The Code of Practice on the Prevention and Control of Infections and Related Guidance (Depart- ment of Health [DH], 2010), part of the Health and Social Care Act 2008, requires healthcare organisations to have, or have access to, ‘an appropriate mix of both nursing and consultant medical expertise (with specialist training in infection prevention and control)’. The Infection Prevention and Control Team (IP&CT), whose size and structure vary depending on where they work and the size of the Trust, are the nursing and medical experts responsible for providing the organisation with evidence-based best-practice advice on all aspects of infection prevention and control, and are the only specialist nursing and medical team with responsibility for patients, staff, the public and the environment. The Consultant Medical Microbiologists primarily advise on the medical management of patients, dealing with laboratory reports, reviewing patients and advising medical teams on treatment, laboratory testing and diagnosis, and antimicrobial prescribing. Box 2.1 lists some of the activities undertaken by the IP&CT, the majority of which fall under the remit of the IP&CT Specialist Nurses. This list is not all inclusive but is intended to illustrate the scope of the Team’s work.
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Box 2.1 Remit and activities of the IP&CT
Clinical advice
•
Undertake clinical reviews of patients – liaise with nursing and medical staff.•
Respond to ad hoc enquiries.•
Advise on patient placement and patient movement.•
Document laboratory results and advice given.•
Maintain patient records.•
Escalate concerns regarding medical management to the Consultant Medical Microbiologist.•
Hold staff to account for clinical practice.Liaison
•
Executive Team and Trust Board•
All Ward and Department Managers, Matrons and nursing and other departmental staff•
Heads of Nursing and Divisional Directors•
Patients, visitors and other members of the general public•
Risk Management Department or Legal Department•
Human Resources Department•
Bed Manager•
Emergency Planning Officer•
Occupational Health Department•
Medical staff – all grades•
Allied Health Professionals•
Facilities and Hotel Services staff (e.g. contract cleaners, porters, catering staff and transport staff)•
Estates staff and building contractors•
Sterile Services Department•
Supplies Department•
Laboratory staff•
Health Protection Agency/Public Health England Reference Laboratories•
Ambulance Service•
IP&CTs at other Trusts•
Local and other Health Protection Units•
Clinical Commissioning Groups (CCGs)•
Community Infection Control Team•
Community Care Teams – District Nurses, GPs, Nursing and Residential Home Managers, and staff in Community Hospitals•
Communications Department•
Local and national media•
Patient Experience Team•
Local Involvement Network21
•
Care Quality Commission•
Department of Health•
Health and Safety Executive.Education and training
•
Induction for new staff•
Medical staff induction – all grades•
Student nurse training (links with local university)•
Mandatory training•
Ad hoc training, and participation in study days and education sessions•
Infection Control Link Worker or Link Practitioner programme•
Preceptorship programme for newly qualified staff•
Speaking and presenting at local and national conferences – promoting and sharing best practice•
Writing for publication.Audit and evaluate clinical practice
•
Develop audit tools, Key Performance Indicators and Clinical Indicators.•
Undertake audits in accordance with the annual audit programme – ensure feedback, devise action plans or assist the Ward or Department Manager with action plan development and implementation, monitor progress and compliance, and escalate issues or concerns.•
Audit compliance with the Code of Practice on the Prevention and Control of Infections and Related Guidance (DH, 2010).•
Prepare a monthly Infection Control Divisional Performance Report for the Trust Board.•
Participate in local and national surveillance.•
Hold staff to account for clinical practice.Risk management
•
Advise on patient placement, transfer and discharge.•
Patient risk factors for developing healthcare-associated infections (HCAIs).•
Assess the need for ward closure during outbreaks.•
Assess and review the availability of isolation facilities.•
Assess and determine staff knowledge and competency.•
Identify environmental risk factors (e.g. poor fabric or repair, cleanliness).•
Advise on the use and availability of equipment and decontamination processes.•
Engage in preparedness planning (e.g. for pandemic influenza).•
Undertake risk assessments (of patients, the environment and equipment).Continued
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•
Engage in ongoing alert organism and alert condition surveillance.•
Comply with NHS Litigation Authority (NHSLA) standards.•
Hold staff to account for clinical practice.Investigation and management of outbreaks and incidents
•
Undertake investigations.•
Organise and chair meetings.•
Write or contribute to the writing of reports and minutes of meetings.•
Chair RCA/PIR meetings.•
Hold staff to account for clinical practice.Service improvement
•
Improve practice and patient care through audit, education and training.•
Develop business cases to support the implementation of best-practice recommendations where there are resource implications.•
Advise on building and refurbishment works.•
Hold staff to account for clinical practice.•
Trial and evaluate products and equipment.•
Assist with research.Policy development and implementation
•
Develop policies, protocols and guidelines based on national evidence-based best-practice recommendations.•
Review the Infection Control Manual.•
Hold staff to account for clinical practice.Administrative and clerical work