BRIEF TO THE NATIONAL ADVISORY COMMITTEE ON
SARS AND PUBLIC HEALTH
July 30 2003
CHICA–Canada is a national, multidisciplinary, voluntary
association of health care professionals. CHICA–Canada
is committed to improving the health of Canadians by promoting
excellence in the practice of infection prevention and control
through education, communication, standards, research and consumer
awareness.
CHICA–Canada is comprised of nineteen chapters. This year, the Thunder
Bay Chapter hosted the annual education conference, with 300 attendees from Canada,
the United States, South Africa, Saudi Arabia, Austria, Germany and Japan
Recent world events have underscored the vital importance of the work of
Infection Prevention and Control Professionals, and the need to ensure infection
control expertise, resources and infrastructure across the health care continuum
- acute care, long term care, public health and the community. CHICA Canada has
determined that 250,000 nosocomial infections occur each year and that between
8,000 and 12,000 people die directly or indirectly from these infections every
year. SARS clearly revealed how flimsy our infection control and prevention is
in Canadian hospitals.
RECOMMENDATIONS:
1. Increased resources with Infection Control Professionals in every health
care facility. Health Canada, with input from CHICA–Canada experts,
developed a resource model for infection prevention and control programs which
recommends three full time equivalent infection control professionals per 500
beds in acute care hospitals, and one full time equivalent infection control
professional per 150-250 beds in long term care facilities.
2. Standards for the number of Infection Control Professionals through the
Canadian Council on Health Services Accreditation. The "RICH" Resources
for Infection Control In Hospitals Study surveyed hospitals across Canada for
their infection control program components with respect to surveillance, resources
and control and outcomes. The results indicated that there was large variability,
inadequate surveillance and less than ideal control efforts with very thin resources.
Hospitals who undertake surveillance at a higher level have fewer infections
with Methicillin Resistant Staphylococcus aureus and other related problems.
3. Hospital infection prevention and control uses many tools to get the job
done (microbiology, epidemiology, molecular biology, basic public health principles
etc). We must not make the mistake of burying hospital infection prevention
and control within the public health portfolio.
4. Integrated system wide infection control and prevention program. Patients
require coordination of care as they move from institutions to other health care
sectors. The need for Infection Control resources in health care agencies and
the community is paramount.
5. Creation of Provincial Centres for Infectious Diseases. For example,
creation of an Ontario Center for Infectious Diseases (OCID) that is mandated
to manage community and hospital infection control matters, research, epidemiology
and control etc. This OCID could be distributed across all of Ontario's
academic health science centers as that is where the intellectual resources are
centralized and can interact for training, research and advancement of the cause.
This is where the academic hospitals and teaching health units are that do most
of the leading edge infection control development.
6. Timely dissemination of information by a central agency, such as the
e-mail distribution capability of the British Columbia Centre for Disease Control.
7. Funding to the Health Canada Population and Public Health Branch’s
Nosocomial and Occupational Infections Bureau should match that of the US CDC
hospital infection program on a per capita basis. This funding should be
used to initiate national surveillance and standard setting in infection control
and prevention. It should build upon the existing Canadian Nosocomial Infection
Surveillance program. Current funding for this essential work is embarrassingly
low.
8. Standards for infection control programs should be set nationally for all
health care facilities. Establishing these should be linked to federal health
transfer payments or other mechanism to ensure they are implemented.
9. A federal research program into the prevention and control of nosocomial
infections including SARS should be established with $20 million dollars over
10 years.
10. Each school of Medicine and Nursing should be provided with $500,000-$1,000,000
per year for 5 years to establish and maintain faculty wide training programs
for the prevention of nosocomial infections and control of antibiotic over use.
11. The federal government should host an international SARS scientific meeting
in the fall of 2003 and again in 2004. It should be open to all scientists
and practitioners who wish to come (i.e. should not be by invitation only but
be run in the same way other professional associations such as CHICA–Canada
run their annual scientific meetings).
Community and Hospital Infection Control Association – Canada
CHICA–Canada
PO Box 46125 RPO Westdale
Winnipeg MB R3R 3S3
Telephone: 204-897-5990/866-999-7111
Fax: 204-895-9595
chicacanada@mts.net
www.chica.org
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