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Best Practices for Infection Prevention and Control ...

Best Practices for Infection Prevention and Control Programs in Ontario In All Health Care Settings, 3rd edition Provincial Infectious Diseases Advisory Committee (PIDAC) Published: September 2008 Second Revision: January 2011 Third Revision: May 2012 Best Practices for Infection Prevention and Control Programs in Ontario | May, 2012 ii NOTES This document REPLACES Best Practices for Infection Prevention and Control Programs in Ontario In All Health Care Settings, 2nd edition, published January 2011. This document is intended to provide best Practices only. Health care settings are encouraged to work towards these best Practices in an effort to improve quality of care Provincial Infectious Diseases Advisory Committee (PIDAC) Ontario Agency for Health Protection and Promotion Tel: 647-260-7100 Email: All or part of this report may be reproduced for educational purposes only without permission.

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1 Best Practices for Infection Prevention and Control Programs in Ontario In All Health Care Settings, 3rd edition Provincial Infectious Diseases Advisory Committee (PIDAC) Published: September 2008 Second Revision: January 2011 Third Revision: May 2012 Best Practices for Infection Prevention and Control Programs in Ontario | May, 2012 ii NOTES This document REPLACES Best Practices for Infection Prevention and Control Programs in Ontario In All Health Care Settings, 2nd edition, published January 2011. This document is intended to provide best Practices only. Health care settings are encouraged to work towards these best Practices in an effort to improve quality of care Provincial Infectious Diseases Advisory Committee (PIDAC) Ontario Agency for Health Protection and Promotion Tel: 647-260-7100 Email: All or part of this report may be reproduced for educational purposes only without permission.

2 Queen s Printer for Ontario, 2012 ISBN 978-1-4606-0109-9 The Ontario Agency for Health Protection and Promotion (Public Health Ontario) is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. As a hub organization, Public Health Ontario links public health practitioners, front-line health workers and researchers to the best scientific intelligence and knowledge from around the world. Public Health Ontario provides expert scientific and technical support relating to communicable and infectious diseases; surveillance and epidemiology; immunization; health promotion, chronic disease and injury Prevention ; environmental and occupational health; health emergency preparedness; and public health laboratory services to support health providers, the public health system and partner ministries in making informed decisions and taking informed action to improve the health and security of Ontarians.

3 The Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control (PIDAC-IPC) is a multidisciplinary committee of health care professionals with expertise and experience in Infection Prevention and Control . The committee advises Public Health Ontario on the Prevention and Control of health care associated infections , considering the entire health care system for protection of both clients/patients/residents and health care providers. PIDAC-IPC produces best practice knowledge products that are evidence-based, to the largest extent possible, to assist health care organizations in improving quality of care and client/patient/resident safety. Disclaimer for Best Practice Documents This document was developed by the Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control (PIDAC-IPC).

4 PIDAC-IPC is a multidisciplinary scientific advisory body that provides evidence-based advice to the Ontario Agency for Health Protection and Promotion (Public Health Ontario) regarding multiple aspects of infectious disease identification, Prevention and Control . PIDAC-IPC s work is guided by the best available evidence and updated as required. Best Practice documents and tools produced by PIDAC-IPC reflect consensus positions on what the committee deems prudent practice and are made available as a resource to public health and health care providers. Suggested Citation Ontario Agency For Health Protection and Promotion. Provincial Infectious Diseases Advisory Committee. Best Practices for Infection Prevention and Control Programs in All Health Care Settings, 3rd edition.

5 Toronto, ON: Queen s Printer for Ontario; May 2012. Best Practices for Infection Prevention and Control Programs in Ontario | May, 2012 iii Best Practices for Infection Prevention and Control Programs in Ontario In All Health Care Settings (3rd edition) SECOND REVISION, JANUARY 2011: Revisions to Best Practices for Infection Prevention and Control Programs in All Health Care Settings, originally published September, 2008: This document incorporates revisions from the following updated Ontario legislation: Long-Term Care Homes Act Public Hospitals Act New information and best Practices from the scientific literature are also reflected in this revision.

6 New material from these documents is highlighted in grey in the text. THIRD REVISION, MAY 2012: This revision addresses influenza vaccination of health care workers, based on the growing evidence of reduced incidence of influenza and associated mortality in patients and residents when health care workers are immunized. See page 30 for information and page 32 for new recommendation. New material in this revision is highlighted in mauve in the text. Best Practices for Infection Prevention and Control Programs in Ontario | May, 2012 iv PIDAC-IPC would like to acknowledge the contribution and expertise of the following individuals that participated in the development this document: PIDAC-IPC Members: Dr.

7 Mary Vearncombe, Chair Medical Director Infection Prevention and Control , Microbiology Sunnybrook Health Sciences Centre, Toronto Dr. Irene Armstrong Associate Medical Officer of Health Toronto Public Health, Toronto Donna Baker Manager, Infection Prevention and Control Bruy re Continuing Care, Ottawa Anne Bialachowski Manager, Infection Prevention and Control St. Joseph s Healthcare, Hamilton Rena Burkholder Infection Prevention and Control Professional Guelph General Hospital, Guelph Judy Dennis Manager, Infection Prevention and Control Children s Hospital of Eastern Ontario, Ottawa Dr. Kevin Katz Infectious Diseases Specialist and Medical Microbiologist Medical Director, Infection Prevention and Control North York General Hospital, Toronto Dr.

8 Allison McGeer Director, Infection Control Mount Sinai Hospital, Toronto Shirley McLaren Director of Client Services CanCare Health Services, Kingston Dr. Kathryn Suh Associate Director, Infection Prevention and Control The Ottawa Hospital, Ottawa Dr. Dick Zoutman Professor, Divisions of Medical Microbiology and Infectious Diseases Queen s University, Kingston Chief of Staff, Quinte Health Care, Belleville Ex-officio Members: Erika Bontovics Manager, Infectious Diseases Policy and Programs Ministry of Health and Long-Term Care, Toronto Dr. Leon Genesove Chief Physician, Health Care Unit Occupational Health and Safety Branch Ministry of Labour, Toronto Pat Piaskowski Network Coordinator Northwestern Ontario Infection Control Network Public Health Ontario, Thunder Bay Liz Van Horne Scientific Lead Manager, Infectious Disease Prevention and Control Resources, Public Health Ontario, Toronto Public Health Ontario Staff: Camille Achonu Epidemiologist Infection Prevention and Control Dr.

9 Maureen Cividino Occupational Health Physician Toronto Shirley McDonald Infection Prevention and Control Specialist /Technical Writer Dr. Samir Patel Clinical Microbiologist Public Health Ontario Laboratory Best Practices for Infection Prevention and Control Programs in Ontario | May, 2012 1 Table of Contents TABLE OF CONTENTS .. 1 EXECUTIVE SUMMARY .. 2 ABBREVIATIONS .. 3 GLOSSARY OF TERMS .. 4 I. PREAMBLE .. 8 1. About this document .. 9 2. Evidence for recommendations .. 9 3. How and when to use this document .. 9 4. Occupational health and safety (ohs) .. 10 II. BEST Practices FOR Infection Prevention AND Control PROGRAMS IN ONTARIO .. 11 1. What are health care-associated infections (hais)?

10 11 2. Adverse health care events and hais .. 11 3. The cost of hais .. 12 4. Patient safety and Infection Prevention and Control .. 12 5. Impact of ipac programs .. 13 6. Mandate/goals and functions of the ipac program .. 14 7. Structure and elements of the ipac program .. 14 a. Structure of the ipac program .. 15 b. Elements of the ipac program .. 15 8. The Infection Prevention and Control committee (ipacc) .. 16 9. IPAC program functions .. 17 a. Surveillance .. 17 b. Policies and procedures .. 24 c. Compliance with legislation and accreditation standards .. 25 d. Occupational health and safety issues .. 27 e. IPAC education, training and evaluation .. 32 f. Other key components of the ipac program.


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