
LM – Dr Elizabeth Murphy,
ST - Sandy Thomson,Lead Pharmacist, Dr Gray’s Hospital, Moray (deputising for Andrew Fowlie)
AM – Dr Alexander Mackenzie, Infectious Diseases Consultant
DO – Deirdre O’Brien, Medical Microbiologist
TOK – Terence O’Kelly, Surgical Lead, Acute Sector
Anneke Street, PA to Infection Control Manager(Minute taker)
1 / Introduction and Apologies /
RSD opened the meeting. Apologies were received from :
Helen Howie (HH) Jenny Gibb (JG) Gladys Buchan (GB) Pamela Molyneaux (PM) Tommy Ovens (TO)
Karen Wares (KDW) Gary Mortimer (GM) Keith Thomson (KT) Lynn Young (LY) Jane Ormerod (JO)
Sue Swift (SS)
2 / Minutes of last meeting
31st July 2012 /
LM was concerned regarding the Pertussis narrative under item 4.1 Standing Items and also the Measles narrative under Item 7 AOCB
This will be looked into and reworded. / PEH
3 / Matters Arising
Item 3.1 /
CJD
TO was invited to the meeting to speak and feedback progress on this subject.
RSD stressed that feasible measures require to be put in place but agreed that implementation may bring more complications. There are 2 risks. The logistical risk is that suspected transmission could be attributed to workable measures not being put in place at the earliest opportunity and the transmission risk is that a patient could become affected and in later years this could be traced back to NHS Grampian inefficiencies.
TOK has looked into feasibility measures.
Item / Subject / Action to be taken and Key Points raised in discussion / Action
3
4 / Matters Arising cont…
Item 3.1
Standing Items
Item 4.1 / TOKspoke to the Committee about a recent case. The patient involved had received blood products in the past and when admitted to the Bleeding Unit was found to require an endoscopic procedure and latterly surgery.
The endoscopic procedure took place with the out of hours/weekend protocol being adhered to and followed until the decontamination process section; there was no correspondence with the Decontamination Unit that this scope had been used on an at risk patient. The surgical procedure performed was low risk.
There then followed a wide ranging discussion around future opportunities to gather risk information electronically, particularly where patients may be reluctant to share risk information.
VS suggested that rapid action was now needed. Work must be started on ensuring that PAS can interface with OPERA. Staff require more robust training and awareness on decontamination procedures. When conflicting advice is present NHS Grampian should err on the side of caution with regards to risk status.
TOK to meet with AMK and Amanda Croft to discuss issues further and will report decisions made to the Committee. RSD asked for a written report to be brought back to the Committee
MRSA Screening Compliance
VS gave the Committee an update with regard to screening within the Acute Sector.
RSD commented that he found the report encouraging and that he felt snapshot audits were a more effective way to show compliance. RSD also felt that there needed to be more involvement with medical staff and suggested approaching them for feedback. The awareness and understanding of MRSA by medical staff in high risk specialties is paramount.
AM replied that nursing staff were the key staff group that feedback should be sought from as this was a nurse led initiative but also agreed that medical staff should have an interest and input. Education is the key but poor attendance at education sessions by medical staff is still a problem.
LM suggested that perhaps a training bundle incorporating vCJD, MRSA and Infection Prevention and Control should be available to medical staff and AMK agreed but it seemed the deep rooted view of medical staff is that infection prevention and control is nurse led and doctors are more removed from this day to day issue.
RSD suggested that updates on screening compliance, to the Committee, be recommenced. No graphs would be required but instead, feedback on day to day practices by both medical and nursing staff.
RSD will speak to Richard Coleman with regard to education of medical staff.
/ TOK/AMK
RSD
Item / Subject / Action to be taken and Key Points raised in discussion / Action
5 / Reporting to Clinical Governance Committee and Board / This itemwas postponed.
6 / AOCB / ES raised the issue of the latest HEI Inspection and suggested it be discussed?
RSD replied that unreported inspections were not normally discussed within the Infection Control Committee remit and that these dialogues were usually had at the Clinical Governance Committee and Board meetings.
VS fedback that perhaps HEI issues warranted a deeper discussion within the Committee and could conceivably be worthy of being an agenda item, at some point, as a “one off” to reassure the Committee.
LM raised the topic of Measles, feeding back that a proactive and supportive immunisation programme showed an uptake in the MMR vaccine at 300 – 400 staff members but reiterated to the Committee that this vaccine is not compulsory to staff and when staff receive the flu vaccine they are made aware of other inoculations that are available.
LM also stated that there are no staff immunity records kept anywhere other than within Occupational Health Services, although some staff are able to identify their immunity. The question was raised as to whether the Committee felt strongly that this method of practice should change.
LM also fedback that the Health and Safety Executive were holding consultations regarding guidance on exposure to BBV and needlestick injuries. Monitoring and auditing of previous incidents is ongoing. Dr Katherine Targett is attending these meetings.
AMK took the opportunity to introduce Dr Deirdre O’Brien to the Committee as the new Infection Prevention and Control Doctor for Community areas. RSD welcomed Dr O’Brien to the Committee and the meeting.
7 / Date of next meeting /
13th November 2012 11.00 – 13.00 in the Conference Room, MacGillivray Centre, AberdeenMaternityHospital
1