The new version of the NSQHS Standards is now available, and there are several key changes that will have an impact on how you establish and monitor the infection, prevention and control surveillance systems within your health care facility.
The first change is the revision of the intent of standard three, to now include effective antimicrobial stewardship within the focus of activities rather than just an action item.
Infectious microorganisms evolve over time, and continue to present new challenges for infection prevention and control, and governance within health care. Of major current concern are the emergence and transmission of antibiotic-resistant bacteria, hence the increased focus on AMS in the new version of the NSQHSS.
Reductions in action items
The second big change is the overall reduction in required action items, from 247 down to 148 across the eight standards (yes, the number of standards has also been reduced down from 10, with three standards removed and one new standard introduced). If I listen carefully I’m sure I can hear huge sighs of relief across the country, especially from the cohort of infection control coordinators who have been struggling under the burden of managing very complex surveillance programs.
In standard three, the required action items have been reduced from 41 down to only 16, which is a huge difference and wonderful news. A lot of the duplication has been removed and requirements are now less prescriptive, with the word “Audit” no longer appearing in the wording of the standard. The requirement to AUDIT is still referenced as an option under “Examples of evidence” in the workbooks/guides, which gives organisations more flexibility in how they choose to monitor IC activities and what they choose to audit. The criteria for standard 3 has also been reduced from five areas down to four. Sterilising is now stand alone and overall there is an increased focus on risk management, which is no big surprise.
Impact of changes
Organisations will need to ask themselves how the changes will impact on their: records, risk assessments, forms, audit and surveillance programs, policies, procedures and processes, and the evidence needed for accreditation. For example, for facilities that sterilise instruments, the requirement for AS4187:2014 will need to be incorporated into business planning and budgeting with progress against a completed gap audit a minimum requirement to be reviewed by the audit team conducting the accreditation.
Successful infection prevention and control requires a collaborative approach and a range of strategies across all levels of the healthcare system. It requires governance support and leadership commitment in the organisation, with both an operational and a clinical management framework implemented and a focus on safety and quality. The frameworks will vary in scope and complexity across different types of organisations and must also be tailored to reflect local context and risk. Regardless of any differences, they must be consistent with Australian guidelines for the prevention and control of infection in healthcare.
The conduct of a gap audit against version two of the NSQHSS will help you to focus your improvement activities where they are needed most. I will be covering all the areas above during my talk at the Infection Prevention & Control conference, and will also be discussing the implementation timeframe for the new standard.