Healthcare-associated infections

1
Healthcare-associated infections antimicrobial
use in long-term care facilities(HALT) 2013

• Our Local HALT Report
• ENTER YOUR LTCFs NAME HERE

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What is HALT?

• A point prevalence survey in nursing
  homes/long-term care facilities (LTCF)
• Commissioned by the European Centre for Disease
  Prevention and Control (ECDC)
• HALT first carried out in May 2010
  Participation in 28 European countries, including
  Ireland
• Ireland performed a further HALT survey in May
  2011
• A further European HALT completed in May 2013

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What is surveillance?

• Surveillance keeping an eye on things
• Systematic collection and analysis of data and
  the use of this information for action
• Improve the care we give to our
  residents/patients
• Reduce the occurrence of preventable
  healthcare-associated infection (HCAI) in our
  residents
• Compare our results with those of other LTCFs
  that look after a similar type of resident

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Surveillance of HCAI

• Two types of surveillance are used in healthcare
• Prevalence specific point in time
• Incidence ongoing capture of data

HALT is a prevalence survey
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Ireland has excellent participation by LTCF in
HALT surveys!
In 2010, Irish LTCF accounted for 9.5 of all
participating LTCF in European HALT survey!
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In HALT 2013, our LTCF has been classified in the
following care group
LTCF CARE GROUP CATEGORIES HIGHLIGHT YOUR LTCF CARE GROUP IN THE BOX BELOW
We are a general nursing home with majority of our residents staying gt12 months (GN gt12 months)
We are a mixed care type LTCF with majority of our residents staying gt12 months
We are a LTCF with the majority of our residents staying lt12 months
We are an intellectually disabled LTCF
We are a psychiatric LTCF
We are a palliative care LTCF
We are a physically disabled LTCF
We are a rehabilitation LTCF
Our LTCF is none of the above we have been classified in the category other LTCF
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What were the demographics of our LTCF on the
HALT survey date in May 2013?

1. Go to your local HALT report page 2, section
   1.1LTCF Demographics
2. Take a snapshot of section 1.1 and then paste it
   into this slide

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What were the demographics of our residents in
May 2013?

• Go to your local HALT report page 2, section 1.2
  Resident Demographics
• Take a snapshot of Figure 1 in section 1.2 and
  then paste it into this slide

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How common were HCAI in our residents in May 2013?

1. Go to your local HALT report page 3, section 2.1
   How common were HCAIs?
2. Take a snapshot of Table 1 in section 2.1 and
   then paste it into this slide

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How common were HCAI in our residents in May 2013?

• Go to your local HALT report page 3, section 2.1
  How common were HCAIs?
• Take a snapshot of Figure 2 in section 2.1 and
  then paste it into this slide

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What types of HCAI were found in HALT 2013?

• Go to your local HALT report page 4, section 2.2
  
• What type of HCAIs were present in residents?
• Take a snapshot of Table 2 in section 2.2 and
  then paste it into this slide

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How does the breakdown of the most common HCAI
types compare over the years?

• Go to your local HALT report page 4, section 2.2
  
• What type of HCAIs were present in residents?
• Take a snapshot of Table 3 in section 2.2 and
  then paste it into this slide

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How common was antimicrobial use in our residents
in May 2013?

1. Go to your local HALT report page 5, section 3.1
   Overall summary of antimicrobial use
2. Take a snapshot of Table 4 in section 3.1 and
   then paste it into this slide

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How common was antimicrobial use in our residents
in May 2013?

1. Go to your local HALT report page 5, section 3.1
   Overall summary of antimicrobial use
2. Take a snapshot of Figure 3 in section 3.1 and
   then paste it into this slide

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Where were the antimicrobials prescribed?

• Go to your local HALT report page 6, section 3.2
  Where were antimicrobials
• prescribed and who prescribed them?
• Take a snapshot of Table 5 in section 3.2 and
  paste it into this slide

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Who prescribed the antimicrobials?

• Go to your local HALT report page 6 section 3.2
  Where were antimicrobials
• prescribed and who prescribed them?
• Take a snapshot of Table 6 in section 3.2 and
  paste it into this slide

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Why were the antimicrobials prescribed?

1. Go to your local HALT report page 6, section 3.3
   Why were antimicrobials prescribed?
2. Take a snapshot of Figure 4 in section 3.3.1 and
   then paste it into this slide

Treatment of infection Therapeutic Light
green bar Prevention of infection Prophylactic
Dark green bar Unknown reason Blue bar
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What were the most common body sites for which
the antimicrobials were prescribed?

1. Go to your local HALT report page 7, section 3.3
   Why were antimicrobials prescribed?
2. Take a snapshot of Figure 5 on page 7 in section
   3.3.2 and then paste it into this slide

Dark blue Urinary tract Light blue
Respiratory tract White Skin or wound Green
Other body site
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For each of the most common body sites, were
antimicrobials prescribed for treatment or for
prevention of infection?

1. Go to your local HALT report page 7, section 3.3
   Why were antimicrobials prescribed?
2. Take a snapshot of Figure 6 on page 7 in section
   3.3.3 and then paste it into this slide

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Where the urinary tract was the body site for the
prescription, what were the prescribed
antimicrobials?

1. Go to your local HALT report page 8, section 3.4
   Which antimicrobials were prescribed?
2. Take a snapshot of Table 7 on page 8 in section
   3.4 and then paste it into this slide

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Where the respiratory tract was the body site for
the prescription, what were the prescribed
antimicrobials?

1. Go to your local HALT report page 8, section 3.4
   Which antimicrobials were prescribed?
2. Take a snapshot of Table 8 on page 8 in section
   3.4 and then paste it into this slide

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Where skin or a wound was the body site for the
prescription, what were the prescribed
antimicrobials?

1. Go to your local HALT report page 9, section 3.4
   Which antimicrobials were prescribed?
2. Take a snapshot of Table 9 on page 9 in section
   3.4 and then paste it into this slide

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How do we fare with regard to ourinfection
prevention and control practices?

1. Go to your local HALT report page 11, section 5
   Infection Control
2. Take a snapshot of Table 11 in section 5 and then
   paste it into this slide

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How do we fare with regard to ourantimicrobial
stewardship practices?

1. Go to your local HALT report page 12, section 6
   Antimicrobial Stewardship
2. Take a snapshot of Table 12 in section 6 and then
   paste it into this slide

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What are the key findings inour local HALT
report for 2013?

• What are the good points?

• What areas need improvement?

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What are the key findings inour local HALT
report in comparison with previous years that we
have done HALT?

• What has improved?

• What hasnt improved?

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What are the top three things that we want to
improve on in the next 12 months?
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How will we achieve those three aims?
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When will we meet again to discuss our progress?
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Have we made sure that everyone who needs to
knowabout our HALT report has seen it and knows
what our quality improvement plans are for the
next year?

1. Our LTCF doctors
2. Our general practitioners
3. Our nurses
4. Our infection prevention and control nurse
5. Our staff
6. Our managers
7. Our residents and their families

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Go to the HPSC website for further information
and guidanceExamples of resources are on the
following slides
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http//www.hpsc.ie/hpsc/A-Z/MicrobiologyAntimicrob
ialResistance/InfectionControlandHAI/Surveillance/
HCAIinlongtermcarefacilities/
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Thank you for your attention