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King Speech To Infection Control Nurses

Speech Notes - Hon A King

Opening Address To The Infection Control Nurses' Division Of The NZ Nurses Organisation Conference

Good morning and welcome to the official opening of your conference. Thank you for inviting me to speak to you today and welcome to everyone who is visiting Wellington. I am sure you will enjoy your time here in this beautiful city - you may find it's like an infection you can't get out of you system.

It's good to be able to address a conference dealing in real and immediate issues. Infection control is not some arcane area of interest to only a few highly trained specialists - it's an issue that affects us all.

Modern medical technology and knowledge save millions of lives each year and safeguard us against many of the infectious diseases that afflicted our forebears.

But the battle against infectious microbes will never end, and infection control will always be at the centre of all medicine.

As the Director of the Centre for Disease Control recently commented: "As we face the new millennium, we must renew our commitment to the prevention and control of infectious diseases, recognising that the competition between humans and microbes will continue long past our lifetimes and those of our children".

It makes me feel safe knowing that you are on the frontline of this battle and are responsible for the 'eternal vigilance' required.

This conference has an important role to play in boosting the profile of this battle, and increasing the public's understanding of the importance of infection control. This will always be a challenging task because of the intangible nature of the microbial world for most people.

It's like the science fiction analogy of Men in Black versus War of the Worlds. It's easy to focus on the bulging eyes, swinging mandibles and offensive habits of the alien monsters in Men in Black - but much more difficult to appreciate the unseen threat of the microbial world that defeated the Martians in War of the Worlds.

I also see that one of the papers to be presented, about Asepsis in a tented operating room in East Timor, literally deals with being on the frontline.

Super bugs

Infection control is particularly important in light of emerging and re-emerging pathogens, the so-called superbugs that are the theme for this conference. As one of the papers describes it, there is a new 'fashion-show of bugs'. Microbes are modelling truly scary 'haute couture'.

The general public is becoming aware of this threat and is beginning to realise that pharmacology no longer has all the answers. However, this conference is also about the ways of countering this threat, and emphasising the continuing importance of the most basic of practices, such as good personal hygiene.

Elaborate systems are important, but the human factor remains pre-eminent. While reminding everyone that thoroughly washed hands save lives and limbs is a cliche, it is true nonetheless. Good infection control practices do save both lives and money.

I am not an expert on infection control. You are, so I want to spend the rest of my time talking to you about how the Government is responding to the challenge of emerging and re-emerging pathogens.

The Government's response is based on three main strands. In 1999, the Ministry of Health made the commitment to develop some standards for infection control.

At your conference last year, the New Zealand Standards for Infection Control were launched. Now at this conference I am very pleased to launch the New Zealand Handbook Infection Control Audit Workbook. This workbook will allow providers to self-review their infection control systems. The Government's quality initiatives

As most of you will know, the Government's effort to establish a comprehensive framework for quality and best practice across the sector focuses on the New Zealand Health Sector Quality Improvement Strategy and the Health and Disability Services Bill. The New Zealand Standard for Infection Control is related to the Safety Bill.

Each of these initiatives is based on positive experiences in other countries that have introduced national health sector quality improvement strategies.

The Zealand Health Sector Quality Improvement Strategy will bring together many pieces of work about quality improvement in the health sector. It will: ? Set clear standards and priorities for quality improvement ? Encourage public and patient involvement ? Establish quality as an every day activity, and ? Develop a strong system for reducing risk and promoting patient safety.

The National Health Committee is writing a discussion document on quality improvement that will be released for public consultation shortly. After submissions are received, a group will be set up by the Ministry to develop the strategy.

The strategy will assist in defining the structural elements that New Zealand requires to advance quality improvement activities in the health sector, as well as establishing the precise role and function of the Mortality Review Committee and the National Health Epidemiology and Quality Assurance Advisory Committee.

The Safety Bill and the Infection Control Standard

Standards such as the Infection Control Standard are integral to the vision embodied in the New Zealand Health and Disability Services Bill. The benefits of implementing this standard are: ? Improved safety for consumers, staff and visitors ? Increased attention to the basic principles of infection control ? Advanced practice standards, and ? Identifying a consistent and applicable baseline for organisations. The Standard is intended as a generic standard to address the basic principles and systems that are the foundation for effective infection control. It is not meant to be an infection control manual or education tool.

It effectively established a blueprint for the service provider to establish safe practice, that minimise the risk of infection, ensure the provision of adequate resources, appropriate documentation, staff education, appropriate surveillance and the promotion of prudent approaches to treatments.

As you know organisations obliged to comply with the Health and Disability Services Act will eventually be required to also comply with the Infection Control Standard.

During the transition phase, I encourage you to move towards compliance, sooner rather than later. You will find the Infection Control Audit Workbook is a very useful tool for aiding this process. The Government also hopes other providers in parts of the sector where the Standard will not become mandatory, will consider adopting it as part of a general commitment to good practice.

The Standards are also particularly important to hospitals and should be seen as the primary quality assurance tool for hospitals.

The total hospital environment

We should also keep in mind that there are six aspects to the Infection Control Standards, encompassing the total hospital environment - governance, infection control teams, policies and procedures, education, surveillance, and antimicrobial usage - as well as quality and risk management.

All of these aspects have to be got right if we are to achieve the high quality and safe health and disability services we are all striving for.

The Government is also redoubling its commitment to improved safety and improved outcomes for patients in the wake of recent instances of poor service to patients, the National Cervical Screening Inquiry and the Cull Report.

We are working on an omnibus bill covering the Health Professionals Competency Assurance Bill, amendments to the Health and Disability Commissioner Act 1994, and amendments to the Health Act 1956 arising from the cervical screening inquiry.

These bills will streamline and strengthens processes for dealing with complaints and disciplinary matters. This will ensure that failures in safety systems are more quickly understood and acted on.

As we move away from the competitive models of health care provision in the past and rebuild the system along non-commercial lines, cost and competition are no longer the main driving forces behind healthcare improvement.

It has now become more important to identify the quality and effectiveness of healthcare services. This requires not only evidence-based guidelines and quality standards to define best clinical practice, but also an ability to measure effectiveness and use information to drive improvement by the healthcare providers in their different DHBs.

Thank you again for inviting me to talk to you today. This is an important conference dealing with real issues that affect all New Zealanders.

While emerging and re-emerging pathogens present a real threat, it's possible to meet this challenge. The new Infection Control Standard, the various quality and audit initiatives currently underway, and comprehensive responses to instances of failure in safety systems, constitute an effective mix to fight this challenge.


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