How to digitise your IPC strategy

For many healthcare professionals, face masks, shields and soap have been the hallmark images of infection prevention and control (IPC) throughout the COVID-19 pandemic. But for an award-winning hospital in Saudi Arabia, digits, dashboards and data cards have become a more fitting emblem.

Khaled Alnafee and colleagues at the King Faisal Specialist Hospital and Research Centre recently installed a program that digitises every IPC-related task across the hospital. From microbiology results to pharmaceutical shopping-list items and HAI case numbers, every bit of data a practitioner might need to execute an IPC strategy is visible on a single portal, at the click of a button.

If the national criteria for benchmarking HAIs changes, an algorithm will automatically update it. If an IPC report is required for a board meeting, the program will automatically generate it. And if a physician is undertaking surveillance, the program will create a spreadsheet showing contamination rates, MDROs and the number of blood cultures from a central or referral line.

Filling the gaps

While auditing the new software for efficacy, Alnafee — who has since won a global award for his efforts — was surprised to find a string of errors, omissions and misinformation. Not in his digital program, but in the paper-based system that preceded it.

“We continued using the paper-based system for a full year alongside our software, in a bid to detect and rectify any issues with the new program. This involved continuously cross-checking the output with the handwritten notes staff were producing,” Alnafee said.

“In doing this, we found that some of the notes compiled by practitioners were incomplete or unclear, meaning we couldn’t establish a full dataset for a particular patient or ward.

“The digital program has helped fill in these gaps and give us a much clearer picture of where we are at in terms of our IPC efforts.”

Raising standards

As a result of the digitisation, almost all key performance indicators (KPI) in relation to IPC are tracking well above benchmark. These KPIs are displayed in colour-coded format on the program dashboard.

“The dashboard gives us a visual snapshot of everything — when the last hygiene audit was done, the total number of surgical site infections, etc. For example, a rate of 1.6 is the benchmark for a specific surgery procedure and we are almost double what is required by this standard,” Alnafee highlighted.

“If we were under the benchmark, the number would be colour coded in red. This allows us to see quickly where our IPC weak spots are for each ward or unit.”

Patient priorities are easy to spot too, with the program providing a visual snapshot of all IPC-related metrics.

“The software automatically links a patient’s lab results, as soon as they become available. It allows the IPC practitioner to tell at a glance whether the patient has any serologies or requires an endotracheal tube, and to see the history of their white blood cell count, for example. Everything you can think of from A to Z is documented and accounted for on this system.”

Pandemic buffers

As well as avoiding any ambiguity in patient care cycles, the system prescribes clear information on whether staff pose an IPC risk. Via an inbuilt survey, the system categorises each staff member as high or low risk of being COVID positive, and gives clear instructions relative to current government guidelines.

“If a colleague has tested positive to COVID, I can jump on the system and answer a few questions. The system will then let me know whether I need to be excluded from work for three days or continue and monitor for signs and symptoms,” Alnafee said.

Meanwhile, the program will capture the precise whereabouts and quantities of PPE supplies, notifying users when supplies are dwindling.

Change management is essential

Despite the efficacy of the system, Alnafee admits there was a fair amount of resistance from staff during its rollout.

“People had grown comfortable using the handwritten notes and some were not overly happy about having to learn a new way of working. For this reason, training, regular communication and leadership has been so crucial to the success of this new system.”

To this effect, Alnafee and colleagues executed a series of campaigns highlighting the value of the new software features.

“We asked to be invited to each committee and take 15 minutes to present the dashboard. We made a video and uploaded it to the hospital portal so staff can access it at any time. We also make ongoing use of the newsletter to remind people and showcase specific features of the software.

“Ultimately, this tool will help them do their jobs better, avoid errors that result in harm or litigation, and make a more meaningful contribution to patient care.

“In short, software like this is well worth weathering any teething problems,” he concluded.

Image credit: ©stock.adobe.com/au/greenbutterfly