CL 7247 INVESTIGATING AND CONTROLLING OUTBREAK OF DISEASES IN THE HOSPITAL FACILITIES - POLICY REVISION UPDATING INFORMATION

Change in title from INVESTIGATING AND CONTROLLING OUTBREAK OF DISEASES IN THE HOSPITAL FACILITIES AND COMMUNITY to INVESTIGATING AND CONTROLLING OUTBREAK OF DISEASES IN THE HOSPITAL FACILITIES

 The major change is that the policy is now revised to apply to only HMC Facilities i.e. excluding Primary Health care centre Definition: Remains technically the same Section RESPONSIBILITIES was removed as per new policy format.

The followings were added

3.2 All outbreaks should be reported to the Chairman Corporate IPC and Head of outbreak team following which a decision would be made whether to manage the outbreak at a corporate or facility level. 3.9.2 Hamad Medical Corporation and Public Health Department Laboratory of Supreme Council of Health (SCH) should be involved in carrying out the tests required to identify the source of food borne outbreaks if warranted

3.10 Notification line of communication was sorted out:

3.10.1 The Attending Physician and the Assigned Head Nurse or Nursing Supervisor should immediately: 3.10.1.1 Notify the Infection Control Practitioners of occurrence of two or more cases of the same infection in a unit. 3.10.2 The ICPs on acquiring initial information from Microbiology, if suspecting a possible clustering/outbreak, will notify the Chairman of the Infection Control Committee of the Facility involved, who in turn should notify the Head of the Outbreak Team.

3.10.3 If outbreak is confirmed the, Head of Outbreak Team should notify the Corporate Chairman of ICC. The facility chairman of the ICC will notify the Chief of Staff, and Hospital Executive Director, and Assistant Executive Director of Nursing
3.10.4 ../ Executive Director of Quality Management department and The Executive Director of Nursing HMC were added to whom Corporate Chairman of ICC would notify if there is any out break

When outbreak is limited to one facility:

3.11.1 The Facility Chairman of the Infection Control Committee should schedule emergency meeting from the affected facility to institute control measures.

3.11.3 If the outbreak is localized in one facility the Outbreak committee would include but not limited to :
Facility Chairman of the Infection Control Committees Infection Control Practitioners Facility Administration Facility Microbiologist Any other Department as deemed fit by the facility Chairman. e.g. Security Department

3.12 Steps in Outbreak Investigation (was summarized and written in sequence):

Steps often occur simultaneously, but the elements in an outbreak investigation include the following: Prepare for the investigation Confirm that an outbreak exists Establish or verify diagnosis of reported cases; identify agent Search for additional cases; collect critical data; develop line listing; collect specimens if indicated Characterize the cases by person, place and time Take immediate control measure, if indicated Formulate tentative hypothesis (making the best guess to explain the observations)

Steps in Outbreak Investigation contd

Test hypothesis (hypothesis should explain the majority of cases) Plan an additional systematic study (or studies) Collect specimens (e.g. culture of environment or personnel based on data) Implement and evaluate control and preventive measure Initiate surveillance Communicate findings; summarize investigation for requesting authority; prepare written reports

3.14 Notification to Department of Public Health from Emergency Department (ED) (was added):
Infection Control Practitioner in-charge of any HMC facility should notify CDC, Dept. of Public Health of Supreme Council of Health, if many patients are coming from community to Emergency Department complaining of the same disease.

3.15 Educate Health Care Workers on

Appropriate isolation precaution to be employed about Multidrug Resistant Organisms (MDROs), correct Personal Protective Equipment (PPE) to wear / apply When to discontinue isolation Flyers, messages shall be sent to concerned staff /units weekly, on the progress on controlling the outbreak.

3.16 Continuous Surveillance

Continuous Surveillance should be carried out in the Hospital
The patient discharged from Hamad Medical Corporation should be given a follow-up appointment to assess his/her progress The Infectious Disease Physician should report to the Hamad Medical Corporation Social Worker about the patients who fail to arrive for their follow-up appointment in the Out-Patient Department.

3.17 Information to Media

The Corporate Chairman of Infection and Control Committee, through appropriate channels, may provide information to the Public about outbreaks

3.18 Reporting and Declaring Outbreak Over

In corporate outbreak: When the outbreak is contained and no new cases identified, the Chairman of Corporate ICC will declare the outbreak to be over / have stopped. The Head of Out Break Team should prepare an official final report about the outbreak, which should be handed over by the Corporate Chairman of ICC to the Medical Director for the further action and management.

3.18 Reporting and Declaring Outbreak Over

In outbreak involving only one HMC facility, the facility chairman of ICC shall declare the outbreak over / have stopped when the infection is contained and there are no more new cases occurring. The Chairman shall submit the final report to the Facility Chief of Staff and report the outbreak in the corporate ICC meeting.

Questions?

Summary
CL 7247 POLICY REVISION - changes have been made in:
The title Notification of the outbreak Reporting of outbreak Management of outbreak when only one facility is affected Steps in Outbreak Investigation (was summarized and written in sequence) Notification to Department of Public Health from Emergency Department (ED) was added

Health Care Workers would be educated on :

Appropriate isolation precaution to be employed about Multidrug Resistant Organisms (MDROs), correct Personal Protective Equipment (PPE) to wear / apply When to discontinue isolation Flyers, messages shall be sent to concerned staff /units weekly, on the progress on controlling the outbreak.

Continuous Surveillance should be carried out to ensure the infection is cleared If Corporate Outbreak, declaring Outbreak Over is done by the Chairman of Corporate IPCC when the outbreak is contained and no new cases identified. The outbreak is declared over by facility Chair of IPCC, if only one facility is affected In Corporate Outbreak, Reports of the outbreak will be written by the Head of out break team, submitted to Medical Director by Chair of Corporate IPCC. If outbreak in a facility, Facility Chair of IPCC would write the report and submit it to the Chief of Staff and the administrators.

THANK YOU.