Here’s why raising standards is key to patient safety

The reduction of healthcare associated infections is a goal that needs to be worked towards by the entire healthcare industry, backed by enforceable guidelines and standards. In hospitals, such standards are set, and clear – albeit with the need for review.

However, in the allied healthcare space, there is an information, standards and guidelines deficit. This often leaves therapists to their own, well-intentioned but often ineffective, devices. As a large and incredibly important sector in healthcare, it is one that deserves and desperately needs infection control and hygiene standards and guidelines on which to work from.

The Australian Commission on Safety and Quality in Healthcare (The Commission) has developed a new draft of the National Safety and Quality Primary Healthcare (NSQPH) Standards. Purifas® is proud to have been involved in their review and has provided verbal and written feedback on how to improve these for the purposes of the allied health sector.

We thank The Commission for the opportunity to do so, and for listening to our contribution so actively. We hope to see some of our recommendations make it through to the final set of standards, expected to be released this year.

What’s the purpose of The Commission and NSQPH standards?

The Australian Commission on Safety and Quality in Healthcare was established in 2006 for improving the safety and quality of national healthcare. It operates in four key areas: safe delivery of health care, partnering with consumers, partnering with healthcare professionals, and quality, value and outcomes.

Presently, The Commission is working on improving safety and quality standards for services that deliver care to people in a primary healthcare setting – these are the NSQPH standards. This of course, includes allied health professionals. There are two key reasons these standards are important:

1. “A significant proportion of health care is provided by primary care services, but little is known about the frequency, causes and consequences of errors and adverse events in this sector.
2. There is also limited evidence on effective patient safety initiatives in this sector.”¹

What about current practice and standards? 

There is currently insufficient focus, information and guidance on effective patient safety in a primary healthcare setting, particularly in areas like hygiene and infection control.

 Healthcare associated infections are mostly preventable, yet they affect about 165,000 patients a year. Some reasons for this include lack of hygiene practice – things like bacterial transfer onto shared surfaces and hands of healthcare workers and even lack of knowledge around the effectiveness of different PPE.

For example, current “standard practice” in a physiotherapy/chiropractor setting include things like covering the bed with single use or reusable bed coverings, which don’t even cover the entire shared surface of the therapy bed. Our swabs research has found that the face hole can contain Rhinovirus and Staphylococcus Aureus. Additionally, towels are a 5-star hotel for breeding bacteria, you can read more on our blog.

How can we raise the standards?

Purifas® has submitted a list of recommendations to The Commission for the National Safety and Quality Primary Healthcare (NSQPH) Standards based on extensive research. Notably, these include:

1. Acknowledging and addressing equipment use that is unique to a therapy environment such as the therapy bed. Best practice for this should include wiping down the shared surface with a TGA Approved product as well as applying a single use barrier that covers the entire contact and droplet surface.

2. Extra focus should be placed on high-risk environments, such as dental, GP and any primary care provider where there may be blood present. The single use barrier should have proven bacterial and bodily fluid filtering properties.

3. Those practitioners who place their patients’ faces on a shared surface (for example, in a prone position) should also have specific guidance on how to ensure the face hole remains clean and safe before, during and after treatment. The eyes, nose and mouth are the entry and exit points for all pathogens so the hygiene practices pertaining to this hole are crucial.

4. We recommend introducing hygiene education across these industries as therapists are most likely to have had minimal education on hygiene through tertiary studies.

5. Putting infection control procedures within the main standards document, instead of referring to a second document, Australian Guidelines for the Prevention and Control of Infections in Healthcare.

Purifas® is proud to have participated in the process of developing the NSQPH standards and believe the inclusion of some or all of our recommendations will play a big role in reducing healthcare associated infections in Australia.

You can download our full submission to The Commission here.

 REFERENCES:

1. https://www.safetyandquality.gov.au/standards/national-safety-and-quality-primary-healthcare-nsqph-standards