Health Check | Infection control on the improve
In 2015, then Minister of Health Dr Fenton Ferguson, in response to several concerns raised about the status of public-health facilities, ordered an internal audit in the four regional health authorities to "determine safety and functionality of the systems". Two years later, The Gleaner has sought to find out what has been done to address the myriad problems uncovered by the audit. These are some of the findings from the South East Regional Health Authority (SERHA).
Several public hospitals in the Corporate Area and St Catherine are reporting a significant improvement in their infection control systems that were found deficient by a Ministry of Health audit two years ago.
A recent report prepared for The Sunday Gleaner by the South East Regional Health Authority points to improvements in high-risk clinical service delivery areas across several institutions.
These include the Bustamante Hospital for Children (BHC), Kingston Public Hospital (KPH), Victoria Jubilee Hospital (VJH) and the Spanish Town Hospital (STH).
According to SERHA, the corrective measures that have been implemented include:
- Standardisation of the cleaning procedures and the ongoing training of janitorial staff.
- Implementation of a monitoring system to assess infection control practices, including the assignment of responsibility to infection control nurses; and making available to staff copies of the health ministry's infection prevention and control manual.
- Adherence to Ministry of Health clinical guidelines/standards for commonly seen conditions.
- Establishment of procedures to ensure the immunisation of health workers.
- Repair and/or provision of critical equipment such as sphygmomanometer, stethoscope, resuscitaire (infant warmer), foetal monitors, blood gas machine and transducers.
- Repairs to operating theatre facilities, including the installation of brighter operating lights and new air-conditioning system at the KPH.
The July 2015 audit by SERHA had found inconsistencies in the quality of the cleaning of high-risk clinical service delivery areas, but SERHA says the cleaning procedures and methods are now done in accordance with the Ministry of Health standards.
According to SERHA, current and new janitors are reminded and orientated respectively on cleaning procedures and methods at all its high-risk clinical service delivery areas.
A breach cited by the July 2015 audit report was the resistance of anaesthetists to wearing facial masks in the VJH operating theatre, but SERHA said these health workers are now "in conformance with operating theatre standards".
The agency also claimed that the shortage of required gear for other medical staff, observed two years ago, has been addressed at the main hospitals in its region.
Regarding the monitoring of the immunisation status of operating theatre staff at KPH and VJH, SERHA said the staff was advised to obtain and submit their immunisation record indicating their health status.
"Systems are now in place for new staff to provide their immunisation to ensure compliance upon employment. This is monitored with the assistance of the infection control nurse and visiting public health nurse," said SERHA.
But former president of the Nurses Association of Jamaica (NAJ), Janet Coore-Farr, has questioned the adequacy of the complement of infection control personnel across the public-health system.
According to Coore-Farr, the ideal ratio should be one infection control personnel per 125 patients, but this does not obtain.
"The Ministry of Health does not recognise the position of infection control nurse, as it's not on the civil service establishment," said Coore-Farr, the immediate past president of the NAJ.
"Generally, not enough has been done to improve the (infection control) system," added Coore-Farr.
- Coming tomorrow: The maintenance deficiencies which were identified and the checklist on how SERHA has done in the two years since the audit was done.