Organization

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Organization Sustainability
By Prof. OSSAMA RASSLAN
Secretary General, Egyptian Society of Infection
Control
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Current Status
Current status in rural areas most P.H.C.
facilities
1. Lack of structure - No ICC - There may be
ICP 2. Lacking or inadequate policies 3. Lack
of resources
Lacking resources - Running water - Hand.W.
facilities - Protective clothes - Steriliz.,
disinf. facilities - Sharps disposal facilities -
Waste disposal facilities - Incineration
facilities
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Current Status (cont.d)
Current status in rural areas most P.H.C.
facilities
4. Lack of knowledge 5. Lack of compliance 6.
Lack of concept 7. Lack of control - Loss -
Overconsumption
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How to practice
1. Establish a structure - ICC, ICT, ICD, ICN,
ICLN - Minimal requirements Who is the ideal IC
man? Who is the ideal IC nurse?
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Infection control Personnel
The ideal IC man is a combination of

• Inf. ds. specialist Teacher
• Epidemiologist Preacher
• Microbiologist Economist
• Psychologist Environmentalist
• (Never ever be a policeman)

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Infection control Personnel
The ideal IC nurse is

• The fairy good mother
• St. Francis assist
• Margaret Thatcher

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How to practice
2. Formulate monitor policies (Guidelines) -
Protective barriers - Ward specific policies -
Site specific policies - Disease specific
policies 3. Use the existing system (Modify
interventions) e.g. a) Cleaning, disinfection
sterilization b) soiled linen mgt 4. Educate
all healthcare workers 5. Raise awareness
establish the right concepts
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How to practice
6. Control security to control overconsumption
avoid loss 7. Recycling Reuse Recycling Most
of hosp. waste is of the household type is
recyclable. Reuse of non critical items, e.g.
masks, gloves, etc. (after being cleaned
disinfected).
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Modify existing systems - basic concepts
- The basic requirement is clean objects -
Determine when sterilization is needed when
disinfection is sufficient - 10 min boiling is
sufficient to avoid almost 90 of
infections - Highly sophisticated equipment is
not required - Less costly methods may be used
to eradicate many organisms - Proper use of
available resources in due time is very
important
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Education of HCW
What are the basic concepts for education? -
Hand hygiene - Personal hygiene - Protective
barriers - Cleaning, sterilization
disinfection - Aseptic work techniques - Safe
food and water supply - Special skills, e.g.
communicology
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Education of HCW
Who should be educated? - The general
population - Special population groups
Teachers, parents, medical non-medical
staff, children, pupils, ... Who should
educate? - Educated experts - IC doctors - IC
nurses - Infectious Diseases specialists
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Education of HCW
How to communicate with IC users? - Handouts
mostly not read Doctors have no time to read,
what they read, they do not believe, What they
believe, they do not do - Posters mostly not
noticed - Lectures mostly not attended -
Scientific literature mostly not understood
/or believed - IC folders where are they?
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Education of HCW (How to communicate w IC
users)

• - Ward rounds
• - Quality circles
• Group meeting Adequate time
• With very ltd. no. At work times
• Different levels Results discussion
• Regular meetings Role playing
• From different work areas
• Discuss self-chosen subjects

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Education of HCW
How to achieve? - Kill all opponents
immediately! - Wait until they die! - Try not
to convince strong opponents - Collaborate with
supporters - Use the top to bottom approach -
The hosp. administrator must be your partner -
The hosp. IC nurses are the key players
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Education of HCW
What should be our goal? - Infection rate not
above average - Low rates of MRSA VRE - No
outbreaks - We are partners - We save you
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Education of HCW
What should not be our goal? - Teach
everybody - Reach everybody - Reach 100
achievement or 100 compliance
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Education of HCW
How to accomplish? - Clearly define your goal -
Involve keen staff - Keep it simple - Do not
try to reach 100 compliance - Do not try to
impose - Do not expect immediate change
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Education of HCW

• How to accomplish? (cont.d)
• - Go to the ward talk to the people
• - Do not wait to approach
• - Keep regular meetings
• with sterilization units
• with ICC
• with regular ward rounds

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Thank You