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Winter 2020 eNews

Issue Thursday 13 August

In this issue

• Aussies 'mask up' to stop the spread of COVID
• Emerging evidence on COVID-19 treatments
• Stay safe with the latest COVID-19 PPE guidance
• Raising awareness of healthcare rights
• Sepsis program to drive early diagnosis and treatment
• Caring for those with cognitive impairment
• Reducing risk with hand hygiene
• New benchmark to reduce Staphylococcus aureus
• What's happening 'In The Name of Safety'?
• Environmental cleaning – more important than ever
• Quick Bites
• Working at the Commission

Aussies 'mask up' to stop the spread of COVID

Following a resurgence of COVID-19 cases – particularly community transmissions – in Victoria and other hotspots across the country, many Australians are now wearing face masks to help stop the spread. Face masks are now mandatory across Victoria, and recommended in all areas where there is community transmission of COVID-19 and maintaining a physical distance of 1.5 metres is difficult.

To help Australians understand when it’s important to wear a mask, the Commission has developed a consumer fact sheet and frequently asked questions. These new resources explain how to safely put on and remove a face mask, and reinforce existing prevention measures, such as staying home if you have symptoms, physical distancing, hand hygiene and cough etiquette.

Healthcare professionals are encouraged to share consumer guidance on face masks and urge at-risk patients to 'mask up'.

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Emerging evidence on COVID-19 treatments

Whilst the mainstay for treatment of COVID-19 is currently supportive care, investigation of experimental treatments for COVID-19 is underway across the globe, focusing on repurposing existing medicines.

The Commission has published a summary of emerging evidence for Potential medicines to treat COVID-19. This includes updates on the latest research including developments in the large collaborative randomised Recovery Trial, the World Health Organization's Solidarity Trial, and the Therapeutic Goods Association's recent announcement on remdesivir.

Due to the rapidly evolving nature of COVID-19, many references have not been peer-reviewed, and any potential treatments should be considered experimental at this stage.

Beyond potential treatments, the Commission has developed guidance for health service organisations and clinicians on the safe management of medication for patients with COVID-19, including a series of position statements.

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Stay safe with the latest COVID-19 PPE guidance

The Commission's COVID-19 web page features up-to-date guidance for clinicians and the community on how to reduce the risk of COVID-19 exposure and infection.

Check the page regularly for essential information including the Australian Guidelines for the Prevention and Control of Infection in Healthcare and the latest advice on infection prevention and control, PPE, hand hygiene, medicines management and more.

Croakey health blog’s recent article As Australia settles in for the long haul of COVID-19, accessible advice is key highlights some of the Commission's important COVID resources.

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Raising awareness of healthcare rights

During the pandemic, it is more important than ever for consumers and patients to understand their rights and participate in their health care.

Download and share our new multimedia resources to help inform people about the Australian Charter of Healthcare Rights.

A short animation explains what consumers, or someone they care for, can expect when receiving health care. Audio resources are also available, including one for each of the seven healthcare rights and a complete reading of the charter.

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Sepsis program to drive early diagnosis and treatment

The Commission is leading a national sepsis program to improve outcomes for people with sepsis, a life-threatening condition that contributes greatly to the global burden of disease.

Partnering with The George Institute for Global Health, all Australian governments, consumers and clinicians, the Commission will gather evidence to support the development of clinical guidance materials to drive early recognition and treatment of sepsis, and coordinate a public awareness campaign funded by the Australian Government Department of Health.

Find out more in the Epidemiology of Sepsis in Australian Public Hospitals report, the first national epidemiological snapshot of sepsis and its impact on Australians.

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Caring for those with cognitive impairment

COVID-19 has brought new challenges for people with cognitive impairment seeking health care. The hospital environment may seem unfamiliar, with health screening measures, visitor restrictions and staff wearing PPE.

Four important actions can help clinicians to provide safe care for people with cognitive impairment: agree to goals of care, involve the carer, prevent delirium, and treat appropriately. Download the new poster and fact sheet to find out more about caring for people with cognitive impairment during COVID.

A new guide, My Healthcare Rights – A guide for people with cognitive impairment, explains the rights all people have to safe and high quality care, informed consent and open disclosure. The ‘Easy English’ translation of this guide, About healthcare rights for people with cognitive impairment, makes this important information accessible to consumers with low English literacy.

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Reducing risk with hand hygiene

Hand hygiene is a primary measure for reducing the risk of infection, and compliance in clinical settings is critical for providing safe, clean care.

Data collection for hand hygiene audits will not be mandatory until the start of the COVID-19 recovery phase.

However, all health service organisations are encouraged to continue to focus on hand hygiene as a key part of their comprehensive infection prevention and control program. Hand hygiene data can continue to be submitted on a voluntary basis, to allow feedback to be provided to healthcare workers, and to support ongoing improvement in hand hygiene practice.

Good hand hygiene is critical to the prevention and containment of COVID-19.

Find out more on the Commission’s National Hand Hygiene Initiative page.

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New benchmark to reduce Staphylococcus aureus

Healthcare-associated Staphylococcus aureus bacteraemia (SAB) infections are commonly associated with significant morbidity and mortality. Preventing these infections is a critical activity for health service organisations. The Australian Health Ministers’ Advisory Council endorsed a new national benchmark for healthcare-associated SAB infections for public hospital reporting, which was implemented from 1 July, 2020. The new benchmark is 1.0 per 10,000 patient days.

The Commission has drawn together a range of resources that support the prevention of SAB infections in healthcare in areas such as: hand hygiene; insertion, management and removal of intravascular devices; perioperative antimicrobial prophylaxis and antimicrobial stewardship; and, surgical site management. This information is available at safetyandquality.gov.au/sab.

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What's happening 'In The Name of Safety'?

Researchers at the University of Technology and St Vincent’s Hospital Sydney are undertaking a national survey of Australian healthcare workers to find out what doesn't help improve patient safety.

'In the Name of Safety' survey is a collaboration with the University of Leeds and Yorkshire Quality and Research Group to identify ineffective non-clinical safety practices that could potentially be stopped to create more time for patient care.

Healthcare workers - please provide feedback via the online survey on what does not improve patient safety before 31 August for the chance to win a gift voucher.

Find out more about the survey in Dr Norman Swan’s ABC Radio interview with lead researcher Dr Deborah Debono.

The study has been approved by St Vincent’s Hospital Human Research Ethics Committee (ethics approval 2020/ETH00072).

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Environmental cleaning – more important than ever

Environmental cleaning is a critical element of standard precautions in all healthcare settings, and should feature in every health service organisation’s infection prevention and control program.

Health services are required by the National Safety and Quality Health Service (NSQHS) Standards to maintain a clean and hygienic environment to reduce infectious agents and minimise the risk of transfer of microorganisms.

The Commission has produced a suite of environmental cleaning resources, providing timely advice on selecting cleaning products and auditing cleaning services. These resources will support health service organisations in meeting Action 3.11 of the Preventing and Controlling Healthcare-Associated Infection Standard, and implementing the environmental cleaning requirements of the Australian Guidelines for the Prevention and Control of Infection in Healthcare.

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Quick Bites

Accreditation update

The Commission is continuing to maintain the accreditation status of health service organisations to the NSQHS Standards given the rapidly changing COVID-19 situation in eastern Australia. Once the reintroduction of onsite assessments becomes feasible, a commencement date will take into consideration the lead-time required for planning and preparation of assessments.

Safe selection and storage of medicines

New guidance on Principles for the safe selection and storage of medicines has been released to help clinicians reduce the risk of medicine selection errors. Developed for use in hospitals, the guide will help to reduce one of the most common types of medication error - look-alike and sound-alike (LASA) medicine names. There is also a survey tool to enable health services to identify suitable risk-reduction strategies.

Role of general practice in antimicrobial stewardship

The latest addition to the Antimicrobial Stewardship in Australian Health Care publication is a new chapter focused on the role of general practice in Antimicrobial Stewardship (AMS). Chapter 13 covers antimicrobial resistance and antimicrobial use in the community, factors that influence antimicrobial prescribing in general practice, AMS strategies for general practice, and considerations for clinical governance and leadership.

CARAlert Annual Report 2019 highlights concern for CPE

The National Alert System for Critical Antimicrobial Resistances (CARAlert) has revealed an overall increase of 27% in CARs reported in 2019 compared to 2018. Of most concern in the newly-released CARAlert Annual Report 2019 is Carbapenemase-producing Enterobacterales (CPE), which have increased annually since 2016. CPE poses a significant risk to patient safety, as bacteria that produce carbapenemase enzymes are almost always resistant to other important antibiotics and effective treatment options may be limited.

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Careers

Working at the Commission

Meet Professor Anne Duggan…

Professor Anne Duggan, Clinical Director, Australian Commission on Safety and Quality in Health Care

What did you do before the Commission?
I have been with Hunter New England Hospital for about 20 years, as senior Staff Specialist Gastroenterologist, Head of Department, and more recently the Director of Clinical Governance. In these roles, I became acutely aware of the need for health service standards. This awareness led me to appreciate the value of introducing the National Safety and Quality Health Service Standards (NSQHSS) in 2013, and also of the leadership of the Commission in the Australian healthcare system.

What do you do now?
I am the Commission's Clinical Director for Healthcare Variation. It has been rewarding to help develop the Australian Atlas of Healthcare Variation series. We are currently working on the Fourth Atlas. Using available administrative data, we have been able to show the variation in health care that Australians receive based on where they live. This has led to some fantastic work by different groups across the country to reduce unwarranted variation and to improve the appropriateness of care. In some cases, this has been through promoting evidence-based standards for care. In other cases it has been through more fundamental changes to care pathways. There is still much work to be done.

What do you love most about your work?
The opportunity to contribute to other areas that improve the safety, quality and equity of health care in Australia. While my primary role is with healthcare variation, I am able to contribute in other ways at the Commission. Currently, I am clinical lead of the Rapid Response Unit for COVID-19, which was established to translate high level advice on the management of COVID-19 into practical advice and tools to support healthcare workers in all scenarios. Recent examples are our elective surgery guidance and personal protective equipment guidance for clinicians.

What is something that is not well known about us?
I think the depth and breadth of corporate knowledge of the healthcare system that staff bring to inform the Commission’s work would be unknown, even to many who work here. For example, among the Commission’s medical advisors alone, there is vast experience across public health, health system management, infectious diseases, intensive care, palliative care and gastroenterology.

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